General Pharmacology

General Pharmacology

• Pharmacology • “Science that deals with

origin/nature/chemistry/effects/use of drugs”

• Drugs• “Chemical compounds that may be administered

to someone as an aid in the assessment, treatment, or prevention of a disease.”

• Relive, Control, Improve condition

General PharmacologyOn the Truck

• Drugs the EMT carries on the ambulance

• Oral Glucose• Glucose gel that is

administered po to pt with AMS/suspected hypoglycemia

• Activated Charcoal • Residue of distillation of

organic molecules (charcoal).• Treated to increase its

absorption • Often used to treat OD/poison

ingestion

Drugs the EMT can assist a pt with

• Prescribed by a physician and pt has them in his/her possession • Nitroglycerin (NTG)

• Works to reduce work of the heart• Reduces peripheral vascular resistance • Dilates Coronary Arteries • Used in chest pains/heart attacks

• Metered-Dose Inhaler (MDI)• Controlled/precise dose of medication inhaled for resp emergencies • Used in asthmatic pts

• Epinephrine • Hormone/catecholamine secreted from adrenal glands

• AKA: Adrenaline • Increases sympathetic activity

• Increased heart rate/force, bronchodilation, etc• Used to treat Anaphylaxis

Drug Names

Chemical– Atomic/molecular structure

Generic– Abbreviated form of chemical name– U.S. Adopted Names (USAN) Council– NEVER capitalized

Trade– Copyright ® – ALWAYS CAPITALIZED

Official– USP/NF– Usually same as generic

Ethyl 1-methyl-4-phenylisonipecotate hydrochloride

Meperidine hydrochloride

Demerol hydrochloride ®

Meperidine hydrochloride, USP

Generic Name Trade Name

Oxygen ----

Activated Charcoal SuperChar

InstaChar

MDI’s

Albuterol Provent/Ventolin

Nitroglycerin Nitrostat

Epinephrine Epi Pen/Epi Pen Jr

Epinephrine Hydrochloride Adrenaline

Indications/Contraindications

• Indication• A condition/disease for

which a drug is expected to have a beneficial effect

• The most common use of a drug in treating a condition

• i.e. Bronchodilators = Asthma

• Contraindication• Situation in which a drug

should not be used b/c it may do harm to the pt or have no effect at all

• i.e. Pt c/o chest pain with hypotension No NTG (vasodilator)

Medication Forms

• Tablet/Compressed Powder• NTG

• Liquid for injection• Epi

• Gels• Glucose

• Suspensions• A preparation of finely divided undissolved substance dispersed in a liquid

• Activated Charcoal • Fine powder for inhalation

• MDI• Sub-lingual spray

• NTG• Liquid/Vaporized

• Nebulizers

Administration Routes

• The method through which a drug is administered to a pt.• Oral/PO

• Requires swallowing by pt• Drug absorbed through GI tract into blood

• i.e. Activated Charcoal• Sublingual

• Beneath the tongue• Drug dissolves and passes through mucous membrane into blood vessels

• i.e. NTG• Inhaled

• Inhaled particles absorbed across vessels under mucous membranes• Have local effects

• i.e. MDI• Injected

• Sub Q- Subqutaneous-Just under the skin - Slow• IM- Intramuscular – Capillary beds – Faster• IV- Intravenous- Into veins – Fastest

• i.e. Epi

Dose

• Quantity of a substance to be given at one time.

• As in a specified amount of a medication

• Typically in metric units• i.e. 15 L/min

• Solids normally in g or mg• 1 g = 1000 mg

• i.e. 0.4 mg NTG

• Liquids typically in g, mg, ug, / L , ml

• 1 L= 1000 ml• Epi 1 : 1,000

Therapeutic Dose

• Therapeutic Dose• Dose of a med required to have the desired effect on a pt• Low enough to minimize side effects & toxic effects from too

much drug

Action and Side Effects

• Actions• Desired effect/change a drug has on the

body/organ• i.e. Action of Supplemental O2

• Increase O2 concentration in blood – Correct Hypoxia

• Side Effects • Effects of a drug other than those for which the

drug is being used• Can be undesirable/detrimental

6 Rights

• 5 Rights must be present before you can assist a pt with their meds

• Right Pt• Right Med• Right Dose• Right Route• Right Date • Right Documentation

Reassessment

• Repeat baseline vitals• On going assessment• Documentation of

response +/- OR neutral

• Document:• Time of administration

of med(s)• Time of vitals• Time of reassessments

Special Considerations

• Peds• Small body mass, therefore, adjust

dosages• Usually mg/Kg (2.2 lbs = 1 Kg)

• Difficult coordinating inhalation of MDI

• Reluctant to take meds• Fast metabolism=Fast effect

• Elderly • Multiple meds/multiple illnesses• May not be sure as to why they

take the meds• More meds = greater chance of

drug interaction• Slower metabolism of drugs• Drugs can provide clues to pt Hx• Transport meds with pt.