Pharmacology Notes for Paramedics

Understanding Mild, Moderate, Severe Reactions

  • Mild Reaction:

    • Good blood pressure
    • Urticaria (hives) present
    • No difficulty in breathing
    • Treatment: Benadryl (Diphenhydramine)
    • 50 mg PO preferred over IV due to better absorption and pharmacokinetics
    • Higher dosage necessary due to loss through absorption and distribution

  • Moderate Reaction:

    • Similar to mild but with difficulty breathing
    • Good blood pressure
    • Requires additional treatment:
    • Benadryl can still be given
    • Bronchodilator (e.g., epinephrine)
      • Use 3 ml of 1:10,000 epinephrine to avoid overdose (3 mg if using 1:1,000)
Pharmacokinetics and Bioavailability
  • Key Concepts:
    • Pharmacokinetics: Includes absorption, distribution, biotransformation, and elimination of drugs
    • Bioavailability: IV route 100% bioavailability, while oral routes have losses due to metabolism
Dosing Calculations
  • Calculate required dosing carefully, especially for IV medications
    • For instance, ( 1\text{ mg} ) in ( 1\text{ ml} ) means ( 0.3\text{ ml} ) for a dose of ( 0.3\text{ mg} )
  • Mistake often made when miscalculating milligrams to milliliters; decimal placement matters
Drug Schedules and Regulations
  • Schedule Drugs:
    • Schedule I: No accepted medical use (e.g., heroin, marijuana)
    • Schedule II: High potential for abuse; used by healthcare providers (e.g., opioids)
    • Schedule III and IV: Lower potential, but still controlled; used in emergency settings (e.g., ketamine, benzodiazepines)
  • Be cautious about dosing, documentation and legal implications
Medication Interaction and Effects
  • Synergistic Effect: Two drugs together produce a greater effect than alone
  • Potentiation: When one drug enhances the effect of another (e.g., benzodiazepines with alcohol)
  • Antagonism: When one drug counteracts another
Case Studies and Examples
  • Discussed the dangers of certain drug combinations (like benzodiazepines and alcohol) leading to enhanced effects or toxicity
Drug Testing and Legal Implications
  • Drug testing is mandatory following incidents; potential issues arise with THC and medical marijuana
  • Importance of maintaining proper documentation to avoid legal repercussions
Conclusion and Exam Preparations
  • Emphasize understanding the knowledge of drugs administered, their side effects, and protocols for treatment
  • Review key terms, dosing strategies, and the implications of drug interactions for the upcoming exams
  • Know the rankings of shock types and their treatment protocols as vital for emergency care
General Recommendations
  • Always be cautious with medication dosages and patient responses, especially in emergency situations
  • Continuous education on pharmacology and patient care remains critical as new protocols may emerge.