Principles of Pharmacology, Medication Administration, and Medical Mathematics

Comprehensive practice flashcards detailing principles of pharmacology, routes of medication administration, medical legal concepts, drug safety rights, and clinical calculations for paramedic students.

Pharmacology

The scientific study of how various substances interact with or alter the function of living organisms.

Drug

Any chemical substance that alters the body's function.

Medication

A drug used specifically to diagnose, cure, treat, or prevent disease. All medications are drugs, but not all drugs are medications.

Pure Food and Drug Act (1906)

Early federal legislation aimed at protecting the public from adulterated or mislabeled drugs.

Food, Drug, and Cosmetic Act (1938)

Federal legislation that created the United States Food and Drug Administration (FDA) to oversee drug testing and evaluate safety and efficacy.

Controlled Substances Act (1970)

Federal statute classifying medications with potential for abuse into five distinct categories or schedules, mandating that substances be strictly secured, distributed, and accounted for.

Schedule I Controlled Substances

Substances classified as having a high abuse potential and no recognized medical purpose (e.g., heroin, marijuana, LSD).

Schedule II Controlled Substances

Substances with a high potential for abuse but an accepted, legitimate medical purpose (e.g., fentanyl/Sublimaze, methylphenidate/Ritalin, cocaine).

Schedule III Controlled Substances

Medications that have a lower potential for abuse than Schedule II substances (e.g., hydrocodone/Vicodin, acetaminophen with codeine #3, ketamine).

Schedule IV Controlled Substances

Drugs that possess a lower potential for abuse than Schedule III drugs (e.g., diazepam/Valium, lorazepam/Ativan).

Schedule V Controlled Substances

Medications with a lower potential for abuse than Schedule IV drugs, such as narcotic cough medicines.

Chemical Name

The precise description of a drug's chemical composition and molecular structure, established under International Union of Pure and Applied Chemistry (IUPAC) nomenclature.

Generic Name

The nonproprietary name suggested by the manufacturer and recognized internationally for a drug.

Official Name

The name under which a drug is formally listed in the United States Pharmacopeia (USP).

Brand Name (Trade / Proprietary Name)

The trademarked, proprietary name assigned to a drug formulation by its manufacturer.

Tall Man Lettering

The practice of using capitalized lettering for distinctive syllables in medication names (such as DiphenhydrAMINE and dimenhyDRINATE) to avoid errors involving look-alike/sound-alike drugs (SALADs).

Bioequivalence

The relative therapeutic effectiveness of chemically equivalent drugs, which may vary depending on inactive fillers, formulations, and routes of administration.

Standard Precautions

The comprehensive procedure of protecting healthcare providers and patients from contamination during every patient encounter, treating all blood and bodily fluids as potentially infectious.

Medical Asepsis

The maintenance of a medical environment free of disease-causing pathogens.

Sterile Environment

An environment or piece of equipment completely free of all forms of life, achieved through extensive heat or chemical processing.

Medically Clean Technique

The careful handling of sterile equipment and supplies using aseptic methods to prevent cross-contamination.

Antiseptics vs. Disinfectants

Antiseptics clean surfaces without producing toxic effects on living tissue, whereas disinfectants are toxic to living tissue and are used on inanimate objects.

Right to Refuse

The patient's legal right to bodily autonomy; administering medication against a competent patient's refusal exposes the provider to charges of assault or battery.

Right Assessment

The obligation to perform a thorough clinical assessment that confirms a valid indication exists and verifies the absence of contraindications prior to administering a drug.

Right Patient Education

The principle of informing responsive patients about the risks, benefits, and expected sensations of a medication as early as clinically feasible.

Closed-Loop Communication (Order Echoing)

The safety technique of repeating verbal orders back completely—including drug name, dose, concentration, and route—to verify accuracy before administration.

Percutaneous Route

Medication administration applied to and absorbed across the skin or mucous membranes.

Transdermal Route

Medication delivery across intact skin via patches, pastes, or ointments designed to produce slow, sustained systemic absorption over an extended duration.

Sublingual Administration (SL)

Administration under the tongue for absorption across oral mucous membranes; requires an alert, conscious patient and is commonly used for nitroglycerin.

Buccal Administration

Medication placement in the oral cavity between the cheek and gum for absorption across oral mucous membranes.

Mucosal Atomization Device (MAD)

A device attached to a syringe that converts liquid medication into a fine mist for intranasal delivery, offering rapid absorption and near $100\%$ bioavailability without needlestick risk.

Aural Route

Administration of topical drops directly into the ear canal to treat localized infections or pain; requires the patient to remain in lateral recumbency with the treated ear up for $10\,\text{minutes}$.

Rectal Administration (PR)

Medication delivery into the rectum via suppository or needleless catheter; provides rapid absorption ($>90\%$ bioavailability) and bypasses the upper GI tract, but displays unpredictable absorption.

Nebulizer

A respiratory drug-delivery device that uses pressurized oxygen or air flowing at $5\text{ to }8\,\text{L/min}$ to disperse liquid medication into a fine aerosol mist for pulmonary inhalation.

Metered-Dose Inhaler (MDI)

A handheld, canister-driven device that delivers a measured puff of aerosolized medication for oral inhalation, often paired with a spacer chamber.

Enteral Route

Any medication administration route where the drug is absorbed through the gastrointestinal tract (oral, gastric tube, rectal).

Parenteral Route

Medication delivery by any route that bypasses the gastrointestinal tract, including intradermal, subcutaneous, intramuscular, intravenous, and intraosseous injections.

Intradermal Injection

Parenteral injection depositing medication into the dermal skin layer using a $25\text{--}27\,\text{G}$, $\frac{3}{8}\text{--}1\,\text{inch}$ needle inserted at a $10^\circ\text{--}15^\circ$ angle bevel-up.

Subcutaneous Injection (SC)

Parenteral administration into subcutaneous adipose tissue using a $24\text{--}26\,\text{G}$, $\frac{1}{2}\text{--}1\,\text{inch}$ needle inserted at a $45^\circ$ angle into pinched skin.

Intramuscular Injection (IM)

Parenteral administration into muscle (deltoid, dorsal gluteal, vastus lateralis, or rectus femoris) using a $21\text{--}23\,\text{G}$, $1\text{--}2\,\text{inch}$ needle at a $90^\circ$ angle into stretched skin.

Intraosseous Infusion (IO)

Rigid needle insertion into the medullary cavity of bone (such as proximal tibia or proximal humerus) for vascular access when IV access is unavailable, maintainable for up to $24\,\text{hours}$.

Ampule

A breakable glass medication container requiring neck scoring/gauze protection to open and the mandatory use of a filter needle or filter straw to withdraw medication safely without glass particulate.

Sharps Disposal Container

A puncture-resistant, labeled biohazard receptacle into which contaminated needles and glass sharps must be disposed immediately without recapping.

Nonconstituted Medication Vial

A dual-chamber or separate vial packaging system containing dry crystalline powder that must be reconstituted with sterile diluent (water or saline) immediately prior to injection.

Pharmacokinetics

The study of the physiological processing of drugs over time, summarized by ADME: Absorption, Distribution, Metabolism (Biotransformation), and Excretion ('what the body does to the drug').

Bioavailability

The percentage or fraction of an administered drug dose that reaches the systemic circulation in an active state.

First-Pass Effect

The initial biotransformation of enterally absorbed medications in the liver via the portal circulation before the active drug can reach systemic distribution.

Phase I Biotransformation

Non-synthetic hepatic metabolic reactions (oxidation, reduction, hydrolysis) that introduce or unmask polar functional groups to increase water solubility for excretion.

transforms drugs into more water-soluble metabolites.

Phase II Biotransformation

Synthetic hepatic conjugation reactions covalently attaching endogenous polar compounds (such as glucuronate, sulfate, or glycine) to drugs or metabolites, markedly increasing their molecular weight and water solubility.

makes drugs more soluble to facilitate elimination (or excretion from the body)

Biologic Half-Life ($t_{1/2}$)

The time required for the body's metabolic and excretory mechanisms to eliminate or reduce the plasma concentration of a drug by $50\%$.

Pharmacodynamics

The study of the biochemical and physiological effects of drugs on the body and their mechanisms of action ('what the drug does to the body').

Affinity

The ability of a medication to bind with a particular receptor site

Efficacy

In a pharmacologic context, the ability of a medication to produce the desired effect.

Potency

The relationship between the desired response of a medication and the dose required to achieve the response.

Agonist vs. Antagonist Receptor Interaction

An agonist binds to a receptor to stimulate a cellular physiological response, whereas an antagonist binds without activating the receptor, physically preventing agonists from binding and eliciting a response.

Downregulation

The process in which a mechanism reducing available cell receptors for a particular medication results in tolerance.

Upregulation

An increase in the total number or sensitivity of cellular receptors in response to chronic antagonism or diminished stimulation, causing heightened cellular responsiveness.

Competitive Antagonist

Medications that temporarily bind with cellular receptor sites, displacing agonist chemicals

Non-Competitive Antagonist

Medications that permanently bind with receptor sites and prevent activation by agonist chemicals.

Idiosyncrasy

An unusual, unexpected, or abnormal drug response peculiar to an individual patient, typically rooted in genetic differences.

Tolerance

A progressive decrease in clinical responsiveness to a specific drug dose following repeated administration over time.

Cross-Tolerance

The development of decreased responsiveness to one drug as a consequence of tolerance acquired toward a pharmacologically related drug.

Tachyphylaxis

A rapidly developing tolerance or acute attenuation of drug response occurring after only a few closely spaced doses.

Cumulative Effect

A marked, increased drug response occurring when repeated doses are given before previous doses have been adequately metabolized or excreted.

Synergism

A drug interaction in which the combined effect of two medications given together is greater than the mathematical sum of their individual effects in a coordinated action.

Summation (Addition)

The combined effect of two drugs that equals the simple algebraic sum of their separate actions ($1 + 1 = 2$).

Therapeutic Index (TI)

The relationship between the median effective dose and the median lethal dose or median toxic dose; also known as the therapeutic ratio.

Broselow Pediatric Emergency Tape

A color-coded, length-based resuscitation tape used to rapidly estimate weight, precalculate drug dosages, and select equipment sizes for pediatric patients based on height.

Macrodrip vs. Microdrip Administration Sets

Intravenous tubing sets differentiated by drop factor; macrodrip delivers $10$, $12$, $15$, or $20\,\text{gtt/mL}$ for rapid fluid infusions, while microdrip delivers exactly $60\,\text{gtt/mL}$ for controlled continuous infusions.

Pharmacokinetics

The branch of pharmacology concerned with the absorption, distribution, metabolism, and excretion of drugs in the body.

Absorption

The process by which drugs enter the bloodstream from the site of administration, influencing the onset and intensity of drug action.

Distribution

The dispersion of drugs throughout the body's fluids and tissues, affecting how much of the drug reaches its site of action.

Biotransforamtion

A process with four possible effects on a medication absorbed into the body: (1) An inactive substance can become active, capable of producing desired or unwanted clinical effects. (2) An active medication can be changed into another active medication. (3) An active medication may be completely or partially inactivated. (4) A medication is transformed into a substance (active or inactive) that is easier for the body to eliminate.

elimination

The process by which drugs are removed from the body, primarily through the kidneys via urine, impacting the duration of drug action and potential accumulation.

Receptors

Proteins on cell surfaces or within cells that bind to specific drugs or signaling molecules, initiating a physiological response.

Endogenous

A term referring to substances or processes that originate from within the organism, such as hormones or neurotransmitters produced by the body.

What happens when a medication binds to a receptor site

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

Agonist medication

The group of medications that initiates or alters a cellular activity by attaching to receptor sites, mimicking the action of a naturally occurring substance. (causes the expected response)

Antagonist medications

The group of medications that prevent endogenous or exogenous agonist chemicals from reaching cell receptor sites and initiating or altering a particular cellular activity.

Osmotic

Characterized by the movement of a solvent, such as water, across a semipermeable membrane (eg, the cell wall) from an area of lower solute concentration to one of higher concentration.

Adverse effects

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

Medication distribution

The process by which a medication is dispersed throughout the body's fluids and tissues after being absorbed into the bloodstream, influencing its effectiveness and duration of action.

Osmosis distribution

The process by which water moves across a semipermeable membrane, affecting solute concentration and distribution of substances in the body.

used with electrolytes, and IV fluids to maintain fluid balance and homeostasis.

Filtration

Use of hydrostatic pressure to force water or dissolved particles through a semipermeable membrane.

Facilitated diffusion

The process of medication molecules binding with carrier proteins when no energy is expended.

Active transport

The process of molecules binding with carrier proteins when energy is used to move the molecules against a concentration gradient.

Alpha 1 receptors

Adrenoceptors that mediate smooth muscle contraction and vasoconstriction, primarily found in blood vessels.

cause constriction of peripheral small arteries and arterioles, vascular smooth muscle, and bladder and GI sphincters

Alpha 2 receptors

receptors inhibit pancreatic enzyme and insulin release, suppress norepinephrine release, and inhibit Gl motility

Adrenoceptor

A type of receptor that binds catecholamines like epinephrine and norepinephrine, involved in various physiological responses such as vascular tone and heart rate.

Catecholamines

Hormones produced by the adrenal glands, including epinephrine and norepinephrine, that play key roles in the body’s stress response and regulation of physiological functions.

Beta 1 receptors

A subtype of adrenoceptors primarily located in the heart, responsible for increasing heart rate and contractility when activated by catecholamines.

One heart = Beta 1

Chronotropic effect

Refers to the effect on heart rate, specifically the increase or decrease in heart rate due to factors such as nerve stimulation.

Dromotropic effect

Refers to the effect on the conduction speed of electrical impulses in the heart, impacting how quickly signals are transmitted through the heart's conduction system.

Beta 2 receptors

A subtype of adrenoceptors primarily found in the lungs, responsible for bronchodilation and relaxation of smooth muscle when activated by catecholamines.

Two lungs= beta 2

Acetylcholine

A neurotransmitter that plays a key role in the autonomic nervous system and is involved in transmitting signals to muscles and various organs, affecting functions such as heart rate and muscle contractions.

nicotinic

receptors are a type of acetylcholine receptor that, when activated, promote fast synaptic transmission in the central and peripheral nervous systems. They play a crucial role in muscle contraction and autonomic functions.

Muscarinic receptors

are a type of acetylcholine receptor that mediate slow synaptic transmission and are involved in various parasympathetic nervous system functions, influencing heart rate, glandular secretion, and smooth muscle contraction.

M1 receptor

A subtype of muscarinic receptors primarily found in the CNS and gastric glands, involved in cognitive functions and gastric acid secretion.

M2 receptors

A subtype of muscarinic receptors primarily located in the heart, responsible for decreasing heart rate and regulating cardiac output.

M3 receptors

A subtype of muscarinic receptors found in smooth muscles and glands, mediating contraction and secretion, particularly involved in regulating airway and gastrointestinal function.