Patient Medications and Implications for EMS Providers

Patient medication history importance

Knowing what medications a patient takes and transporting them or a list to the emergency department is crucial for assessment.

Nonprescription medications

Patients may take OTC medications, herbal remedies, or other supplements in addition to prescription medications.

Patient reporting check

Many patients do not volunteer this information; always ask specifically about OTCs, herbal medications, and supplements.

Prescription adherence statistics

Approximately 20% of new prescriptions are never filled, and 50% of all prescriptions are not taken correctly.

Medication effects despite adherence

A patient may take medications correctly yet still experience toxicity, adverse reactions, or body changes affecting pharmacodynamics and pharmacokinetics.

Clinical context consideration

Always consider a patient’s medications in the context of the current clinical encounter.

Beta-adrenergic and calcium channel blockers

Medications like metoprolol (Lopressor), atenolol (Tenormin), amlodipine (Norvasc), and diltiazem (Cardizem) can prevent heart rate from increasing during sepsis, trauma, hemorrhage, or tachycardia.

Effect of beta-blockers on shock

Patients on these medications may show normal or low heart rates even when perfusion is impaired and shock is worsening.

Antiplatelet medications

Drugs such as aspirin and clopidogrel (Plavix) decrease platelet aggregation.

Anticoagulant medications

Medications like warfarin (Coumadin), apixaban (Eliquis), and rivaroxaban (Xarelto) interfere with blood-clotting mechanisms.

Bleeding risk

Patients on antiplatelet or anticoagulant therapy are predisposed to bleeding; suspect intracranial hemorrhage if neurologic symptoms or altered mental status are present.

Transport consideration for hemorrhage

For complicated hemorrhages, transport to a facility capable of managing severe bleeding.