Pharmacology EMT (JCCC EMS 132)

medication that treats/reduces fever

antipyretics

meds that enter through digestive system

enteral med.

generic name

original chemical name for med

amount of time med takes to work

onset of action

any unwanted clinical results of a med

adverse effects

when medication is working most

peak

med given through mouth

per os

process that med works on body

pharmacodynamics

how body works on med. (how it absorbs, distributes, changes, and eliminates)

pharmacokinetics

use of many meda on regular basis

polypharmacy

a liquid mixture that cannot be seperated

solution

a mixture of fluid that can be seperated, but its distributed evenly

suspension

the desired effect of med

therapeutic effect

the brand name

trade name

actions that are undesirable but pose little effect to patient.

unintended effect

actions that can be harmful to patient

untoward affects

beta blockers 

blocks certain responses 

inotrope 

helps with strength of contraction

dromotrope

increased electrical activity

chronotrope

hr elevates

betta 1

heart-rate increases, pumps harder, and conductivity increases

betta 2

lungs dialate

Alpha 1

blood pressure and flow

a common blood thinner

warfarin (coumadin=tradename)

hold auto injector in place for how long?

5-10 seconds

what size needle for EMT IM admin

19-21 gauge, 1-1.5 inch

the larger the needle gauge…

the smaller the needle

max ccs for deltoid

2ccs

max ccs for gluteus, vastus lateralis

5cc

drug bolus formula

DD x VH/DH = VTBA

“Dose I need, times what I see,

Divide by what it’s labeled

trade names for albuterol and what type of med is it

proventil, ventolin- sympathomimetic and beta 2 agonist

albuterol indications and contraindications

ind: reversible bronchospasm with COPD, asthma, and respiratory irritant. Anaphylaxis/allergic reaction

cont:none

albuterol side effects

nausea, tachycardia, tremors

albuterol dose

2.5 mg in 3 ccs of sterile saline for mild wheezing

5 mg in 6ccs for respiratory distress

repeat as needed

on 6-8 lpm

albuterol precautions/consid.

ECG in pt over 50 yo who has hx of CAD

what type of med is aspirin

anti-pyretic, anti inflammitory, and platelet aggregator inhibitor

aspirin indications and contraindications

ind: cardiac chest pain

cont: bleeding hemorrhage, especially gastric ulcers. NOT FOR CHILDREN

aspirin side effects

none pre hospital

aspirin dose

162-324 mg

aspirin precautions

may exacerbate bronchospasm in asthmatics.

when taken with nitro, may cause hypotension

ipratropium bromide trade name and class

atrovent- anticholinergic (parasympatholytic- fights parasymp ns), bronchodialtor chemically related to atropine

atrovent indications and contraindications

ind: asthma, COPD, bronchospasm

cont: 3 years and older only

atrovent dose

0.5 mg in 2.5 ccs of sterile saline with first 3 albuterol NBT

special connsid for atrovent

should not be given for bronchiolitis

what two meds in duodote and how much

atropine 2.1 mg, pralidoxime (2- PAM chloride) 600 mg

duodote indications and cont.

ind: treatment of poisons by organophosphate nerve agents or insecticides

cont: none

duotode side effects

transient increase in BP lasts up to 4 hrs. Hypertonia at injection site. Pain at injection

Atrovent side effects

nausea, oral dryness and irritation, headache, nervousness

how many duodote doses do you give

1 for mild symptoms, 3 total for severe

epinephrine class and dose

sympathomimetic with alpha and betta properties, (inotrope, dromotrope, and chronotrope) 

inhibitation of MAST cell degranulation

1:1000 (1mg for 1cc) used as EMT

0.3 mg for adults repeat every 5-15 mins PRN

0.15 mg for peds every 5-15 mins < 8 yo usually/ < 25 kg or 55lbs

epi indications and cont.

allergic reaction with 2 or more body systems (anaphylaxis)

• Skin or mucosal irritation with either respiratory compromise, decreased blood

  pressure or signs of end-organ dysfunction

  OR

  Hypotension after exposure to a known allergen SBP< 90 mmHg for adults

  OR

  Two or more of the following occurring rapidly after exposure to an allergen

  Skin and/or mucosal involvement (urticaria, itching, swollen tongue/lips)

  Respiratory compromise (dyspnea, wheezing, stridor, hypoxemia)

  Persistent gastrointestinal symptoms (vomiting, abdominal pain, diarrhea)

  Hypotension or associated symptoms (syncope, hypotension, chest tightness,

  incontinence)

cont: expired/cloudy fluid

Epi considerations

monitor ecg in pts with hx of CAD/ACS or that are 40+

use with caution in pt with htn or overuse of symapthomometic inhales

glucagon dose and class

hormone secreted from alpha cells of the islets of langerhans- pancreas

0.5-1 mg adults

0.5mg up to 20kg the 1 mg for >20kg

glucogon inndications and cont

ind: hypoglycemic pts with adequate store of glycogen in the liver (if they are in starvation or

unstable diabetes)

cont:none

glucogon side effects

hypotension, n/v, vent. tachydysrhythmias

nitro trade names, class

nitrostat tablets, nitrobid ointment, nitrolingual (spray)

vascular smooth muscle dilator- dilates coronary arteries and lowers preload

nitro ind and cont.

ind; cardiac chest pain and pulmonary edema

cont: SBP <100 mm Hg

use of erectile dysfunction drugs

currently recieving Rx of pulmonary htn

nitro side effects

hypotension (particularly orthostatic)

headache

N/V, sublingual burning

nitro dose

0.4 for cardiac chest pain if SBP is above 100

0.4 for pulmonady edema if SBP is below 160 but above 100

0.8 for pulmonady edeme if SBP is above 160 (MAP > 120) 

repeated every 5 minutes PRN if SBP stays in limits

oral glucose (everything)

class- carbohydrate monoasccharide

ind: AMS with BGL less than or equal to 60 AND symptomatic

cont: cant swallow or manage airway

no side effects

dose- 1 tube usually 31 grams

naloxone HCL/ narcan class, ind and cont

opiate receptor antagonist

ind: suspected or known OD

cont: none

narcan side effects

withdrawl (n/v, sweating, tachycardia, increased BP, and tremulousness/trembling or quivering, seizures)

narcan dose

0.4-2 IM and 0.4-4 IN repeat every 2-3 mins. titrated to respiratory response. -ADULT

0.1mg/kg up to 5yo or 20kg at which adult dose given

activated charcoal trade name, class, and dose

actidose, absorbent compound, 1g/kg PO

activated charcoal ind and cont 

ind: ingested poison within 1 hour of ingestion 

• extended delayed release meds

• acetaminophen

• beta-blocker or calcium channel blocker OD

cont:

corrosivs ingestion (acids and alkalis)

patients with declining loc

sorbitol does what

makes you poop faster

act charcoal side effects and consid.

no side effects

shake thouroughly, watch for dehydration for sorbitol

prescription meds: metformin (glucophage)

diabetes

prescription meds: lisinopril (zestril)

htn

prescription meds: metoprolol (lopressor)

betta blocker, htn, chf

prescription meds: phenytoin (dilantin)

seizures

Acetaminophen

15 mg/kg PO or IV, max dose 1 g

pain fever control

cont: liver disease

Ibuprofen

10 mg/kg PO for patients greater than 6 months of age, max dose

800 mg

pain, fever, inflammation

Avoid ibuprofen in patients with NSAID allergy, aspirin-sensitive asthma, renal

insufficiency, pregnancy, or known peptic ulcer disease

Isopropyl alcohol

anti emetic- allow patient to inhale vapor from isopropyl alcohol wipe 3

times every 15 minutes as tolerated

but be able to understand directions

epi side effects

tremor, cool sweat skin

decreased fib threshold, vent. ectopy (extra beat), htn, tacy, angina