Pharmacology - PA State Psychomotor

agonist

binds to a receptor and activates it

Antagonist

binds to a receptor and blocks other medications or chemicals

Enteral Medications

enter the body through the digestive system

• pill or liquid form

• usually non-emergency, absorbed slowly

Parenteral Medications

enter the body through means that are not the digestive system

• liquid form, needle/syringes

• absorbed quickly and more predictable and measurable response

Per R3ctum

easy to administer and provides reliable absorption

PO

per oral (by mouth)

max 1 hr for absorption

IO

intraosseous, into the bone

Inhalation

medication inhaled into the lungs

SL

sublingual, under the tongue

ex. nitroglycerin

Transcutaneous/Transdermal

through the skin

Rights (9)

• pt

• medication and indication

• dose

• route

• time

• education

• refuse

• response and evals (after)

• documentation

Cross Check

saying and confirming all rights with partners before administering medication

Oxygen

• usually delivered through NRB, nasal cannula, BVM, nebulizer

• reveres hypoxia

• lungs have O2 to distribute

• 28-100% delivered

Narcan Action

reverses respiratory depression secondary to opioid overdose

Opoid antagonist!!

Narcan Indiation

opioid poisoning

Opioid Poisoning

pupils very small, ventilate first and foremost, narcan only shortens the time needed to ventilate

strong bounding pulse

diaphoresis, tachycardia

vitals should get better after narcan administration

Narcan contra

hypersensitivity (relative)

Narcan routes

IM or IN

Narcan Adverse effects

nausea/vomiting, complete physical withdrawal, agitation, headache

Narcan dose

4mg IN with atomizer into right nostril

2mg IM autoinjector

must ventilate with BVM after

Narcan Desired effect

return of respiratory drive

reassess after 2-3 minutes, additional doses may be necessary

Bronchodilators (3)

expands bronchi

• albuterol

• duoneb

• levalbuterol

Albuterol action

stimulates nervous system causing bronchodilation

• Beta-2 Agonist, bronchodilator, fast acting medication

Albuterol indication

respiratory distress

need to open air passages in the lungs, acute asthma attacks, etc

• wheezing will usually be including

Albuterol contra

relative: hypersensitivity, tachycardia, CHF

Albuterol routes

inhalation via metered dose inhalers and nebulizers

Albuterol adverse effects

tachycardia, chest pain

Albuterol Interactions

hypertension, tachycardia, anxiety, restlessness

Albuterol Dose

1-2 inhalations, 3mg, wait 5 minutes

via metered dose inhaler or nebulizer

2.5 mg albuterol in Nebulizer

90 mcg metered dose inhaler of albuterol

Duoneb Dose

2.5 mg albuterol

0.5 mg Ipatropium

via nebulizer

Nebulizer

6-8 LPM

Oral Glucose Action

when absorbed, provides glucose for cell energy use

Oral Glucose Indications

hypoglycemia - low blood glucose level

BGL<80

Oral glucose contra

dec level of consciousness, unable to protect own airway

Oral glucose routes

PO

Oral glucose adverse effects

none, temp may be affected but the patient should eat a proper meal after

oral glucose dose

1 tube, 15 g

under tongue inside cheek

oral glucose desired effect

increase BGL

Epinephrine Action

Stimulates nervous system, hormone and neurotransmitter

sympathomimetic agent

Epinephrine Indications

Anaphylactic Reaction, bronchoconstriction

Epinephrine Contra

Chest pain of cardiac origin, Hypothermia, Hypertension (relative)

Epinephrine Dose

0.3 mg adult

0.15 mg child

Epinephrine Route

IM

Epinephrine desired effect

bronchodilation, vasoconstriction

Epinephrine side affects

anxiety, tachycardia, headache

Nitroglycerin Action

Dilates Blood vessels, which helps afterload on the heart (drug class is nitrates)

Nitroglycerin Indications

Chest pain of cardiac origin

Nitroglycerin Contra

ED drugs in last 24 hours (consider men and women)

Systolic less than 100

ED drugs (3)

viagra, levitra, cialis

Nitroglycerin Routes

Sublingual, tablet or spray

Nitroglycerin Dose

0.4 mg

Nitroglycerin Desired effect

chest pain relief

Nitroglycerin Adverse Effects

Headache, burning under tongue, hypotension, nausea

aspirin indications

cardiac chest pain

aspirin contradiction

allergies, GI bleed, liver/kidney issues

aspirin action

to prevent clotting in the blood vessels

aspirin dose

81 mg, up to 324 mg (4 pills)

aspirin route

oral chewable

aspirin side affects

nausea and bleeding