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Paramedic Class (AACC) > Pharmacology > Flashcards

Pharmacology Flashcards

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1
Q

MEDICATION vs DRUG

A

Medication refers to a substance used to treat an illness or condition.

Drug is any substance that produces a physiologic effect (whether therapeutic or not) when used in a clinical sense.

EVERY MEDICATION IS A DRUG, NOT EVERY DRUG IS MEDICATION.

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2
Q

PHARMACOLOGY

A

Scientific study of how various substances interact with or alter the function of a living organism.

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3
Q

Pure Food and Drug Act (1906)

A

Prohibited altering or mislabeling medications

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4
Q

Opium Exclusion Act (1909)

A

Opium was prohibited from being imported

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5
Q

Harrison Narcotics Act (1914)

A

Restricted the use of various opiates and cocaine

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6
Q

Food, Drug, and Cosmetic Act (1938)

A

FDA was given enforcement authority for rules requiring that new drugs were safe and pure

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7
Q

“off-label”

A

purpose not approved by the FDA

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8
Q

Controlled Substances Act (1970)

A

classifies certain medications with the potential of abuse into five categories (schedules)

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9
Q

Schedule I

A

may not be prescribed, dispensed, used, or administered for medical use. High abuse potential; no recognized medical purpose

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10
Q

Schedule I Examples

A

Heroin, Marijuana***, LSD
***CONTROVERSIAL

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11
Q

Schedule II

A

High abuse potential; legitimate medical purpose

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12
Q

Schedule II Examples

A

Fentanyl (sublimaze), methylphenidate (ritalin), cocaine

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13
Q

Schedule III

A

lower potential for abuse

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14
Q

Schedule III Examples

A

Hydrocodone (vicodin), acetaminophen with codeine (tylenol with codeine #3), ketamine

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15
Q

Schedule IV

A

lower potential for abuse than Schedule III

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16
Q

Schedule IV Examples

A

diazepam (valium), lorazepam (ativan)

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17
Q

Schedule V

A

lower potential for abuse than Schedule IV drugs

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18
Q

Schedule IV Examples

A

narcotic cough medicines

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19
Q

Sources of Medication

A

Plant
Animal
Microorganism
Mineral
Synthetic (made in laboratory setting)
Semisynthetic (made from chemicals derived from P, A, or M sources then modified in lab setting)
Genetic Engineering

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20
Q

Plant Sourced Medications

A

Atropine, aspirin, digoxin, morphine

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21
Q

Animal Sourced Medication

A

Heparin, antivenom, thyroid preparations, insulin

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22
Q

Microorganism Sourced Medications

A

streptokinase, numerous antibiotics

(bacteria, fungi, mold)

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23
Q

Mineral Sourced Medications

A

iron, magnesium sulfate, lithium, phosphorus, calcium

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24
Q

Class of Medication

A

grouping to which a medication belongs

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25
Q

Three names of medication

A

Chemical, Generic, Brand

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26
Q

Indication

A

a sign/symptom; reason for giving a medication

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27
Q

Mechanism of Action

A

the way in which a medication produces the intended response

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28
Q

Onset

A

estimated time it will take for medication to take effect

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29
Q

Peak

A

estimated amount of time it will take for medication to have greatest effect

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30
Q

Duration

A

estimated amount of time that the medication will have an effect

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31
Q

Medication Monograph

A

profile including medication information

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32
Q

Affinity

A

ability of a medication to bind with a particular receptor site

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33
Q

Efficacy

A

ability to initiate of alter cell activity in a desired manner

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34
Q

Harmful environmental effects to medication

A

direct sunlight, extreme heat or cold, physical damage

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35
Q

Pharmacodynamics

A

process of a medication altering a function or process of body

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36
Q

Side Effect vs Adverse Effect

A

Side Effect usually expected reaction to medication
Adverse Effect an unexpected/undesired response to a medication

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37
Q

Pharmacodynamics

A

biochemical and physiologic effects and mechanism of actions of a medication

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38
Q

Pharmacokinetics

A

activity of medications in the body over time, such as absorption, distribution, and elimination

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39
Q

Processes of Medication Administration

A
  • Absorption
  • Distribution
  • Biotransformation (metabolism)
  • Elimination
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40
Q

Agonist Medications

A

initiate or alter a cellular activity by attaching to a receptor site

(prompts cell response)

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41
Q

Antagonist Medications

A

prevent endogenous or exogenous agonist chemicals from reaching cell receptor sites and initiating or altering a particular cellular activity

(BLOCKS a certain response)

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42
Q

Beta 1

A

One Heart

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43
Q
A
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44
Q

P-450

A

alters the chemical structure of a medication

(mainly liver)

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45
Q

Define Pharmacology

A

scientific study of how various substances interact with/alter the function of living organisms

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46
Q

Define Medication

A

substance used to treat an illness or condition

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47
Q

Paramedics are likely to carry and administer which schedules of drugs

A

Schedule II and Schedule IV

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48
Q

Medications are either _____ or _____ (pertaining to sources)

A

synthetic or semisynthetic

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49
Q

Semisynthetic medications are derived from (4 things)

A

plants, animals, minerals, microorganisms

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50
Q

Med names are either ____ (3 names)

A

Generic, chemical, brand

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51
Q

Define Indication

A

circumstance that points to/shows cause, pathology, treatment, or issue of an attack or disease

albuterol is indicated for broncho-constriction

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52
Q

Define Mechanism of Action

A

way in which a medication produces the intended response

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53
Q

Define Contraindicated

A

any condition, especially a disease, that renders some particular line of treatment improper or undesirable

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54
Q

Most basic concern regarding medication storage is the ______

A

integrity of the medication container

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55
Q

USP-NF recommended temp range for medication storage is…

A

15-30 degrees C

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56
Q

Define Absorption

A

process by which molecules of substance are moved from the site of entry/administration into systemic circulation

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57
Q

Define Distribution

A

movement and transportation of a medication throughout the bloodstream to tissues and cells, and ultimately to its target receptor

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58
Q

Biotransformation

A

process with 4 possible effects of how a medication can be absorbed into the body

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59
Q

Define Elimination

A

ability of a medication to bind with a particular receptor site

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60
Q

Define Affinity

A

ability of a medication to bind with a particular receptor site

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61
Q

Threshold Level

A

concentration of medication at which initiation or alteration of cellular activity begins

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62
Q

Define Potency

A

concentration of medication required to initiate a cellular response

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63
Q

Define Efficacy

A

ability to initiate/alter cell activity in a therapeutic/desired manner

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64
Q

Diuretic

A

chemical that increases urinary output

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65
Q

Agonist Medication

A

initiate/alter cellular activity by attaching to receptor sites

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66
Q

Partial Agonist

A

binds to receptor site but do not initiate as much cellular activity or change as do other agonists

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67
Q

Full agonist

A

binds to a receptor site and initiates all activity the receptor is responsible for

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68
Q

Antagonist

A

binds to receptor site to prevent a cellular response to agonist chemicals

block a certain response

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69
Q

Competitive Antagonist

A

TEMPORARILY bind with cellular receptor sites, displacing agonist chemicals

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70
Q

Noncompetitive Antagonist

A

PERMANENTLY bind with receptor sites and prevent activation by agonist chemicals

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71
Q

Effects of noncompetitive antagonist medication continue until ____

A

new receptor sites or new cells are created

72
Q

Define analgesia

A

state of being insensible to pain while still conscious

73
Q

_____ (drug we give) is an opiate antagonist

A

Narcan (Naloxone)

74
Q

Alpha 1 effects…

A

vasoconstriction of arteries and veins

75
Q

Beta 1 effects…

A

Heart

  • increased heart rate (chronotropic effect)
  • increased myocardial contractility (lontropic effect)
  • increased myocardial conduction (dromotropic effect)
  • renin secretion from urinary retention
76
Q

Beta 2 effects…

A

lungs

  • bronchus and bronchiole relaxation
  • insulin secretion
  • uterine relaxation
  • arterial dilation in certain key organs
77
Q

Dopaminergic receptor effects…

A

vasodilation of renal and mesenteric arteries

78
Q

Nicotinic receptor

A

present at neuromuscular junction, allowing ACj to stimulate muscle contraction

79
Q

Muscarinic receptor

A

present in the heart, activated by ACj to offset stimulation of the sympathetic nervous system.

decreases HR, contractility, and electrical conduction velocity

80
Q

Opioid receptor

A

present in CNS and PNS, bowels, and various tissues.

activated by opioid substances to produce analgesia, euphoria, respiratory depression

81
Q

Most prominent opioid receptor

A

Mu

82
Q

Factors affecting response to medications

A
  • age
  • weight
  • environment
  • genetics
  • pregnancy
83
Q

FDA Pregnancy Category A

A

controlled studies in women fail to demonstrate a risk to the fetus in the first trimester, possibility of fetal harm appears remote

84
Q

FDA Pregnancy Category X

A

studies in animals and humans have demonstrated fetal abnormalities. risk of the use of the drug cleary outweighs the benefit

85
Q

Define Cumulative Action

A

several smaller doses of a particular medication capable of producing the same clinical effects as a single larger dose of the same med

86
Q

Define Untoward effects

A

a clinical change caused by a medication that causes harm or discomfort to a Pt

AKA adverse effect

87
Q

Define Stevens-Johnson Syndrome

A

a severe, possibly fatal reaction that mimics a burn

may be due to a medication

88
Q

Define Therapeutic Index

A

the relationship between the median effective dose and the median lethal dose OR median toxic dose

AKA therapeutic ration

89
Q

Define Tolerance

A

condition that develops following repeated use by a PT of a medication that results in decreased efficacy or potency

90
Q

Define Habituation

A

the unusual tolerance to the therapeutic and adverse clinical effects of a medication or chemical

91
Q

Define Dependence

A

the physical, behavioral, or emotional need for a medication or chemical to maintain “normal” physiologic function

92
Q

Addition or Summation

A

2 meds with a similar effect combine to produce an effect equal to the sum of the individual effect of each med

93
Q

Synergism

A

2 meds with a similar effect combine to produce an effect greater than the sum of one of the meds effect

94
Q

Potentiation

A

effect of 1 med is greatly enhanced by the presence of another med, which doesn’t have the ability to produce the same effect on its own

95
Q
A
96
Q

Altered Absoption

A

the action of 1 med may increase or decrease the ability of another med to be absorbed by the body

97
Q

Altered Metabolism

A

the action of one medication increases or decreases the metabolism of another medication within the body

98
Q

Altered Distribution

A

the presence of one medication alters the area available for the distribution of another medication in the body

99
Q

When would altered distribution become important?

A

when both medication are bound for the same site, such as plasma proteins

100
Q

if proteins are already occupied by one med, ____ of the other med may develop

A

toxic levels

101
Q

Physiologic Antagonism

A

2 meds–each producing opposite effects–are present simultaneously, resulting in minimal or no clinical change

102
Q

Neutralization

A

2 meds bind together in the body, creating an inactive substance

103
Q

Diagnostic Error

A
  • error/delay in diagnosis
  • failure to employ indicated tests
  • failure to act on results of monitoring or testing
104
Q

Treatment Error

A
  • error in the performance of an operation, procedure, or test
  • error in administering treatment
  • error in the dose/method of using a drug
  • inappropriate care
105
Q

Preventative Error

A
  • failure to provide prophylactic treatment
  • inadequate monitoring or follow-up of treatment
106
Q

other medical errors

A
  • failure of communication
  • equipment failure
  • other system failure
107
Q

First Order Elimination

A

the rate of elimination is directly influenced by plasma levels of a substance

108
Q

Zero Order Elimination

A

fixed amount of a substance is removed during a certain period, regardless of the total amount in the body

109
Q

Half-Life

A

the time needed in an average person for metabolism/elimination of 50% of the substance in plasma

110
Q

Most biotransformation of drugs occurs in the ___

A

liver

111
Q

Elimination occurs in ____

A

the kidneys and excreted into urine

112
Q

10 rights of medication administration

A
  • Right Patient
  • Right Medication
  • Right Dose
  • right route
  • right time
  • right education
  • right documentation
  • right assessment
  • right evaluation
  • right to refuse
113
Q

Angioedema

A

localized areas of swelling beneath the skin

114
Q

Components of Medication Profiles

A
  • medication name
  • category or class
  • use/indication
  • mechanism of action
  • pregnancy risk factor
  • contraindications
  • available forms
  • dosage
  • administration/monitoring considerations
  • potential incompatibilities
  • adverse effects
  • pharmacokinetics
115
Q

Anticoagulant

A

reduce efficacy of clotting factors present in blood

116
Q

Antidysrhythmics

A

prevent or control various cardiac dysrhythmias

117
Q

Antiemetics

A

treat or prevent nausea and vomiting

118
Q

Beta-Agonist

A

bronchodilation

119
Q

Beta-Blocking Agents

A

reduce heart rate and blood pressure

120
Q

Calcium Channel Blockers

A

reduce heart rate and blood pressure

121
Q

Cholinergics

A

activate secretory glands in eyes and GI tract; improve muscle weakness

122
Q

Corticosteroids

A

decrease inflammation; immunosuppressant

123
Q

Diuretics

A

promote excretion of urine; manage fluid overload

124
Q

Narcotic Analgesics

A

relieve pain and relieve/suppress cough

125
Q

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

A

treat pain and inflammation

126
Q

Class I Antidysrhythmic

A

slow movement of sodium through channels in certain cardiac cells

127
Q

Class II Antidysrhythmics (Beta Blockers)

A

competitively inhibit catecholamine activation of beta receptor sites

128
Q

Class III Antidysrhythmic

A

increase the duration of phases 1, 2, and 3 of the cardiac cycle. These meds prolong the absolute refractory period

129
Q

Class IV Antidysrhythmics (calcium channel blockers)

A

displace calcium @ certain receptor sites or enter smooth muscle cells in place of calcium. this action relaxes smooth muscle present in the heart, blood vessels, GI tract, and uterus.

they also slow conduction through the AV node

130
Q

Define Orthostatic Hypotension

A

a fall in blood pressure that occurs when moving from a recumbent to a sitting or standing positions

  • diastolic falls by 20mmHg
  • systolic rises by 10mmHg
  • pulse increases by 20bpm
131
Q

Beta Blockers end in…

A

-olol or -lol

132
Q

ACE inhibitors end in…

A

-pril

133
Q

Anticoagulants

A

impair the function of blood clotting or coagulation chemicals in the bloodstream

134
Q

Antiplatelets

A

reduce platelet aggregation (clumping), preventing new thrombus formation, or the extension of an existing thrombus

135
Q

____ is a common example of an antiplatelet

A

Aspirin

136
Q

Inotropic Effect

A

force of cardiac contraction

137
Q
A
138
Q

Dromotropic Effect

A

rate of electrical conduction

139
Q

Chronotropic Effect

A

change in heart rate

140
Q

Sterile Technique

A

the destruction of all living organisms and is achieved by using heat, gas, or chemicals

141
Q

Antiseptic

A

chemicals used to cleanse an area before performing invasive procedure

ie isopropyl alcohol or iodine

142
Q

Disinfectant

A

chemicals used on non-living objects to kill organisms; toxic to living tissues

143
Q

Disposal in…

A

sharps

144
Q

Crystalloid Solutions

A

solutions of dissolved crystals (ie salts or sugars) in water; contain compounds that quickly dissociate in solution

145
Q

Colloid Solutions

A

solutions that contain molecules (usually proteins) that are too large to pass out of the capillary membranes and, therefore, remain in the vascular compartment

146
Q

Isotonic Solution

A

a solution that has the same concentration of sodium as does the cell. water does not shift, and no chance in the cell shape occurs

0.9% sodium chloride (normal saline), LR

147
Q

Hypertonic Solution

A

a solution that has a greater concentration of sodium than does the cell; increased osmotic pressure can draw out water from the cell and cause it to collapse

3% saline, blood products, albumin

148
Q

Hypotonic Solution

A

a solution that has a lower concentration of sodium than does the cell; increased osmotic pressure lets water flow into the cell, causing it to swell and possibly burst

5% dextrose in water (D50)

149
Q

Macrodrip Set

A

an administration set named for the large orifice between the piercing spike and the drip chamber; allows for rapid fluid flow into the vascular system

10 or 15 gtts/mL

150
Q

Microdrip Set

A

an administration set named for the small orifice between the piercing spike and the drip chamber; allows for carefully controlled fluid flow and is ideally suited for medication administration

60 gtts/mL

151
Q
A
152
Q

Initial IV insertion angle: ___, then drop to ___

A

45 degrees, about 15 degrees

153
Q

Helpful hints when giving IV

A
  • allow arm to hang off stretcher
  • pat/rub area without being too vigorous
  • apply wrapped chemical heat pack for about 60 sec
  • if you meet resistance from valve, elevate extremity after 2 misses, let partner try
  • never pull catheter back over needle
154
Q

When documenting IV, include:

A
  • gauge
  • IV attempts vs success
  • the site location
  • type of fluid
  • rate @ which fluid is running
155
Q

Infiltration

A

escape of fluid into the surrounding tissue, causes localized edema.

  • discontinue IV line and reestablish on opposite extremity or in more proximal location.
  • direct pressure over swollen area
156
Q

Occlusion:

A

Physical blockage of a vein or catheter

  • Sign: decreasing drip rate or presence of blood in tubing
    • use syringe with clean IV fluid to add pressure to line to disrupt occlusion
157
Q

Thrombophlebitis

A

inflammation of a vein.

  • common in regular IV drug users and Pts who receive long-term IV therapy
  • pain/tenderness along the vein and redness/edema @ site
  • easier to prevent than treat
158
Q

Hematoma

A
  • accumulation of blood in the tissues surrounding IV site
  • blood can be seen rapidly pooling around IV site, leading to tenderness and pain
  • if occurs while attempting, stop and apply direct pressure
159
Q

Nerve/tendon Damage

A
  • improper identification of IV site
    • Pt will experience sudden and severe shooting pain
    • numbness and tingling common
160
Q

Arterial Puncture

A
  • accidentally puncture artery
    • immediately withdraw catheter, apply direct pressure for at least 5 min or until spurting stops
161
Q

Pyrogenic Reaction

A

a reaction characterized by an abrupt temperature elevation (as high as 106 degrees F [41 degrees C]) with severe chills, backache, headache, weakness, nausea, and vomiting

162
Q

When a medication binds with a receptor site, one of four actions will occur…

A
  1. channels permitting the passage of ions (charged particles) in cell walls are opened or closed
  2. a biochemical messenger becomes activated, initiating other chemical reactions within the cell
  3. a normal cell function is prevented
  4. a normal or abnormal function of the cell begins
163
Q

Endogenous

A

occurring naturally within the body

164
Q

Exogenous

A

from outside the body

165
Q

Medications distribute into three primary types of body substances…

A

water, lipids/fat, protein

166
Q

Medication metabolism in the liver is affected by the…

A

cytochrome P-450 system

167
Q

Paradoxical medication reaction

A

patient experiences effects opposite from the intended effect

168
Q

the percentage of EBC/s in the intravascular space is known as…

A

hematocrit

169
Q

Median Lethal Dose (LD50)

A

weight-based dose of a medication that causes death in 50% of the animals tested

170
Q

Median Toxic Dose (TC50)

A

50% of the animals tested had toxic effects at or above this weight-based dose

171
Q

Down-regulation

A

reduced available cell receptors for a particular medications

AKA tolerance

172
Q

Repeated doses of medication within a short time rapidly cause tolerance, making medication virtually ineffective

A

Tachyphylaxis

173
Q

Two Parts of the Autonomic Nervous System

A

Sympathetic and Parasympathetic Nervous Systems

174
Q

Mydriasis

A

Pupil Dilation

175
Q

Neurotransmitter for SNS is…

A

norepinephrine

176
Q

Neurotransmitter for PNS…

A

Acetylcholine

Paramedic Class (AACC) (4 decks)

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