General Pharmacology

Pharmacology

The study of bodily functions to chemical changes. (Normally in context of drug administration)

To be a drug:

Has to do one or more; treat, prevent, and/or diagnose.

Indication

When to give a drug

Action

What the drug does to the body

Dose

Amount to be given

Contraindication

Harmful or fatal if given in a certain situation

Side Effect

A known effect of a drug that has nothing to do with the reason for taking the drug

Drug types

Prescription and over the counter (OTC)

Generic

Without a trademark; general.

Trade Name

Given by the manufacturer. Trademarked

Tablet

Powders pressed to pill for

Pill

Solid sheet of drug cut into easy swallow shapes.

Gels

Medication in a liquid or gel form

Gelatin Capsule

A carrier with drug inside. Helps for time delay or taste of the drug

Sublingual Spray

Liquid spray placed under the tongue

Suspensions

Heterogeneous mixtures with large, often visible solutes that tend to settle out. Needs to be shaken to ensure patient also gets the drug (solutes that settle out)

Gases

No definite shape or volume; like oxygen

Intramuscular Injection (IM)

Needle placed in the middle of a large muscle. Needle is administered 90 degree angle to the skin

Subcutaneous Injection (SubQ)

Drug delivered in fat layer of the skin. Needle is 45 degree angle to the skin

Intravenous (IV)

The fastest and most accurate way to get drugs into circulation. Medication administred straight into a vein

Oral (PO)

Most medications take 20-30 minutes to see benefits. Drugs like Tylenol and alcohol is absorbed very quickly

Rectal (PR)

Liquid, or gel form medication. Benefits in about 30 minutes for most drugs

Sublingual

Easy to give and relatively fast. Minutes into circulation

Given under the tongue

Inhalation

Second fastest way into circulation. Administered by inhaling medications.

Intraosseous (IO)

Needle into bone marrow of long bone. Just as fast as IV

Topical

Placed and absorbed through the skin like a nicotine patch

The 5 rights prior to drug administration

1) Right patient

2) Right drug

3) Right route

4) Right date

5) Right amount

You must check a drug at least two times which includes a final recheck right before administering the drug

Nitroglycerin Indication

Chest pain

Nitroglycerin Action

Smooth muscle dilation, dilates the coronary vessels and reduced the workload on the heart

Nitroglycerin Route

Sublingual, spray or dissolvable tablet

Nitroglycerin Dose

.4mg every 5 minutes up to three times

Re-check 2-3minutes after medication administration

Nitroglycerin Contraindications

Absolute: BP less than 90mmHg

Relative: BP less than 100mmHg

Max dose given, or unspecified tachycardia

Oral Glucose Indication

Hypoglycemia, low sugar levels in blood stream

Oral Glucose Action

Increases blood sugar

Oral Glucose Side effects

None in emergency.

Oral Glucose Route

Mucus membranes (oral or rectal)

Oral Glucose Dose

25-50 grams

Double dose if given rectually

Oral Glucose Contraindication

Do not give if patient is nauseated or vomiting. Do not give if patient is not able to follow instructions

Activated Charcoal Indication

Oral overdose/poisoning

Activated Charcoal Contraindications

Nausea/Vomiting, AMS (altered mental status), liquids, or ingestion of heavy metals or corrosive substances

Activated Charcoal Actuib

Stops absorption through GI tract

Activated Charcoal Route

Oral

Activated Charcoal Dose

25g to 50g or .5g/kg to 1g/kg

-If the patient vomits the first dose, it may be given once more

Epi-Pen Indication

Severe Allergic Reaction

-Dyspnea and lowering BP

Epi-Pen Contraindication

None in emergency

Epi-Pen Action

Increases heart rate, dilates the bronchioles (alpha-beta agonist)

Epi-Pen Side Effects

Tachycardia, anxiety

Epi-Pen Route

Intramuscular (IM) midshaft lateral thigh.

-If patient does not have leg(s) due to amputation, next choice is deltoid

Epi-Pen Dose

.3mg in Adult, .15mg in Pediatrics

Syrup of Ipecac Indication

Oral poisoning or overdose

-note: no longer given in emergency medicine but some daycares may use it, very rare

Syrup of Ipecac Contraindication

Nausea/Vomiting, AMS, consumed heavy metals or corrosive substances

Oxygen Indication

Hypoxia, dyspnea

Oxygen Action

Increases oxygen concentration

Oxygen Contraindications

None in emergency; but not advised in certain situations

Oxygen Route

Inhalation

Oxygen Dose

Depends on condition/device used

Albuterol Indication

Dyspnea due to bronchospasms (or congestion, does not reduce congestion, but congestion can be worse to due bronchospams)

Albuterol Contraindications

None in emergency, allergies

Albuterol Action

Beta 2 agonist (bronchodilation). Dilates smooth muscles in broncioles

Albuterol Side Effects

Anxiety, tachycardia, hypertension, shaking, N/V, dry mouth, sleeplessness

Albuterol Route

MDI or Nebulizer

Albuterol Dose

MDI: 180mcg (90mcg/puff; so 2 total puffs)

Nebulizer: 2.5mg/3mL

Aspirin Indication

Myocardial Infarction (MI)

Aspirin Contraindication

Allergic, do not give to kids under 12 with a fever, any suspected bleeding internal or external

Aspirin Action

Slows platelet clumping therefore reduces vessel blockages, reduces fever, pain, headaches and sore throat pain

Aspirin Dose

325mg in emergency. 82mg (baby aspirin) taken daily if recommended by doctor

Aspirin Route

Oral (chew and swallow)

Aspirin Side Effects

Bleeding

Closed Loop Communication

A communication technique used to prevent misunderstandings; the receiver confirms that the message has been received and understood by repeating back word for word

Example: Physician: give 325mg of Aspirin by mouth

EMT: Giving 325mg of Aspirin by mouth

Things to ask patient before giving drug:

1. May I give it to you?

2. Do you have any allergies?

3. Have you taken any recently?

5 drug rights

1. Right patient. 2. Right medication 3. Right area 4. Right dose. 5. Right time

Make sure you recheck a drug at least once before giving it