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GENERIC NAME: ONDANSETRON (on·dan·se·tron)
- Brand name: Zofran
- CLASS: Antiemetic agent (an·ti·e·met·ic)
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Drugs used to combat nausea and vomiting
Antiemetic
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GENERIC NAME: PHENYLEPHRINE (fen·e·eph·rine) NASAL SPRAY 0.5%
- BRAND NAME: Neo-synephrine Nasal Spray 0.5%
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CLASS: Topical vasoconstrictor
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GENERIC NAME: OXYTOCIN
- BRAND NAME: Pitocin, Syntocin
- CLASS: Pituitary hormone,polypeptide, uterine stimulant
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GENERIC NAME: SODIUM BICARBONATE 8.4%
- BRAND NAME: Sodium Bicarbonate 8.4%
- CLASS: Buffer
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Metric units of weight:
1 gram (gm) =
1,000 milligrams
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Metric units of weight:
1 milligram (mg)=
1,000 micrograms (mcg)
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The ability of a medication to produce the desired effect; to initiate or alter cell activity
Efficacy
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The study of the bodily absorption, distribution, metabolism, and excretion of drugs; medication or chemical following adminstration
Pharmacokinetics
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A branch of pharmacology dealing with the reactions between drugs and living systems
PHARMACODYNAMICS
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Define PHARMACOLOGY
The scientific study of how various substances interact with or alter the function of living organisms
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Who is given the enforcement authority for rules requiring that new drugs were safe and pure; and remains responsible for approving new meds and removing unsafe meds
United States Food and Drug Administration (FDA)
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Medications used as "off-label" means:
- For a purpose not approved by the FDA
- Doses different from recommended
- Administered by route not approved by FDA
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Who can approve "off-label" medications to be administered
- Service medical director
- Agency/Regional protocol
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Paramedics need to be familiar with the rules and regulations implemented under what act
- The Controlled Substance Act of 1970
- The Comprehensive Drug Abuse Prevention and Control Act
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Reliable sources of medication information available to paramedics
USP-NF United States Pharmacopeia-National Formulary
PDR Physicians' Desk Reference
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Medication information is typically compiled in a format called
- Medication monograph
- or Medication profile
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What is the issue paramedic may face when using the AMA (American Medical Association) resource
Not every medication has received FDA approval
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The recommended temperature range for the storage of most medications used in the prehospital setting
15C to 30C (55F-86F)
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In regards to medication security Controlled substances require:
- Additional security
- Record keeping
- Disposal precautions
- Locked storage or held by on-duty EMS provider
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EMS agencies and individual paramedics are jointly responsible for adhering to all:
- Federal
- State
- Local regulations
- regarding the security and accountability of controlled substances
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Describe Schedule I medications
May not be prescribed, dispensed, used, or administered for medical use
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Description of controlled substances
High abuse potential
No recognized medical purpose
- Schedule I
- (Heroin, Marijuana, LSD)
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All Schedule II through V medications require
- Locked storage
- Significant record keeping
- Controlled wasting procedures
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The human body simultaneously begins the process of what following adminstration
- Absorbtion
- Distribution
- Biotransformation
- Elimination
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The action of the body on a medication is known as
Pharmacokinetics
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What initiates or alters a celluar activitiy by attaching to receptor sites, prompting a cell response
Agonist medications
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Medications are developed to reach and bind with
Particular receptor sites of target cells
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Receptors that are activated naturally within the body and by the presence of medications and chemicals abosored into the body
Endogenous chemicals
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Exogenous means
Originating outside the organism (body)
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Bicatbonate ions are able to bind with excess hydrogen (H+) ions, raising the ______ and decreasing the _______ of various body fluids
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Medications distribute into three primary types of body substances following administration
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Who has the lowest percentage of body protein
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What type of medication dissolves blood clots in arteries
Fibrinolytics
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Classification of drugs contains potent antiseizure, anxiolytic (antipanic) ,and sedative properties
Benzodiazipines
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It is recommended to administer 2 to 2.5 times the IV dose when utilizing what route
Endotracheal
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The concentration of a medication required to initiate a cellular response?
Potency
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When two medications with similar effects combine and the resulting sum is greater than the sum of the effects of the medications
Synergism
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The name for a drug as it is listed in the United States Pharmacopeia (USP)
The official name
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What are the components of a drug profile 1-6
- Names
- Category/Class
- Use/indications
- Mechanism of action (Pharmacodynamics)
- Pregnancy risk factors
- Contraindications
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What are the components of a drug profile 7-12
- Available forms
- Dosages
- Admin & monitoring considerations
- Potential incompatibility
- Adverse effects
- Pharmacokinetics
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Common adverse effects:
- Nausea
- Vomitting
- Sedation
- Palpitations
- Hyper/Hypotension
- Brady/Tachcardia
- Respiration depression
- Dizziness
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The concentration of medication at which initiation or alteration of cellular activity begins
Threshold level
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The threshold dose is lower for medications with
Higher potency
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Fat and lipid soluble medications require higher weight-based doses in elderly people because
Their body fat percentage & increased fat distribution
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The weight-based dosing is determined by
The quantity of medication multiplied by the patients weight in kilograms
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Data regarding the percentages of body water, fat, and protein at various ages become less reliable as
Obesity and malnutrition affect society
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Ability of a medication to bind with a particular receptor site
Affinity
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Agonist effects of:
Alpha (a)-1
Vasoconstriction of arteries and veins
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Agonist effects of:
Alpha (a)-2
- Insulin restriction
- Glucagon secretion
- Inhibition of norepinephrine release
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Agonist effects of:
Beta (b)-1
- Increased heart rate
- Increased myocardial contractility (inotropic effect)
- Increased myocardial conduction (dromotropic)
- Renin secretion for urinary retention
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Agonist effects of:
Beta (b)-2
- Bronchus and bronchiole relaxation
- Insulin secretion
- Uterine relaxation
- Arterial dilation in certain key organs
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Agonist effects of:
Dopaminergic
Vasoldilation of renal and mesenteric arteries(Numeros receptor subtypes exist)
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