Pharmacology Flashcards
What 8 medications are in the EMT scope?
Albuterol
Aspirin
Nitroglycerin
Narcan
Oral Glucose
Activated Charcoal
Epinephrine
Oxygen
Sympathomimetic
mimic the effects of the sympathetic nervous system
Such drugs are used to treat cardiac arrest, low blood pressure, or even delay premature labor, amongst other things
Beta 2 agonist
- class of drugs used to treat asthma and other pulmonary disease states
- act on the beta 2 adrenergic receptor
- causing smooth muscle relaxation, resulting in dilation of bronchial passages.
Albuterol
Trade Name
Class of drug
Trade: Ventolin, Proventil
Class: Sympathomimetic, selective beta 2 agonist
Albuterol
Actions
Onset, Duration
- Activates the beta 2 adrenergic receptors to relax smooth muscle
- Bronchodilation, relieves bronchospasms, and reduces airway resistance
Onset = 5 Mins
Duration = 3-4 Hours
Albuterol
Indications
- Respiratory distress with bronchospasms
o Respiratory origin
o Allergic reaction/anaphylaxis
o Pneumonia
Albuterol
Contraindications
- MI
- Cardiac pulmonary edema
- Cardiac dysrhythmias associated with tachycardia (relative, >120) – paramedic is responsible for EKG, paramedic and EMT are responsible for identifying heart rate.
Albuterol
Side Effects
- Restlessness/anxiety
- Vertigo
- Tachycardia/palpations
- Dysrhythmias – paramedic
- Heavy chest (Paradoxical Bronchospasms)
Albuterol
Special Information
- Albuterol may precipitate angina pectoris and dysrhythmias. Check lung sounds, O2 saturation,
- paramedic checks capnography, respiratory rate before and after administration of Albuterol.
Albuterol
Dosage/Route
SVN 2.5 mg in 3 mL of saline @ 6 lpm
* repeat as needed.
* Connect oxygen tubing to SVN and run at 6-8 lpm.
MDI is equal to 90 mcg.
Aspirin
Chemical/trade name
Class of drug
Chemical name: ASA, Acetylsalicylic Acid
Trade: Bayer, St. Joseph, and multiple others
Class: Antiplatelet
Aspirin
Actions
onset/duration
- Interrupts Thomboxane A2
- Inhibits plateltes. makes them slippery.
- Onset = 15-30 minutes Duration = 4-6 hours
Aspirin
Indications
- Any kind of chest pain of suspected cardiac origin
Aspirin
Contraindications
- Unable to swallow
- Caution if patient has history of active bleeding ulcer
- Asthma Attack
Aspirin
Side effects
- Stomach irritation (nausea/vomiting, epigastric pain, heartburn, indigestion)
- Bronchospasms in some patients with asthma – cause yet to be fully understood
Aspirin
Special Information
- can be chewed and swallowed
- minimizes clotting process
- just stops growth does not get rid of clot
- can be given to pt on anti-coagulants
Aspirin
Dosage/route
- Oral route (po)
- range from 162 mg to 325 mg
- 2 to 4, 81 mg tablets
- 4, 81 mg tablets for a total of 324 mg
MDI
Meter dose inhaler
SVN
Small Volume Nebulizer
Antiplatelet drugs
Prevent blood clots from forming
Nitroglycerine
Actions
Onset/duration
- Relaxes systemic venous and arterial vessels = vasodilation =
o Decreasing cardiac preload and afterload, myocardial workload, myocardial O2 consumption - Dilates coronary arteries
- SL Onset = 2 min
Topical onset = 30-60 min - SL Duration = 30-60 min
Topical = 24 hours
Nitroglycerine
Indications
- CHest pain
- Cardiac pulmonary edema – paramedic only
Nitroglycerine
Contraindications
- Systolic BP less than 90
- Suspected right ventricular MI
- ED meds within 24 hours (Viagra, Cialis, Levitra) = Hypotension & Tachycardia
Nitroglycerine
Side effects
- Headache
- Hypotension
- Increased HR
- Vertigo
- Nausea
Nitroglycerine
Special Considerations
- Cumulative, reapeat doses usually necessary
- do not shake bottle
- Inform pt of side effects
- Remind pt to not swallow
- burning sensation under tongue possible
Nitroglycerine
Doses / Route
- SL Routeor patch
- If systolic BP > 100 = administer 0.4 mg SL q 3-5 minutes
- no more than 3 doses is usually ineffective
Nitroglycerine
Generic/trade
Class
Generic: Nitro / Nitroglycerine
Trade: Nitrostat, Nitro-bid, Nitrolingual
Class: Nitrate
Define
SL
Sublingual
Oral Glucose
Trade / Class
Trade: Glutose, Insta-Glucose
Class: Monosaccharide, Carbohydrate
Oral Glucose
Actions
Onset/Duration
- obsorbed in GI tract - Distributed to tissues
- Onset (Dependent on pts hypoglycemia) = 1 - 10 min
- Duration = varies
Oral Glucose
Indications
- Hypoglycemia (altered mental status with history of diabetes)
- The ability to swallow the medication.
Oral Glucose
Contraindications
- Unresponsive, unable to swallow
Oral Glucose
Precautions
- Altered L.O.C.
- Ascertain the patient’s ability to swallow an oral preparation of glucose without airway compromise.
- Must be swallowed, not absorbed sublingually, or buccally
Oral Glucose
Side effects
- nausea
- Hyperglycemia (Rare)
Oral Glucose
Special Information
- Symptomatic hypoglycemia = altered mental status
- Check glucometer first
- transport refusal = get pt food to eat + suggest someone remains with pt
- Explination for hypoglycemia = Poor compliance, increased stress, decreased sleep, illness, change in insulin regiment
- Comes in many forms = Gel, Liquid (Dextrose), tablet
Oral Glucose
Dosage / Route
one tube = 15 grams
2-3 Tubes = 30 - 45 grams
pediatric = 4 - 45 grams
Activated Charcoal
Trade/ Class
Generic: Activated Charcoal
Trade: SuperChar, InstaChar, Actidose, LiquiChar, Others (preferably use only aqueous charcoal, not charcoal in Sorbitol)
Class: Antidote, absorbent
Activated Charcoal
Actions
- Binds to certain poisons and prevents them from being absorbed into the body
- Not all brands of activated charcoal are the same; some bind much more poison than others, so consult with medical direction regarding any questions as the brand that you carry.
Activated Charcoal
Indications
Poisoning by mouth, oral poisoning
Activated Charcoal
Contraindications
Inability to swallow, follow comands, protect own airway
Agonist medication
Activate physiological receptors
Antagonist medication
Blocks physiological receptors
Medication Routes for EMT
Oral
Sublingual
Intramuscular
Inhaled
Intranasal
5 Rights for Medication Administration
Right Patient
Right Medication
Right Route
Right Dose
Right Date / Time / Interval
Medication review when to give
Oxygen = Anyone who needs it
Aspirin = Chest pain / MI
Nitro = Chest pain / MI
Epi = Anaphylaxis
Albuterol = Bronchoconstriction / Asthma
Oral Glucose = Hypoglycemia
Narcan = Suspected opiod overdose with respiratory depression
Activated charcoal = Poision/ingestions
Activated Charcoal
Side effects
black stool
vomiting
Activated charcoal
Special Information
pt Vomits = Dose repeated once
Does not adhere too (PHAILS):
Pesticides
Hydrocarbons (gasoline, kerosene, lighter fluid, etc.) / Heavy metals (arsenic mercury, etc.)
Alcohols / Acids / Alkalis
Iron
Lithium
Solvents
Activated Charcoal
Route / Dosage
1g = 1Kg
Epinephrine
Actions / onset / duration
- Bronchodilation
- Vasoconstriction
- Increased HR and automaticity of the heart
- Onset - 5-10 min
- Duration - 1-4 hours
Epinephrine
Indications
- Allergic reaction / Anaphylaxis
(hives(expose chest/back), swelling of tongue/throat ) - Medication is perscribed for this patient by a physician
Epinephrine
Contraindications
- None when used in a life threatening situation
- Possible Myocardial Infraction
(Tachycardia >150)
Epinephrine
Side effects
- Increased HR
- Pallor
- Vertigo
- Chest pain
- Headache
- Nausea
- Vomiting
- Anxiousness
Epinephrine
Special information
Epinephrine increases myocardial oxygen demand; therefore, your patient with an allergic reaction should be on high-flow oxygen before and after administering epinephrine
Epinephrine
Dosage/form
Dosage:
Adult - 0.3 mg (1:1000 epinephrine) x4 or 0.4 x 3 (dont exceed 1.2mg)
Pediatric - 0.15 mg (1:2000)
Form:
Liquid administered via automatically injected needle and syringe system
