Chapter 12 - Principles of Pharmacology

absorption

the process by which medications travel through body tissues until they reach the bloodstream

action

the therapeutic effect of a medication on the body

adverse effects

any unwanted clinical results of a medication

agonist

a medication that causes stimulation of receptors

antagonist

a medication that binds to a receptor and blocks other medications

antibiotic

a medication used to treat infections caused by a bacterium

anticoagulant

a medication that impairs the ability of blood to clot

antifungal

a medication used to treat infections caused by a fungus

antiplatelet

a medication that prevents blood platelets from clumping or sticking together

antipyretics

medications that treat or reduce a fever

aspirin (acetylsalicylic acid or ASA)

a medication that is an antipyretic, analgesic, anti-inflammatory, and a potent inhibitor of platelet aggregation

contraindications

conditions that make a particular medication or treatment inappropriate because it would not help, or may actually harm, a patient

dose

the amount of medication given on the basis of the patient’s size and age

duration

the amount of time that clinical effects of a medication last

elimination

the process of removing a medication or chemical from within the body

EMT-administered medication

administration of a medication by the EMT directly to the patient

enteral medications

medications that enter the body through the digestive system

epinephrine

a medication that increases heart rate and blood pressure but also eases breathing problems by decreasing muscle tone of the bronchiole tree

gel

a semiliquid substance that is administered orally in capsule form or through plastic tubes

generic name

the original chemical name of a medication;

the name is not capitalized

hypoglycemia

an abnormally low blood glucose level

indications

the therapeutic uses for a specific medication

inhalation

the active, muscular part of breathing that draws air into the airway and lungs;

a medication delivery route

intramuscular (IM) injection

an injection into a muscle;

a medication delivery route

intranasal (IN)

a delivery route in which a medication is pushed through a specialized atomizer device called a mucosal atomizer device (MAD) into the naris

intraosseous (IO) injection

an injection into the bone;

a medication delivery route

intravenous (IV) injection

an injection directly into a vein;

a medication delivery route

medication

a substance that is used to treat or prevent disease or relive pain

medication error

inappropriate use of a medication that could lead to patient harm

metered-dose inhaler (MDI)

a miniature spray canister used to direct medications through the mouth and into the lungs

mucosal atomizer device (MAD)

a device that is used to change a liquid medication into a spray and push it into a nostril

nitroglycerin

a medication that increases cardiac perfusion by causing blood vessels to dilate;

EMTs may be allowed to assist the patient to self-administer this medication

onset of action

the amount of time from the administration of a medication to the onset of clinical effects

oral

by mouth;

a medication delivery route

oral glucose

a simple sugar that is readily absorbed by the bloodstream;

it is carried on the EMS unit

over-the-counter (OTC) medications

medications that may be purchased directly by a patient without a prescription

oxygen

a gas that all cells need for metabolism;

the heart and brain, especially, cannot function without oxygen

parenteral medications

medications that enter the body by a route other than the digestive tract, skin, or mucous membranes

patient-assisted medication

when the EMT assists the patient with the administration of their own medication

peak

the point or period when the maximum clinical effect of a drug is achieved

peer-assisted medication

when the EMT administers medication to themself or to a partner

per os (PO)

through the mouth;

a medication delivery route;

same as oral

per rectum (PR)

through the rectum;

a medication delivery route

pharmacodynamics

the process by which a medication works on the body

pharmacokinetics

the processes that the body performs on the medication, including how it is absorbed, distributed, possibly changed, and eliminated

pharmacology

the study of the properties and effects of medications

polypharmacy

the use of multiple medications on a regular basis

prescription medications

medications that are distributed to patients only by pharmacists according to a physician’s order

solution

a liquid mixture that cannot be separated by filtering or allowing the mixture to stand

subcutaneous injection

injection into the fatty tissue between the skin and muscle;

a medication delivery route

sublingual (SL)

under the tongue;

a medication delivery route

suspension

a mixture of ground particles that are distributed evenly throughout a liquid but do not dissolve

therapeutic effect

the desired or intended effect a medication is expected to have on the body

topical medications

lotions, creams, and ointments that are applied to the surface of the skin and affect only that area;

a medication delivery route

trade name

the brand name that a manufacturer gives a medication;

the name is capitalized

transcutaneous (transdermal)

through the skin;

a medication delivery route

unintended effects

actions that are undesirable but pose little risk to the patient

untoward effects

actions that can be harmful to the patient

receptors

sties on cells where medications or chemicals produced in the body can bind and produce an effect

What factors does the dose of a medication depend on?

• weight

• age

• desired action

What do the pharmacokinetic properties for a medication include?

• onset of action

• duration

• elimination

• peak

What three interactions can profoundly alter the pharmacodynamics and the pharmacokinetics of medications administered by prehospital providers?

1. shock states

2. altered vital signs

3. medication

What are the two types of adverse effects?

1. unintended effects

2. untoward effects

What are the two categories of the routes of medication administration?

1. enteral

2. parenteral

Why are most emergency medications not administered orally?

the delayed absorption would limit their efficacy when time is crucial

Is the sublingual (SL) route of administration enteral or parenteral?

enteral

Is the per rectum (PR) route of administration enteral or parenteral?

enteral

Is the oral (PO) route of administration enteral or parenteral?

enteral

Is the intravenous (IV) route of administration enteral or parenteral?

parenteral

Is the intraosseous (IO) route of administration enteral or parenteral?

parenteral

Is the inhalation route of administration enteral or parenteral?

parenteral

Is the intranasal (IN) route of administration enteral or parenteral?

parenteral

Is the intramuscular (IM) route of administration enteral or parenteral?

parenteral

Is the subcutaneous route of administration enteral or parenteral?

parenteral

Is the transcutaneous route of administration enteral or parenteral?

parenteral

What is the rate of absorption for the sublingual (SL) route of administration (slow/moderate/rapid/immediate)?

rapid

What is the rate of absorption for the per rectum (PR) route of administration (slow/moderate/rapid/immediate)?

rapid

What is the rate of absorption for the oral (PO) route of administration (slow/moderate/rapid/immediate)?

slow

What is the rate of absorption for the intravenous (IV) route of administration (slow/moderate/rapid/immediate)?

immediate

What is the rate of absorption for the intraosseous (IO) route of administration (slow/moderate/rapid/immediate)?

immediate

What is the rate of absorption for the inhalation route of administration (slow/moderate/rapid/immediate)?

rapid

What is the rate of absorption for the intranasal (IN) route of administration (slow/moderate/rapid/immediate)?

rapid

What is the rate of absorption for the intramuscular (IM) route of administration (slow/moderate/rapid/immediate)?

moderate

What is the rate of absorption for the subcutaneous route of administration (slow/moderate/rapid/immediate)?

slow

What is the rate of absorption for the transcutaneous route of administration (slow/moderate/rapid/immediate)?

slow

What are the ten common routes of medication administration?

1. per rectum (PR)

2. oral or per os (PO)

3. intravenous (IV) injection

4. intraosseous (IO) injection

5. subcutaneous injection

6. intramuscular (IM) injection

7. inhalation

8. sublingual (SL)

9. transcutaneous (transdermal)

10. intranasal (IN)

Per rectum (PR) administration is most commonly used with _____ because of easier administration and more reliable absorption.

children

What are the advantages of using the oral route of administration?

• noninvasive

• less expensive

What is the main disadvantage of using the oral route of administration?

unpredictability of medication absorption

What is the fastest way to deliver a chemical substance?

intravenous (IV) injection

Can the IV route be used for all chemicals?

no;

aspirin, albuterol, and oxygen cannot be given by the IV route

What is required to give a medication by the IO route?

drilling a needle into the outer layer of the bone

When is the IO route used most often?

because it is painful, mostly for patients who are unconscious as a result of cardiac arrest or extreme shock;

or for children who have fewer available (or hard to access) IV sites

Any medication that can be given by the IV route can be given by the…

IO route

Why do medications given by subcutaneous injection absorb more slowly and have longer lasting effects?

there is less blood there than in the muscles

Why are medications that are administered by IM injection absorbed quickly?

muscles have a lot of blood vessels

Can all medications be administered by the IM route?

no

What are the possible problems with IM injections?

• damage to muscle tissue

• uneven, unreliable absorption (especially for people in shock)

Generally, ______ minimizes the effects of the medication in other body tissues.

inhalation

Medications that are administered through inhalation come in the form of…

• aerosols

• fine powders

• sprays