16)General Pharmacology

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16)General Pharmacology

  1. 1. General Pharmacology
  2. 2. General Pharmacology <ul><li>Pharmacology </li></ul><ul><ul><li>“Science that deals with origin/nature/chemistry/effects/use of drugs” </li></ul></ul><ul><li>Drugs </li></ul><ul><ul><li>“Chemical compounds that may be administered to someone as an aid in the assessment, treatment, or prevention of a disease.” </li></ul></ul><ul><ul><li>Relive, Control, Improve condition </li></ul></ul>
  3. 3. General Pharmacology On the Truck <ul><li>Drugs the EMT carries on the ambulance </li></ul><ul><ul><li>Oral Glucose </li></ul></ul><ul><ul><ul><li>Glucose gel that is administered po to pt with AMS/suspected hypoglycemia </li></ul></ul></ul><ul><ul><li>Activated Charcoal </li></ul></ul><ul><ul><ul><li>Residue of distillation of organic molecules (charcoal). </li></ul></ul></ul><ul><ul><ul><li>Treated to increase its absorption </li></ul></ul></ul><ul><ul><ul><li>Often used to treat OD/poison ingestion </li></ul></ul></ul>
  4. 4. Drugs the EMT can assist a pt with <ul><li>Prescribed by a physician and pt has them in his/her possession </li></ul><ul><li>Nitroglycerin (NTG) </li></ul><ul><ul><li>Works to reduce work of the heart </li></ul></ul><ul><ul><li>Reduces peripheral vascular resistance </li></ul></ul><ul><ul><li>Dilates Coronary Arteries </li></ul></ul><ul><ul><li>Used in chest pains/heart attacks </li></ul></ul><ul><li>Metered-Dose Inhaler (MDI) </li></ul><ul><ul><li>Controlled/precise dose of medication inhaled for resp emergencies </li></ul></ul><ul><ul><li>Used in asthmatic pts </li></ul></ul><ul><li>Epinephrine </li></ul><ul><ul><li>Hormone/catecholamine secreted from adrenal glands </li></ul></ul><ul><ul><ul><li>AKA: Adrenaline </li></ul></ul></ul><ul><ul><li>Increases sympathetic activity </li></ul></ul><ul><ul><ul><li>Increased heart rate/force, bronchodilation, etc </li></ul></ul></ul><ul><ul><li>Used to treat Anaphylaxis </li></ul></ul>
  5. 6. Drug Names <ul><li>Chemical </li></ul><ul><ul><li>Atomic/molecular structure </li></ul></ul><ul><li>Generic </li></ul><ul><ul><li>Abbreviated form of chemical name </li></ul></ul><ul><ul><li>U.S. Adopted Names (USAN) Council </li></ul></ul><ul><ul><li>NEVER capitalized </li></ul></ul><ul><li>Trade </li></ul><ul><ul><li>Copyright ® </li></ul></ul><ul><ul><li>ALWAYS CAPITALIZED </li></ul></ul><ul><li>Official </li></ul><ul><ul><li>USP/NF </li></ul></ul><ul><ul><li>Usually same as generic </li></ul></ul>Ethyl 1-methyl-4-phenylisonipecotate hydrochloride Meperidine hydrochloride Demerol hydrochloride ® Meperidine hydrochloride, USP
  6. 7. <ul><li>Generic Name Trade Name </li></ul><ul><li>Oxygen ---- </li></ul><ul><li>Activated Charcoal SuperChar </li></ul><ul><li>InstaChar </li></ul><ul><li>MDI’s </li></ul><ul><li>Albuterol Provent/Ventolin </li></ul><ul><li>Nitroglycerin Nitrostat </li></ul><ul><li>Epinephrine Epi Pen/Epi Pen Jr </li></ul><ul><li>Epinephrine Hydrochloride Adrenaline </li></ul>
  7. 8. Indications/Contraindications <ul><li>Indication </li></ul><ul><ul><li>A condition/disease for which a drug is expected to have a beneficial effect </li></ul></ul><ul><ul><li>The most common use of a drug in treating a condition </li></ul></ul><ul><ul><ul><li>i.e. Bronchodilators = Asthma </li></ul></ul></ul><ul><li>Contraindication </li></ul><ul><ul><li>Situation in which a drug should not be used b/c it may do harm to the pt or have no effect at all </li></ul></ul><ul><ul><ul><li>i.e. Pt c/o chest pain with hypotension No NTG (vasodilator) </li></ul></ul></ul>
  8. 9. Medication Forms <ul><li>Tablet/Compressed Powder </li></ul><ul><ul><li>NTG </li></ul></ul><ul><li>Liquid for injection </li></ul><ul><ul><li>Epi </li></ul></ul><ul><li>Gels </li></ul><ul><ul><li>Glucose </li></ul></ul><ul><li>Suspensions </li></ul><ul><ul><li>A preparation of finely divided undissolved substance dispersed in a liquid </li></ul></ul><ul><ul><ul><li>Activated Charcoal </li></ul></ul></ul><ul><li>Fine powder for inhalation </li></ul><ul><ul><li>MDI </li></ul></ul><ul><li>Sub-lingual spray </li></ul><ul><ul><li>NTG </li></ul></ul><ul><li>Liquid/Vaporized </li></ul><ul><ul><li>Nebulizers </li></ul></ul>
  9. 10. Administration Routes <ul><li>The method through which a drug is administered to a pt. </li></ul><ul><li>Oral/PO </li></ul><ul><ul><li>Requires swallowing by pt </li></ul></ul><ul><ul><li>Drug absorbed through GI tract into blood </li></ul></ul><ul><ul><ul><li>i.e. Activated Charcoal </li></ul></ul></ul><ul><li>Sublingual </li></ul><ul><ul><li>Beneath the tongue </li></ul></ul><ul><ul><li>Drug dissolves and passes through mucous membrane into blood vessels </li></ul></ul><ul><ul><ul><li>i.e. NTG </li></ul></ul></ul><ul><li>Inhaled </li></ul><ul><ul><li>Inhaled particles absorbed across vessels under mucous membranes </li></ul></ul><ul><ul><li>Have local effects </li></ul></ul><ul><ul><ul><li>i.e. MDI </li></ul></ul></ul><ul><li>Injected </li></ul><ul><ul><li>Sub Q- Subqutaneous-Just under the skin - Slow </li></ul></ul><ul><ul><li>IM- Intramuscular – Capillary beds – Faster </li></ul></ul><ul><ul><li>IV- Intravenous- Into veins – Fastest </li></ul></ul><ul><ul><ul><li>i.e. Epi </li></ul></ul></ul>
  10. 11. Dose <ul><li>Quantity of a substance to be given at one time. </li></ul><ul><ul><li>As in a specified amount of a medication </li></ul></ul><ul><ul><li>Typically in metric units </li></ul></ul><ul><ul><ul><li>i.e. 15 L/min </li></ul></ul></ul><ul><ul><li>Solids normally in g or mg </li></ul></ul><ul><ul><ul><li>1 g = 1000 mg </li></ul></ul></ul><ul><ul><ul><ul><li>i.e. 0.4 mg NTG </li></ul></ul></ul></ul><ul><ul><li>Liquids typically in g, mg, ug, / L , ml </li></ul></ul><ul><ul><ul><li>1 L= 1000 ml </li></ul></ul></ul><ul><ul><ul><ul><li>Epi 1 : 1,000 </li></ul></ul></ul></ul>
  11. 12. Therapeutic Dose <ul><li>Therapeutic Dose </li></ul><ul><ul><li>Dose of a med required to have the desired effect on a pt </li></ul></ul><ul><ul><li>Low enough to minimize side effects & toxic effects from too much drug </li></ul></ul>
  12. 13. Action and Side Effects <ul><li>Actions </li></ul><ul><ul><li>Desired effect/change a drug has on the body/organ </li></ul></ul><ul><ul><ul><li>i.e. Action of Supplemental O2 </li></ul></ul></ul><ul><ul><ul><ul><li>Increase O2 concentration in blood – Correct Hypoxia </li></ul></ul></ul></ul><ul><li>Side Effects </li></ul><ul><ul><li>Effects of a drug other than those for which the drug is being used </li></ul></ul><ul><ul><li>Can be undesirable/detrimental </li></ul></ul>
  13. 14. 6 Rights <ul><li>5 Rights must be present before you can assist a pt with their meds </li></ul><ul><ul><li>Right Pt </li></ul></ul><ul><ul><li>Right Med </li></ul></ul><ul><ul><li>Right Dose </li></ul></ul><ul><ul><li>Right Route </li></ul></ul><ul><ul><li>Right Date </li></ul></ul><ul><ul><li>Right Documentation </li></ul></ul>
  14. 15. Reassessment <ul><li>Repeat baseline vitals </li></ul><ul><li>On going assessment </li></ul><ul><li>Documentation of response +/- OR neutral </li></ul><ul><ul><li>Document: </li></ul></ul><ul><ul><ul><li>Time of administration of med(s) </li></ul></ul></ul><ul><ul><ul><li>Time of vitals </li></ul></ul></ul><ul><ul><ul><li>Time of reassessments </li></ul></ul></ul>
  15. 16. Special Considerations <ul><li>Peds </li></ul><ul><ul><li>Small body mass, therefore, adjust dosages </li></ul></ul><ul><ul><ul><li>Usually mg/Kg (2.2 lbs = 1 Kg) </li></ul></ul></ul><ul><ul><li>Difficult coordinating inhalation of MDI </li></ul></ul><ul><ul><li>Reluctant to take meds </li></ul></ul><ul><ul><li>Fast metabolism=Fast effect </li></ul></ul><ul><li>Elderly </li></ul><ul><ul><li>Multiple meds/multiple illnesses </li></ul></ul><ul><ul><li>May not be sure as to why they take the meds </li></ul></ul><ul><ul><li>More meds = greater chance of drug interaction </li></ul></ul><ul><ul><li>Slower metabolism of drugs </li></ul></ul><ul><ul><li>Drugs can provide clues to pt Hx </li></ul></ul><ul><ul><li>Transport meds with pt. </li></ul></ul>

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