Exam 5: Chapter 16, 17, and 20 Flashcards
1
Q
What is pharmacology?
A
the study of drugs, their sources, their characteristics and their effects
2
Q
What are the drugs that EMTs can administer?
A
EMTS can administer or assist administering: spirin, oral glucose, oxygen, prescribed bronchodilator inhalers, nitroglycerin, and epinerphrine auto=injectors and can assist with activated charcoal and naloxone
3
Q
What is aspirin?
A
a medication used to reduce the clotting ability of blood to prevent and treat clots associated with myocardial infarction not to be given if allergic or there suspected gastrointestinal bleeding
4
Q
What is oral glucose?
A
form of glucose (a kind of sugar) given by mouth to treat an awake patient (who is able to swallow) with an altered mental status and a history of diabetes found in a tube of gel placed on tongue depressor and placed between patient’s cheek and gum or under tongue.
5
Q
What is oxygen?
A
a gas commonly found in the atmopshere pure oxygen is used a drug to treat any patient whose medical or traumatic condiiton may cause him to be hypoxic or low in in oxygen
6
Q
What is activated charcoal?
How do you give it to them?
A
powder premixed with water forming slury used to treat poisoning or overdose when substance is swallowed and in patient’s digestive tract and it absorbs the positions preventing them from being absorbed by body.
7
Q
What is an inhaler and what are the side effects?
A
a spray device with a mouthpiece that contains an aerosol form of a medication that a patient can spray into his airway used in patients with asthma, emphysema or chronic bronchiti. with side effects of an increased heart rate and jiteriness make sure theirs
8
Q
What is nitroglycerin?
A
a drug that helps to dilate the coronary vessels that supply heart muscle with blood given to patient with chest pain make sure the patients and the patient hasnt taken anything for erectile dysfunction (sildenafil- viagra, vardenafil-levitra, tadalalfil-cialis). side effects are a drop in blood pressure
9
Q
What is epinephrine?
A
a drug that helps to constrict the blood vessels and relax passage of the airway. it may be used to counter a severe allergic reaction with increased heart rate and blood pressure to assist patient and have on ambulance need to ask medical direction first though
10
Q
What is atomizer?
A
a device attached ot the end of a syringe that atomized medication (turns it into very fine droplets). used for epinepehrine and naloxone
11
Q
What is naloxone?
A
an antidote for narcotic overdoses reversing side effects of respiratory failure and have on ambulance need to ask medical direction first though can use atomizer or nasal spray if mucous membranes not damaged
12
Q
What are indications?
A
specific signs or circumstances under which it is appropriate to administer a drug to a patient
13
Q
What are contraindications/
A
specific signs or circumstances under which it is not appropriate and may be harmful to administer a drug to a patient
14
Q
What are side effects?
A
any action of a drug other than the desired action
15
Q
What are untoward effects?
A
an effect of a medication in addition to its desired effect that may be potentially harmful to the patient
16
Q
What is parenteral?
A
referring to a route of medication administration that does not use the gastrointestinal tract, such as an intravenous medication ex. epipen
17
Q
What is enteral?
A
referring to a route of medication administration that uses gastrointestinal tract, such as swallowing a pill.
18
Q
What is pharmacodynamics
A
the study of the effects of medication on the body
19
Q
What are force protection medications?
A
atropine in auto-injector used to treat repsonders such as you and your partner in the event of a chemical weapons attack like nerve gas.
20
Q
How many names do drugs have?
A
chemical name (technical formulas), genric name, and trade/brand names given by various manufacturers
21
Q
What is off-line medical direction?
A
standing order written down in protocols based on circumstances and conditions outlined in rules and regulations
22
Q
What is on-line medical direction?
A
speak directly to physician for verbal permission to administer medication echoing what they say
23
Q
What are the five rights?
A
do i have the right patient is is their meds? right time based on what im seeing? right medication right bottle? right dose? right route of administration?
24
Q
What are the different routes of administration?
A
oral or swallowed, sublingual dissolved under the tongue, inhaled or breathiness into lungs as tiny aerosol particles like inhaler or gas, intranasal or sprayed, intravenous or injected into vein, intramuscular or injected into muscle, subcutaneous or injected under skin, intraosseous or injected into bone marrow cavity, endotracheal or sprayed directly into tube inserted into trachea
25
What are pros and cons of giving a patient sublingual ?
or dissolved under tongue placed under tongue and allowed to dissolve, absorbed by vascular soft tissue of mouth faster than swallowing pills but is difficult if circulation is poor
26
What are pros and cons of giving a patient inhaled ?
or breathiness into lungs as tiny aerosol particles like inhaler or gas absorbed into bloodstream through alveoli putting mask on patient or via inhailers
27
What are pros and cons of giving a patient intranasal ?
or sprayed spray fine droplets of medication into one or both nostrils with atomizer, if capillaries are intact and not blocked medications absorbed similarly to injection. atomizer to end of medication-filled syringe
28
What are pros and cons of giving a patient intravenous ?
or injected into vein fast and precise way to administer into body directly beyond EMT
29
What are pros and cons of giving a patient intramuscular ?
or injected into muscle directly into muscle, rapidly abosrbig medication and transferring it to other parts of body fast and allows for effects of medication to rapidly occur affected by poor circulation with more complication rate needing needle which can cause infections
30
What are pros and cons of giving a patient subcutaneous?
or injected under skin into layers of skin instead of muscle resulting in slowe absoprtion thatn muscular
31
What are pros and cons of giving a patient intraosseous ?
or injected into bone marrow cavity technology allowing rigid needle into bone marorw reaching central ciruclation as fast as IV, ALS
32
What are pros and cons of giving a patient endotracheal ?
or sprayed directly into tube inserted into trachea absorbed by tissue of lungs unpredicatble absorption rates as last resort ALS
33
What are heparin or saline locks?
catheter placed in vein with lock over skin to andminster meds and no IV
34
What is the Iv and what does it need?
gives fluid needs drip chamber, flowregularot and drug or needle port?
35
What is a drip chamber?
near fluid IV bag: micro drip=minial fluid for children 60 small drops equal to 1cc or mL. macro drip: higher flow of fluid is needed for multitrauma patient in shock, no barrel just 10-15 large drops equal to 1 cc or 1 mL
36
What is a flow regulator?
located below drip chamber pushed up or down to start, stop, or control rate of flow
37
What is a drug or needle port?
below flow regulator paramedic injects mediction into opening
38
What do you do to set up IV?
inspect bag, remove wraper, check epiration, clear and free of particles, squeeze for leaks. choose administration set, uncoil tubing if extension used andcheck it. flow regulator closed rolling stopcock awa from bag. remove protective covering , spiked end of tubing into fluid bag with twist maintining sterility. fluid bag higher than drip chamber, squeezing it to start flow and filling to marker line ⅓. open flow regulator to flush air from tubing loosening cap at lower end to flow make sure air bubbles flushed and turn off flow
39
How do you maintain an IV/
take constricting band off, make sure flow regualtor open, make sure clamp open, make sure tubing not kinked or caught under patient or backbaord, and move around patien’ts arm to work.
40
What is an infiltrated IV?
needle puncred vein and exitied other side or pulled out vein causing fluid to flow into tissues killing it with meds if complaingng of pain, swelling, stop flow and disctontinue IV
41
What is adequate breathing?
no distress, speak full sentences without having to catch breath, color, mental status and orientation normal, normal oxygen saturation,. Adult: 12-20, child: 15-30, infant 25-50
42
What does OPQRST stand for?
| in respiratory problems what might you also expect
onset, provocation, quality, radiation, severity, and time
gained weight in past few days, where have been, new drug
43
What are the in depth assessment one makes of patients with respiratory emergencies?
mental status, unusual anatomy (barrel chest), patient's position (tripod), work of breathing, pale cyanotic or flushed skin, pedal edema, sacral edema, noisy breathing, ausculatint lung sounds on both sides, vital changes, changes in breathing rate and rhythm, hypertension and hypotension
44
What is the tripod position?
leaning forward and sitting with feet dangling and leaning forward
45
What are the work symptoms of breathing?
retractions, use of accessory muscles to breath, flared nostrils, pursed lips, number of words patient can say
46
What is pedal edema?
sweeping around calves ankles and feet,
47
What is sacral edema?
swelling around back in bedridden patients
48
What are some kinds of noisy breathing?
wheezing, gurling, snoring, crowing stridor-harsh high pitched, coughing, oxygen saturati
49
what are some vital sign?
changes such as increased pulse rate decreased pulse rate. documenting pulse oximetry before and after giving it
50
What are wheezes?
high-pitched sounds that seem musical from air moving thorugh narrowed air passages in lungs found in asthma, emphysema and bronchitis during expiration
51
What are crackles/rales?
fine crackling or bubbling sound heard on inspiration caused by fluid in alveoli or opening of closed alveoli early congestive heart failure found in lower lobes
52
What is rhonchi?
lower-pitched sounds resembling snoring or rattling caused by secretions in larger airways seen with pneumonia or bronchitis or material aspirated into lungs with rhonchi louder than crackles
53
What is stridor?
high-pitched sounds on both sides heard in inspiration upper airway sounds with partial obstructions
54
What is CPAP?
a form of noninvasive positive pressure ventilation (NPPV) consisting of a mask and a means of blowing oxygen or air into the mask to prevent airway collapse or to help alleviate difficulty breathings at low pressures preventing alveoli from collapsing pushing fluid out of alveoli back into capillaries patient. used in pulmonary edema and drowning, asthma and COPD, respiratory failure.
55
What are the anatomic physiological contraindications of CPAP?
mental status depressed cannot protect airway, lack of nromal spontaneous respiratory rate so increase CPAP volume but not rate, nability to sit up, hypotension, less than and unable to make could seal
56
What are the pathological contraindications of CPAP?
nausea and vomiting, pentrating chest trauma- pneumothorax, shock upper gastrointestinal bleeding or recent gastric surgery, or preventing of good masc seal
57
When do you not use the CPAP?
claustrophobic and unable to tolerate mask, inability to use, secretions so copious need suctioning, pulmonary firbosis
58
What are the side effects of CPAP?
less blood able to return to heart thorugh veins, when used cause blood to return to heart with cardiac output decreases resulting in drop in blood pressure making hypotensive so person must have systole of 90. pressure may lead to lung rupture or collapse, especially with COPD and asthma. drying of corneas of eye, small leak at mask lead to high volume blowing into eye.
59
What do you do with patients who have COPD?
COPD and asthma put on BiPAP. patients vomiting, nauseated or at risk of vomiting,
60
What is COPD?
classified as emphysema, chronic bronchitis, black lung, undetermined respiratory illnesses. middle-aged and older patients, with the main cause being cigarette smoking
61
What is chronic bronchitis?
bronchiole lining is inflamed and excess mucus is formed. cells in bronchioles are not able to clear away mucus because cilia has been damaged or destroyed.
lungs lose elasticity and walls break down and mucous coughed up with high fever (pink puffers-decrease in elasticity and surface area with alveolus possibly collapsing, puffing and whistling purse lipped breathing, barrel chested and thin difficulty with expiratory wheezes breathing with exertion home O2), treat with oxygen be careful with hypoxic driving with too much oxygen.
62
What is emphysema?
walls of alveoli break down, reducing surface area of respiratory excahnge with lung reducing elasticity allowing stale air in cardon dioxide trapped in lungs reducing effectiveness of normal breathing efforts. in rare cases may reduce or stop breathing with extra oxygen.
63
What is asthma?
chronic disease has episodic exacerbations or flares at irregular intervals doenst produce hypoxic drive but can be life threatening. attacks can be precipitated by insect stings, air pollutants, infection, strenuous excercise or emtoional stress and when it happens small bronchioles lead to air sacs of lungs are narrowed because of muscle contractions making up airway with overproduction of thick mucus closing down and restricting airflow. patient inhales expanding lung extrts outward pull increasing diameter of airway allowing air to flow into lungs, exhalation opposite occurs with stale air trapped making patient exhale forcefully producing wheezing sounds.
64
What is pulmonary edema?
fluid accumulating in lungs preventing from breathing adequately inability to pump blood from left ventricle results in pressure building up and going back to the lungs. when pressure build up fluid easily crosses barrier and accumulates in alveoli if fluid in lower airways oxygen does not reach blood resulting in dyspnea. hear crackles or wheezes cough of frothy sputum. treating high concentration oxygen maskkeeping legs hanging down. CPAP useful to push fluid out. can also occur in high altitude situations with same treatment.
65
What is pneumonia?
infection of one or both lungs caused by bacteria, viruses, or fungi. Resulting from inhalation of certain microbes that grow in lungs causing inflammation COPD and other respriatory diseases more likely to get pneumonia and tose with chronic health problems. symptoms include coughing (mucus that is green, yellow or bloody), fever, chest pain, and severe chills with shortness of breath, chest pain on inhalation, headache, pale, sweaty skin, fatigue, and confusion. crackles.
66
What is a spontaneous pneumothorax?
lung collapses without injury or other cause result of a rupture of bleb, small section of lung that is weak. once bleb ruptures, lung collapses and air leaks into pneumothorax with tall thin people having weak spot and smoking destroys lung tissues. Sharp, pleuritic chest pain and shortness of breath, mild when small when larger tachycardic exhibitting cyanosis. breath sounds lower or absent on side with injured lung, needing small catheter or chest tube removing air not having CPAP.
67
What is a pulmonary embolism?
blood clot (deep vein thrombosis- DVT cancer, from bone marrow or fractured bone), air, or fat tries to go through blood vessels getting stuck and blocking artery in lungs. symptoms include- chest pain, shortness of breath, anxiety, cough (bloody spurt), sweaty skin pale and cyanotic, tachycardia, and tachypnea. begin feeling light-headed or dizzy with pain and swelling in one or both legs. can hear wheezing and become hypotensive going into cardiac arrest. Give oxygen
68
What is an epiglottis?
infection inflames areas around and above epiglottis leading to tissue swelling, closing off airway. typically found in men in 40s with a recent cold with sore throat and painful or diffuclt swallowing. Tripod posiiton to increase opening with sick appearance, muffled voice, fever, and drooling because of pain and difficulty swallowing with stridor sounds. children with this have sudden onset, make patient calm and comfortable not inspecting the throat give high concnentration oxygen transport as soon as possible.
69
What is cystic fibrosis?
thick, sticky mucus accumulating in lungs and digestive system can cause life-threateneing lung infections and serious problems with ingestions. symptoms include coughing with a lot of mucus, fatigue, pneumonia with fever and more coughing, abdominal pain and distention, couging up blood, nausea, and weight loss. ask for help treating.
70
What are viral respiratory infections?
sore or scratchy throat with sneezing, runny nose, and feeling of fatique, fever and chills spreading into lungs causing shortness of breath with persistent cough producing sputum yellow or green persisting for one to two weeks. administer oxygen.
71
What is bronchioconstriction?
constriction, or blockage, of the bronchi that lead from the trachea to the lungs. give inhaler to dilate enlarging air passage making it easier
72
What is the proper way to use an inhaler?
right patient, time, medication, dose and route. expiration, room temperature, shake. alert enough to use it properly using spacer if available. exhales deeply, press inhaler to activate deeply, patient inhales holding breath as long as possible
73
What is a nebulizer?
runnning oxygen or air through liquid medication prescribed for patients with chronic respiratory conditions such as asthma, emphysemsa, or chronic bronchitis with a continuous flow over several minutes. some ambulances have. may have increased pulse rate, tremors, nervousness, or jittery fealing dont give to patients who cant breathe deeply enough
74
What are allergic reactions?
an exaggerated immune response
75
What are allergens?
something that causes an allergic reaction
76
What is anaphylaxis?
a severe or life-threatening allergic reaction in which the blood vessels dilate, causing a drop in blood pressure, and the tissues lining the respiratory system swell, interfering with the airway. or anaphylactic shock
77
What are insect allergies?
stings of bes, yellow jackets, wasps, and hornet cause rapid and severe reactions
78
What are food allergies?
nuts, eggs, milk, and shellfish everything except penauts has effects slower than bee stings and can have allergies to related foods
79
What are plant allergies?
contact with poison oak, poison ivy, and poison sumac can cause rash that is severe, with 2/3rds of population allergic to the oil. some people are allergic to plant pollen rarely anaphylaxis.
80
What are medications?
anti-toxins and drugs such as antibiotics like penicillin and once allergic to one allergic to related
81
What are hives?
uticaria are red, itchy, possibly raised blotches on the skin
82
What are the symptoms of allergic reactions in skin?
itching, hives (localized around sting or generalized over wide areas of body), flushing (red skin), swelling of: face (eyes and lips), neck, hands, feet, or tongue. warm, tingling feeling in the face, mouth, chest, feet, and hands
83
What are the symptoms of allergic reactions in respiratory?
tightness in throat or chest, cough, rapid breathing; labored, noisy breathing; hoarseness, muffled voice, or loss of voice entirely; stridor (harsh, high-pitched sound during inspiration), wheezing (audible without a stethoscope)
84
What are the symptoms of allergic reactions in cardiac?
increased heart rate, decreased blood pressure
85
What are the symptoms of allergic reactions in generalized findings?
itchy, watery eyes; headache, runny nose, patient expresses a sense of impending doom
86
What are the signs an symptoms of shock?
altered mental status; flushed, dy skin or pale, cool, clammy skin; nausea or vomiting; changes in vital signs: increased pulse, increased respirations, decreased blood pressure
87
What are hives?
uticaria are red, itchy, possibly raised blotches on the skin
88
What are symptoms of allergic reactions in the skin?
itching, hives (localized around sting or generalized over wide areas of body), flushing (red skin), swelling of: face (eyes and lips), neck, hands, feet, or tongue. warm, tingling feeling in the face, mouth, chest, feet, and hands.
89
What are symptoms of allergic reactions in the respiratory system?
tightness in throat or chest, cough, rapid breathing; labored, noisy breathing; hoarseness, muffled voice, or loss of voice entirely; stridor (harsh, high-pitched sound during inspiration), wheezing (audible without a stethoscope).
90
What are symptoms of allergic reactions in the cardiac system?
increased heart rate, decreased blood pressure
91
What are generalized symptoms of allergic reactions?
itchy, watery eyes; headache, runny nose, patient expresses a sense of impending doom
92
What are symptoms of shock?
altered mental status; flushed, dy skin or pale, cool, clammy skin; nausea or vomiting; changes in vital signs: increased pulse, increased respirations, decreased blood pressure.
93
What do you do in response to anaphylaxis?
manage patient’s airway and breathing, high concnetration oxygen through nonrebreather mask if in distress or having reaction. give epi-pen auto-injector
94
What is an auto-injector?
a syringe preloaded with medication that has a spring=loaded device that pushes the needle through the skin when the tip of the device is pressed firmly against the body
95
What is epinephrine?
a hormone produced by the body. as a medication, it constrict blood vessels and dilates respiratory passage and is used to relieve severe allergic reaction dilate bronchioles. with pulse increase expected to increase afterwards, bad if person hypertensive try to do only if in shock under genralized anaphyloxis.
96
What are some things we need to remember about medications?
All medications are position if given to the wrong patient, at the wrong time or in toxic quantities
97
What are drugs?
chemical agents used in diagnosis treatment, and prevention of disease
98
What are medications?
chemical substance used to treat or prevent disease or relieve pain, medication is a type of drug
99
What are the government agencies that regulate drugs?
FDA, DEA
100
What are some considerations to make with pediatric patients?
reduce metabolic capacity, slow absorption of oral medications and delayed elimination
101
What are some considerations to make with geriatric patients?
hepatic functions an dgastrointestinal activity slow, delaying absorption and eliminiation with noncomitatnt therapies may interact and modify the effects of each medication
102
What are some things EMTs can do?
can assist with inhaler and albuterol treatments, narcan- reverse opioid overdose after 20 minutes blocking potential too far gone
103
What are the forms of ways that we can give to patients?
(PO) ingestion/oral-slow, intranasal (rapid-narcal), inhalation (rapid)
104
What do you do before giving drugs?
get a good patient history SAMPLE, a good history of present illness/injury- OPQRST, history of any known allergies again, and a set of vital signs. If not stable then give.
confirm “rights”: right patient, medication/drug, dose, route, time (expiration date on med, and appropriate time to administer), the, right documentation vs. before and after administration, rights, patient response good or bad. Expired medication not cloudy or floaters especially no floaties still good and then send overseas.
105
How long do you expect to see results for epipen?
3 minutes
106
What are some of the emergency things that we can do?
nitroglycerin(chewable every 5 minutes to max of 3 doses, patient’s own self-administered SBP must be at least 120 mmHg), Oxygen, aspirin (check allergy and contraindications-upset stomach don't give if active GI or hemorrhagic stroke)
107
What does a headache mean?
hemorrhagic stroke don't give aspirin
108
What are the medications we can give?
nitroglycerin(chewable every 5 minutes to max of 3 doses, patient’s own self-administered SBP must be at least 120 mmHg dont give to person with erectile dysfunction if taken in 48 hours), Oxygen, aspirin (check allergy and contraindications-upset stomach don't give if active GI or hemorrhagic stroke)
109
What do you do to give epic-pen?
to give epinephrine need to call medical control to give epi-pen if over 65. adults yellow or orange, pediatric are green. put back in container and goes into sharps container. plunge in for 6 seconds then rub it to spread medication. pediatric give 0.15mg call medical control for second dose and call medical control if under 6 months of age, .3 for adult and anyone over 25kg. can give two doses.
110
What do you do if you want to give glucose?
give glucose when patient conscious and can swallow, second dse in 10 minutes if symptomatic
111
What do you do for albuterol?
assist with metered dose inhaler and if trained
112
What is chronic bronchitis?
| what do you treat with?
3 months of bronchitis for for 2 years, cough, cyanotic haze lips blue and slightly overweight, course rhonchi (force cough to clear mucous)
113
What is COPD?
emphysema and chronic bronchitis
114
What is pneumonia?
small particles caused by virus and bacteria with signs and symptoms of coughing that is productive and get worse when person inhales, confusion, rales, peaked skin, and to trat give them oxygen if saturation less than 94% and use PPV if necessary and viral respiratory infections a lot of things associated with having cold and repsiratory with viruses fatigue, fever, chills, difficulty breathing and can ventilate treating symptoms
