Chapter 12

How Medications Work

• Pharmacology is the science of —-.

• A medication is a substance used to:

  • Prevent or treat ——

  • Relieve ——

• Pharmacodynamics is a process by which —- works on the ——.

• Agonist: causes —— of receptors

• Antagonist: binds to a receptor and —- other medications or chemicals

  • — is an example

• Dose: —- of medication given

• Action: the —— —- that a medication is expected to have on the body

• Pharmacokinetics: actions of the —- upon the —— or chemical

  • Onset of action

  • Duration

  • Elimination 

  • Peak action

drugs, disease, pain, medication, body, stimulation, blocks, narcan, amount, therapeutic, effect, body, medication, 

How Medications Work

• Factors affecting how a medication works:

  • Route of —-

  • — states

• Indications: —- or —- to take the medication

• Contraindications: —- effects; reasons or conditions to NOT take the medication

  • Absolute : medication must be avoided —- because it poses —- risks

  • Relative : caution is advised, —- —-

• Adverse effects

  • Unintended effects: any kind of —- effects

  • Untoward effects: specific type of unintended effects that is specifically ——

administration, shock, reasons, conditions, harmful, entirely, significant, side effects, unintended, harmful 

Medication Names

• Generic name: a simple, clear, —— name

  • Example: ibuprofen (Advil)

  • Example: Acetylsalicylic acid (aspirin)

  • Example: acetaminophen (Tylenol)

• Trade name: manufacturer’s —— name

  • One drug may have —- than one trade name.

  • Example: Tylenol, Aspirin

• Prescription medications

• Over-the-counter (OTC) medications

• Recreational drugs

• Herbal remedies

• Enhancement drugs

• Vitamin supplements

• Alternative medicines

nonproprietary, brand, more

Routes of Administration

• Enteral medications

  • Enter the body through the —- system.

• Parenteral medications

  • Enter the body by some —- ——

• Absorption is the process by which medications travel through body —- to the ——.

digestive, other means, tissues, bloodstreams

Routes of Administration

• Common routes of administration:

  • Per rectum (PR): by rectum

    • — rate of absorption

  • Oral or per os (PO): by —-

    • — rate of absorption

  • Sublingual (SL): under the —-

    • — rate of absorption

  • Subcutaneous (SC): —- the —-

    • — rate of absorption

  • Intramuscular (IM): into the —-

  • Inhalation: inhaled into the ——

  • Intranasal (IN): into the —- via a mucosal atomizer device (MAD)

  • Non-EMT routes….

    • Intravenous (IV): into the —-

    • Intraosseous (IO): into the —-

    • Transcutaneous (transdermal): —- the —-

rapid, mouth, slow, tongue, rapid, beneath, skin, slow, muscle, lungs, nostril, vein, bone, through,

Medication Forms

• The form of medication usually dictates the —— of administration.

• The manufacturer chooses the form to ensure:

  • Proper —- of administration

  • — of the medication’s release into the bloodstream

  • — on the target organs or body systems

• Tablets and Capsules

  • Capsules are — shells filled with powdered or liquid medication.

  • Tablets often contain —- materials that are mixed with the medication and compressed.

• Solutions and Suspensions 

  • A solution is a liquid —- of substances.

    • Will not —- by filtering or letting it stand

    • Can be given as an IV, IM, or SC injection

  • A suspension is substance that does not —- well in liquids.

    • Will —— if it stands or is filtered.

• Metered-Dose Inhalers 

  • Liquids or solids broken into small enough droplets or particles may be inhaled.

  • A metered-dose inhaler (MDI) directs such substances through mouth into lungs.

  • Delivers the —- amount each time

route, route, timing, effects, gelatin, other, mixture, separated, dissolve, separate, same

Medication Forms

• Topical Medications

  • Include lotions, creams, and ointments

  • Applied to skin —- and affect only that —-

  • Examples

    • Lotion: calamine lotion

    • Cream: hydrocortisone cream

    • Ointment: Neosporin ointment

• Transcutaneous / Transdermal Medications 

  • Designed to be absorbed —— the skin

  • Usually in the form of ——

  • Also referred to as —-

  • May have —- effects

  • If you touch the medication with your skin, you will absorb it just like the patient.

• Gels

  • Semiliquid

  • Administered in capsules or through plastic tubes

  • Example: oral —- for patient with diabetes

• Gases for Inhalation

  • Usually delivered through a —— mask or —- —-

  • Outside the operating room, most commonly used is —-

surface, area, through, patches, transdermal, systemic, glucose, nonrebreathing, nasal cannula, oxygen 

General Steps in Administering Medication

• Medications should be administered only under the authorization of —- ——.

  • unless they are a part of —- ——

• Follow the “——” of medication administration

  • Medication —- almost always result from failure to follow these “rights.” 

• Circumstances in which medications may be administered:

  • —-assisted administration

  • —-assisted administration

  • —-administered medications

• Determined by:

  • State and local ——

  • — —

medical control, standing orders, rights, errors, peer, patient, EMT, protocols, medical control 

Oral Medications

• Confirm that the patient has a patent —- and is able to —-, and then instruct the patient to swallow or chew the medication. 

• Oral glucose

  • A sugar that cells use for energy

  • Treats —-

  • EMTs give it only by —-.

  • Do not give to an —- patient or one who cannot protect the —-.

• Aspirin

  • Reduces fever, pain, and inflammation… EMTs only give this for — —-

  • Inhibits —- aggregation 

    • Useful during heart attack

  • Contraindications

    • — to aspirin

    • — damage

    • — disorder

    • —

    • Should not be given to — 

airway, swallow, hypoglycemia, mouth, unconscious, airway, heart attack, platelet, hypersensitivity, liver, bleeding, asthma, children 

Sublingual Medications

• Advantages

  • Easy to advise patients

  • — absorption

• Disadvantages

  • Constant evaluation of the —-

  • Possible —— 

  • Not for —- or —- patients

quick, airway, choking, uncooperative, unconscious

Sublingual Medications

• Nitroglycerin

  • Can be absorbed through the —- … must always wear —-

  • Relieves —- pain (cardiac patients)

  • Increases —- —-

  • Relaxes and —- veins

  • Before administering:

    • Check —- —- (do not administer if BP is low)

      • Make sure systolic is above —-

    • Obtain —- to administer.

  • Possibility of MI, if no relief

  • Should not be used with —- —- medications

    • Currently not a problem

  • May cause mild ——

  • Administration by tablet 

    • Sublingually under the —-

    • Slight —- or —-

    • — is important … nitroglycerin is only good for ~30 days after opening bottle and exposing to air

  • Administration by metered-dose spray

    • Better for — as bottle remains completely sealed

    • On or under —

    • One spray = one — 

skin, gloves, angina, blood flow, dilates, blood pressure, 120, order, erectile dysfunction, headache, tongue, tingling, burning, storage, storage, tongue, tablet

Sublingual Medications

• Nitroglycerin Administration considerations (for both tablet and spray):

  • Wait —- minutes before repeating dose.

  • Monitor —- signs , especially ——

  • can only give —- doses

  • Wear —-.

  • Know local protocols.

5, vital, blood pressure, 3 gloves,

Intramuscular Medications

• Advantages

  • Quick, easy access without using —-

  • Stable blood flow to ——

• Disadvantages

  • Use of a —- (and subsequent pain)

  • Patients may fear pain or injury.

vein, muscles, needle

Intramuscular Medications

• Epinephrine

  • Controls ———- response

  • — medication for delivery IM

  • Also called ——, released inside the body under ——

  • Sympathomimetic (—- nervous system)

  • — heart rate and — blood vessels

  • Do not give to patients with —-, —-, —-, or —-.

  • May be delivered with an auto-injector to treat life-threatening ——

• Naloxone (narcan) 

  • Used to reverse the effects of an —- overdose

  • Important considerations:

    • Consult medical direction.

    • Effects may not last as long as opioids; —- doses may be necessary

    • Can cause severe —— symptoms

    • Consider your —-.

fight or flight, primary, adrenaline, stress, sympathetic, increases, constricts, hypertension, hypothermia, MI, wheezing, anaphylaxis, opioid, repeated, withdrawal, safety

Intranasal Medications

• Naloxone (Narcan)

  • The most —- technique for naloxone administration is via the intranasal route. 

common

Inhalation Medications

• Oxygen

  • All cells need it to survive.

  • Generally administered via:

    • — mask 

    • — — 

• MDIs and nebulizers

  • Liquid turned into —- or —-

  • Medication breathed in and delivered to —-

  • — absorption rate 

  • — route to access

  • Portable

• Use a spacer to avoid spray misdirection

  • Fits over the —- like a sleeve 

  • Patient sprays the prescribed dose into the chamber and then breathes in and out of the mouthpiece. 

  • Especially useful with young children

• Small-volume nebulizers 

  • — to use than MDIs

  • Take — to deliver medication

  • Require an — air or oxygen source

  • More effective in patients with — to — respiratory distress

  • Can be used while a patient is on —- and during —-mask ventilation

nonrebreathing, nasal cannula, mist, spray, alveoli, fast, easy, inhaler, easier, longer, external, moderate, severe, CPAP, bag

Patient Medications

• Patient assessment includes finding out which —- the patient is taking.

  • Provides vital —- to the patient’s condition

  • — treatment

  • Will be useful to the emergency department

• Do not underestimate the importance of obtaining a thorough medication history.

• Medications are often —- taken as prescribed.

• Medications may —- the clinical presentation.

medications, clues, guides, , not, alter, 

Medication Errors

• Inappropriate use of a medication that could lead to patient —-

• May be possible to minimize errors if —— are understood

• Ensure the —- does not contribute to errors. 

• If a medication error occurs:

  • Provide appropriate patient care.

  • Notify medical control.

  • Follow protocols.

  • Document thoroughly, accurately, and honestly.

  • Talk with your partner, supervisor, or medical director. 

harm, circumstances, environment 

Pharmacology is defined as the study.science of —- and —-

drugs, medicine 

Which of the following statements regarding medications is FALSE?

• Many medications are known by different names.

• Some medications affect more than one body system.

• Over-the-counter drugs must be prescribed by a physician.

• EMTs should ask about any herbal remedies or vitamins that the patient may be taking.

over the counter drugs may be prescribed by a physician 

Which of the following routes of medication administration has the fastest effect?

Oral

Intravenous

Subcutaneous

Intramuscular

intravenous 

When administered to a patient, a metered-dose inhaler will deliver the —- dose each time

same

You are managing a 62-year-old woman who complains of crushing chest pain. Her blood pressure is 84/64 mm Hg, and her heart rate is 110 beats/min. Medical control advises you to assist her in taking her prescribed nitroglycerin. After receiving this order, you should —— the patient’s —- —- to the —— and then confirm the ——

repeat, blood pressure, physician, order

Activated charcoal is indicated for patients who have ingested certain drugs and toxins because it —- to chemicals in the —- that —- absorption

bind, stomach, delay

With regard to pharmacology, the term “action” refers to the:

ability of a drug to cause harm.

ability of a drug to produce side effects.

amount of time it will take the drug to work.

expected effect of a drug on the patient’s body.

expected effect of a drug on the patient’s body 

Which of the following patients is the BEST candidate for oral glucose?

Conscious patient who is showing signs of hypoglycemia

Unconscious diabetic patient with a documented low blood sugar

Conscious diabetic patient suspected of being hyperglycemic

Semiconscious patient with signs and symptoms of low blood sugar

conscious patient who is showing signs of hypoglycemia

Epinephrine is given to patients with anaphylactic shock because of its effects of: —- and ——

bronchdilation and vasoconstriction

The process by which medications travel through body tissues until they reach the bloodstream is called

absorption