Module 8: Pharmacology Flashcards
Name Sean’s three rules of pharmacology
- All drugs want to be in your bloodstream
- Once in bloodstream, drugs will seek out target cell receptor sites
- Once at cell receptor sites, drugs will either stimulate (agonist) or block (antagonist)
Is narcan an agonist or antagonist?
Antagonist
The protocol that allows NY state EMTs to administer or assist with approved drugs is also called
standing order
What is a dose?
amount of drug administered
What is the action?
Expected EFFECT on the pt
What are indications?
Reasons WHY you are giving the drug (found in protocol)
What is the contraindication?
Reasons why you can NOT administer the drug
What is a side effect?
An unintentional action
Unless there is a specific protocol, patients are pediatric up until they are __ years old
15
Name the routes of administration for drugs and which you CAN do as an EMT
Can:
Oral (PO), SLOW.
Sublingual (SL), FAST, placed under tongue, absorbed by mucous membranes.
Intramuscular (IM)
Inhalation
Intra nasal (IN)
__ medication enters body through digestive system, while ___ medication enters body through mucous membranes
Oral/PO
Sublingual/SL
Name the routes of administration for drugs and which you CANNOT do as an EMT
Cannot:
IV injection, FAST. Injected directly into vein
Intraosseous (IO), bone marrow
Subcutaneous (SC)
Transcutaneous
How is intra nasal medication administered?
Mucosal atomizer device (MAD)
What is the one drug EMTs can assist with per rectum?
Diastat, a muscle relaxer
Not carried in ambulance
Do EMTs use capsules?
No, because you need medications to dissolve quickly
What are the 6 rights of medication administration?
patient
drug
time
dose
route
documentation
What are the six medications on an EMS unit?
- Oxygen
- Glucose
- Albuterol
- Epinephrine
- Naloxone
- Aspirin
What are the three prescribed medications an EMT may be able to assist with?
- nitroglycerin
- Diastat
- Inhalers
Should using supplemental O2 be used with caution for smokers because they breathe with a hypoxic drive?
No, this is not a prehospital contraindication
What is the contraindication with glucose?
can’t protect airway
can’t drink
fear of aspiration
Why do EMTs administer aspirin?
To prevent more blood clots from accumulating in coronary arteries during a heart attack
What do coronary arteries feed the myocardium with?
Oxygenated blood
Define atherosclerosis
Narrowing of coronary artery from plaque. Contributing factors include smoking, age, and genetics
What is the dosage for aspirin?
324 mg chewable ASA, 81 mg tablets/ea
four tablets total
When would you give multiple doses of aspirin?
NEVER.
Name the contraindication and side effect of aspirin
contra: inability to swallow
side effect: bleeding
What is the form, dose, and route of nitroglycerin
form: tablet or sublingual spray
dose: 0.4 mg spray under tongue (may be assisted 3 doses, 5 minutes apart)
route: sublingual
What is the action and side effect of nitroglycerin?
Widens/dilates coronary arteries. Note that it may affect blood pressure
What is the contraindication and indication of nitroglycerin?
indication: pt possesses drug, has chest pain, and SBP is above 120
contra: SBP below 120, has taken viagra in last 72 hours
What is the side effect of nitroglycerin?
headache, hypotension
What sort of drugs should you ensure a pt is not taking when assisting in administering nitroglycerin?
if they have taken viagra in past 72 hours
What is the action of albuterol? What is the contraindication? What is the dosage? What is the route and form?
bronchodilation. No contraindication. Nebulized at 6-8lpm and three doses may be administered. Route is inhalation and the form is solution.
What is the dosage for epinephrine? patient? contraindication?
dosage is 0.3 mg for adults .66lbs and 0.15 mg pediatric <66 lbs. No prehospital contraindications, but use caution for those with cardiac disease.
Name some characteristics of anaphylaxis
If two or more of the following occur:
difficulty breathing
swelling
hives
low BP
GI distress
If the adult dose is 0.3 mg for an epi, how much of a vial should you draw up in milliliters?
0.3 ml
For a 4yo with anaphylaxis, how much of the vial should you draw up in milliliters?
0.15 ml
Do EMTs have to call OLMC to administer epi for anaphylaxis?
No standing order
Do EMTs have to call OLMC to administer epinephrine for a severe asthma attack?
Yes
What is the dosage for narcan/naloxone?
depends.
for narcan 4 mg in one nostril for everyone
for generic
adult 1 mg for each nostril, 2 mg total
pediatric 1 mg, 0.5 in each nostril
Why do we give narcan to patients?
respiratory depression secondary to a suspected opioid overdose
What is the contraindication for narcan?
epistaxis (nasal blood vessel burst)
cardiac arrest
seizures
What is the route and form of naloxone?
route: intranasal
form: solution
Which patients would you most likely administer albuterol via a nebulizer to?
1. 16 yo pt with difficulty breathing after running on treadmill
2. 25 yo female who is breathing 4x a minute with a history of asthma
3. 64 yo female with wheezes
4. 35 yo man with difficulty breathing and hemoptysis
- 64 yo female with wheezes
Which of the following is considered an enteral route of medication administration?
1. intramuscular
2. intranasal
3. by mouth (PO)
4. intravenous
- by mouth
What is the form of albuterol?
solution
You wish to administer 0.15mg IM of a 1:1000 solution of epinephrine; you would draw up how much epinephrine into the syringe?
0.15 mL
Which routes fall under the Emergency Medical Technician’s scope of practice? - Select all that apply
1. By mouth (PO)
2. Intravenous (IV)
3. Sublingual (SL)
4. Intranasal (IN)
5. Intramuscular (IM)
all but IV
The use of multiple medications regularly is called:
polypharmacy
What effects does epinephrine have on the body?
1. constricts bronchioles
2. dilates blood vessels
3. dilates bronchioles
4. constricts blood vessels
- dilates bronchioles
- constricts blood vessels
Written documents giving the EMT the ability to administer medication are called:
offline medical control
