Patient Care - Pharmacology & Medical Emergencies (Unit 3)

Analgesics

Relieve pain without causing loss of consciousness.

• Aspirin, Fentanyl, Oxycodone, Tramadol, Tylenol (acetaminophen)

Anesthetic Agents

Reversibly depress neuronal function, producing loss of ability to perceive pain and other sensations.

• Xylocaine (lidocaine)

Antianxiety

Treatment of anxiety. Act on the CNS to calm or relax the anxious patient.

• Midazolam (versed)

Antiarrhythmic

Treat arrhythmias

• Xylocaine (lidocaine)

Antibiotics

Used to kill or inhibit the growth of microorganisms.

• Amoxicillin

Anticholinergic

Reduce the smooth muscle tone, motility of the GI tract, and secretions from respiratory tract and secretory glands.

Anticoagulant

Inhibit clotting of the blood or increase the coagulation time.

• Heparin, Warfarin (coumadin)

Antidepressants

Treatment of depression. Often require 6 to 12 weeks of administration to achieve their maximal therapeutic effect.

Antidiabetics

Treatment to control/manage diabetes. Works to lower high blood glucose levels.

• Metformin (Glucophage)

Antiemetic

Prevent and treat nausea and vomiting.

• Ondansetron (Zofran)

Antiepileptics

Prevent or control the occurrence of seizures. They do not treat the cause of seizures; they reduce or eliminate seizure activity.

Antihistamine

Treat allergic disorders, both acute and chronic.

• Benadryl (diphenhydramine)

Antihyperlipidemics

Management of hyperlipidemia. Reduction of lipid levels in the blood.

Antihypertensive

Treat high blood pressure.

Antiplatelets

Inhibit platelet aggregation.

• Aspirin

Antipyretic

Used to prevent or reduce fever.

• Tylenol (acetaminophen)

Bronchodilators

Used in the treatment of asthma and COPD. Relax bronchial smooth muscles and dilate the respiratory passages.

• Epinephrine (adrenalin)

Cathartic (laxative)

Act to promote the passage and elimination of feces from the large intestines.

Coagulants

Used to control hemorrhage or to speed up coagulation.

Corticosteroids

Used to reduce the symptoms associated with chronic inflammatory disorders or acute inflammatory conditions.

Diuretics

Increases the amount of urine excreted by the kidneys, thus removing sodium and water from the body.

NSAIDs

Have analgesic, antipyretic, and anti-inflammatory actions.

• Ibuprofen (Motrin)

Opioid Antagonist

Block the effects of opioids.

• Naloxone (Narcan)

Sedatives/Hypnotics

Produce varying degrees of CNS depression ranging from mild sedation to sleep.

Stimulants

Increase the activity of the brain and spinal cord.

• Epinephrine (adrenalin)

Thrombolytic

Dissolve the thrombi (clots) that have already formed.

Vasoconstrictors

Cause blood vessels to constrict, thus increasing heart action and raising blood pressure.

• Epinephrine (adrenalin)

Vasodilators

Cause blood vessels to dilate.

• Nitroglycerin

Drugs can have at least 3 different names:

• Chemical name

• Generic name

• Brand name

Chemical Name

Identifies the actual chemical structure of the drug

Generic Name

Name given to the drug when it becomes comercially available.

• May also be called: Nonproprietary name

Brand Name

Given to a drug manufactures by a specific company.

• May also be called: Trade name

What is the physicians' desk reference (PDR)?

Provides a drug summary listing the essential info on medications

What are some substances that are not controlled by the FDA, but may be listed as 'drugs' by your patient? It is important to document these as they may interfere with prescribed medications.

Dietary supplements, vitamins, supplements, and herbal remedies

Tablet

Powder or granulated drug that has been compressed into a solid hard disk.

Capsule

Powered or liquid drug is contained in a gelatin shell. Shell dissolves in the stomach.

Inhalant

Breathable chemical vapor that may cause systemic and local effects.

Suppository

Shaped for insertion into a body opening. Dissolves in the body at body temperature.

Solution

One or more drugs dissolved in a liquid carrier. They are rapidly absorbed and administered orally or parenternally.

Suspension

One or more drugs in small particles are suspended in a liquid carrier. Administered orally, never intravenously.

Transdermal Patch

Permits a drug to be applied on the skin surface, where it is absorbed into the blood stream.

Antagonist Drug

Drug that blocks the passage of impulses through the parasympathetic nerves. Blocks or interferes with the effects of another substance, preventing a biological response.

Benzodiazepines are classified as antianxiety or anxiolytics, but these drugs may also be used in the radiology department for:

• A common brand name is:

• Preoperative drugs for various procedures.

• Ativan, Xanax, Versed, Valium

Patients with diabetes often need to discontinue __________ prior to administration of IV contrast media. What is the brand name and generic name?

• Antidiabetics or Metformin

• Glucophage/Metformin

The __________ is the main organ involved in metabolism.

Liver

The __________ is the main organ incolced in excretion.

Kidneys

__________ is a pain reliver that does not cause the loss of consciousness. It is divided into 2 subgroups: non-opioid & opioid.

Analgesic

__________ is a drug classification used to treat allergic disorders, both acute & chronic. For severe allergic reactions, the drug administration route is usually __________. 

• List common drugs under this classication:

• Antihistamines

• Intramuscularly

• Allegra, Benadryl, Claritin, Vistaril

__________ is a commonly used anticoagulant; administered parenterally.

Heparin

__________ & stimulants are both drug classifications that may treat shock.

Vasoconstrictors

__________ may be administered parenterally for acute MI & strokes.

Thrombolytic

__________ may be given to diabetics who are hyperglycemic.

Insulin

__________ is a vasodilator that may be used on a patient who suffers from angina pectoris.

Nitroglycerin

__________ abnormal response to a drug; something that wasnt expected to occur.

Idiosyncratic

__________ an unintended secondary effect from a drug.

Side effect

__________ an adverse effect resulting from too high of a dose or is the body is unable to filter the drug out.

Toxic effect

__________ is used to stimulate defecation; it can be classified as a laxative.

Cathartic

List the 6 rights to drug administration:

• Right patient

• Right medication

• Right dose

• Right route

• Right time

• Right documentation

Pharmacokinetics

Study of drugs within the body; absorption, distribution, metabolism, and excretion.

Pharmacodynamics

Study of what the drug does to the body (physiological and biochemical effects).

Pharmacogenetics

Study of how people respond to a drug based on their genetic makeup.

How many times should the drug label be checked?

3 times minimum

• Once when container is removed from shelf

• When drug is removed from the container

• When the container is replaced

if you accidentally drew up more medication than you needed into a syringe, what should you never do with the extra?

Never put it back into the original container

List the enteral routes of administration:

Oral, sublingual, buccal, and rectal

The most common method of drug administration is:

• Medications ordered to be administered this way use what abbreviation?

• Oral

• PO

Nitroglycerin is commonly given via this route: _____________. Which allows for rapid absorption.

Sublingual

Topical routes of administration will apply the drug directly onto the __________ where it is absorbed into the __________. Examples include:

• Skin

• Bloodstream

  • Ointments, creams, transdermal patch

Define parenteral routes of administration:

Drugs that are injected into the body, not be mouth/GI

Intravenous

Injected directly into the vein

Intra-arterial

Injected directly into an artery

Intrathecal

Injection into the subarachnoid space of the spine.

Intramuscular

Injected directly into the muscle; fast acting.

Subcutaneous

Injected directly under the skin

Intradermal

Injected inbetween the layers of the skin

Intraosseous

Injected directly into the bone marrow

A __________ angle is used for intramuscular injections.

90

A __________ angle is used for subcutaneous injections.

45

A __________ angle is used for intravenous injections.

25 or less (around 15)

Label synringe

1. Tip

2. Barrel

3. Plunger

Label needle

1. Bevel (make sure it is always up)

2. Shaft

3. Hub

Label

1. Cephalic vein

2. Basilic vein

3. Radial vein

4. Median vein

5. Basilic vein

6. Cephalic vein

Intravenous injection methods:

1. Slow single administration of the drug: administering a drug throug a syringe that is connected to an IV.

2. Intravenous bolus or push: allows for rapid push of drugs into the vein.

3. Drip infusion: used for administering large amounts of fluid. Can control the amount administered over a specific period of time.

Bolus

Amount or quantity of fluid being injected

Extravasation

Discharge or escape of fluid from a vessel into the surrounding tissue that can cause localized vasoconstriction.

List the steps you must take if extravasation (infiltration) occurs:

• Remove the needle

• Apply pressure

• Apply a cold compress

What should be administered through the IV before and after contrast media?

Saline

HIV exposure risk is relatively low/high after an accidental needle stick.

Low

What steps should you take after a needle stick?

• Wash hands with soap and water

• Notify supervisor and clinical coordinator

• Blood tests for HIV, HPV, etc

Define C.A.B

Compressions, Airway, Breathing

Current AHA ratio for adult CPR:
Compression Rate:
Compression Depth:

• 30:2

• 100-120 compressions/min

• 2” depth

Current AHA ratio for pediatric CPR:
Compression depth:
Ratio for 2 person pedi CPR:

• 30:2 (100 compressions/min)

• 1/2-1” depth

• 15:2 (100 compressions/min)

Which heart arrythmia would require the used of an AED?

Ventricular fibrillation

If a patient is choking and verbalizes they are, what should be done?

Encourage them to keep coughing

If a patient is chocking and cannot speak, what should be done?

Heimlich maneuver

List signs & symptoms of someone experiencing a deteriorating state of consciousness:

Irritability, lethargy, slowing pulse rate, slowing breathing

List some medical supplies that may contain latex:

Tourniquet, enema tips, catheters, gloves, syringes, any healthcare product could have latex

What is the Glasgow Coma Scale?

Numerical scale used to evaluate changes in a patient’s LOC over time.

4 LOC's

1. Alert and Conscious

2. Drowsy but responsive

3. Unconscious but reactive to painful stimuli

4. Comatose

List and describe the 4 types/classifications of shock:

1. Hypovolemic Shock - loss of blood or tissue fluid

2. Cardiogenic Shock - variety or cardiac disorders including MI

3. Neurogenic Shock - spinal anesthesia or damage to upper spinal cord

4. Vasogenic Shock - sepsis, deep anesthesia, or anaphylaxis

Signs and symptoms of shock

• Restlessness

• General anxiety

• Tachycardia

• Decreasing blood pressure

• Cold and clammy skin

• Palor