Principles of Pharmacology (Ch. 18)

What are the seven medications that an EMT can administer

1. Aspirin

2. Oral Glucose

3. Oxygen

4. Prescribed Bronchodilator Inhaler

5. Nitroglycerin

6. Epinephrine auto-injector

7. Naxolone

Aspirin, when to give when not to give

We give aspirin to people with chest pain, because it can reduce the clot causing them problem.

We don’t give aspirin to someone with aspirin allergies or who has GI bleeding.

What is activated charcoal for

It absorbs some poisons preventing them from being absorbed by the body

Who is Naxolone for?

Naxolone (trade name Narcan) is for narcotic overdoses.

Nitroglycerin

What’s the pathway?

What are contraindications?

The pathway is absorbed (spray) or dissolved (pill) under the tongue. If swallowed it will be neutralized by the stomach.

Erectile dysfunction medicine. (women sometime take Cialis also)

Who is Epinephrine Auto-Injectors for?

Who is it for?

What are the differences between the two trade names?

It’s for anaphylaxis caused respiratory distress.

Epi-Pen is just an auto injector. Auvi-Q gives voice instructions.

What are Force Protection Medications

They protect against chemical weapon attacks.

What are the 3 names that drugs have?

1. Chemical Name

2. Generic Name

3. Trade/Brand Name

What information is needed to know when giving medication to a patient

1. Indications

2. Contraindications

3. Side Effects

4. Untoward Effects

5. Form of medication

6. Route of medication

What are the 5 Rights?

1. Right Patient. Was the medication prescribed (previously or by medical direction) to this patient?

2. Right Time. Is it appropriate to give this medication under these circumstances?

3. Right Medication

4. Right Dose

5. Right Route

Identify the basic route for each.

• Inhaled. Absorbed through alveoli.  

• Intranasal. Spray medication with an atomizer. Can be strong. 

• Intramuscular. What’s the problem?

• Subcutaneous. Where does it delivered?

• Intraosseous (IO). Where does it deliver?

• Endotracheal. Where does it deliver? How effective is it?

Inhaled medications are absorbed through the alveoli.

Intranasal medications use an atomizer

Intramuscular are prone to higher complication rates.

Subcutaneous are delivered into the skin. Have slower absorption.

Intraosseous. Delivers into bone marrow.

Endotracheal. It’s sprayed into a tube which is inserted into the trachea. Recent evidence has called it’s effectiveness into question, still used as a last resort though.

What are pharmacodynamics?

What are the two considerations the text pointed out?

Study of the effect of medication on the body.

1. Children don’t need as much medication

2. Geriatric patients can’t eliminate the medication as well.

When should reassessment occur?

What should documentation include?

1. Reassessment should occur immediately after the medication was given and should be repeated frequently.

2. 4 Rights which aren’t Right Patient (sorta. time is different) + effects. Time of administration, medication administered, dosage, route, and then also any effects noted (in condition and vitals).

What’s the book that EMTs carry with them and what does it have?

It’s a pocket guide.

It’s a list of the most common medications and a general category of that medication

Types of IV

Components of IV

Types: Bag and Port

1. Drip Chamber

   1. Micro (or mini) drip. Has a column contained inside the tube.

      1. 60 small drops = 1 cm³ = 1 mL

   2. Macro drip. No column inside the tube.

      1. 10-15 large drops = 60 small drops

2. Flow regulator. Located below drip chamber. Can stop, start, or control flow.

3. Drug/Needle Port. Insertion point for medication.

4. Extension Set. Incase extra wiring is needed, can help when handling patient.

What to do if an end of the IV touches a surface?

Swap out for a new IV because you risk exposing the patient to germs through IV which is dangerous.

How to set up IV for the ALS

1. Remove wrapper from bag, check to see if bag contains desired fluid, check expiration date, check to make sure the fluid is clean, squeeze the bag to check for leaks.

2. Select the correct set, uncoil the tubing without letting ends touch any surface.

3. Connect extension set if necessary.

4. Make sure flow regulator is closed

5. Connect everything

6. Open flow regulator to get air bubbles out. Turn off flow then replace cap.

What are problems that can occur with IV?

1. Constricting band might be left on

2. Tubing might kink, flow regulator might be shut, clamp might be closed.

3. Gravity might be working against the path.

4. Drip chamber might overfill.

What is KVO

Refers to the rate required to “Keep the Vein Open”

• 30 small drops per minute micro

• 10 drops per minute macro

Yeah, the rates don’t make that much sense, but I think the infrequency of the macro drips probably requires more volume.

Explain terms:

Runaway IV

Infiltrated IV

Runaway IV refers to when the flow rate is too fast.

Infiltrated IV is when with IV you’ve punctured a vein or came out the other side, either way causes bleeding and medicine to go into surround tissue potentially damaging it.

What’s the type of IV catheter we use and what is it used for?

Heparin locks and saline locks

It’s used to maintain access for future medications.