Chapter 10

10: General Pharmacology

Cognitive Objectives 4-1.1 Identify which medications will be carried on the unit. 4-1.2 State the medications carried on the unit by the generic name. 4-1.3 Identify the medications with which the EMT-B may assist the patient with administering. 4-1.4 State the medications the EMT-B can assist the patient with by the generic name. 4-1.5 Discuss the forms in which medications may be found.

Objectives Affective 4-1.6 Explain the rationale for administration of medications. Psychomotor 4-1.7 Demonstrate general steps for assisting the patient with self-administration of medications. 4-1.8 Read the labels and inspect each type of medication.

General Pharmacology • You will be responsible for administering certain drugs. • You will be responsible for assisting patients to self-administer other drugs. • Not understanding how medications work places you and the patient in danger.

Pharmacology Definitions (1 of 2) • Pharmacology – The science of drugs, including their ingredients, preparation, uses and actions on the body • Dose – Amount of medication given • Action – Therapeutic effects expected on the body

Pharmacology Definitions (2 of 2) • Indications – Therapeutic uses for a particular drug • Contraindications – Conditions in which a medication should not be given • Side effects – Actions of a drug other than the desired ones

Medication Names • Trade name – Brand name given by manufacturer • Generic name – Original chemical name

• Prescription drugs – Given by pharmacists according to doctor’s order • Over-the-counter (OTC) drugs – Available without a prescription

Routes of Administration (1 of 3) • Intravenous (IV) injection – Injected directly into the vein • Oral – Taken by mouth; enters body through digestive system • Sublingual – Placed under the tongue; absorbed by mucous membranes

Routes of Administration (2 of 3) • Intramuscular (IM) injection – Injection into the muscle • Intraosseous (IO) – Injection into the bone marrow • Subcutaneous (SC) injection – Injection into tissue between skin and muscle

Routes of Administration (3 of 3) • Transcutaneous – Medications absorbed through the skin • Inhalation – Medications inhaled into the lungs • Per rectum (PR) – Administration by rectum

Dosage Forms (1 of 4) • Tablets – Materials mixed with medication and compressed under pressure • Capsules – Gelatin shells filled with powdered or liquid medication

Dosage Forms (2 of 4) • Solutions – Liquid mixture of one or more substances • Suspensions – Mixture of fine particles distributed throughout a liquid by shaking

Dosage Forms (3 of 4) • Metered-dose inhaler – Miniature spray canister, used to direct medication through the mouth into the lungs • Topical medications – Lotions, creams, and ointments applied to skin

Dosage Forms (4 of 4) • Transcutaneous medications – Designed to be absorbed through the skin • Gels – Semi-liquid substances administered orally • Gases for inhalation – Oxygen

Medications Carried on EMS Unit

Oxygen • Required by all cells of the body • Administered as a gas for inhalation • Ignites easily, requiring caution near sources of ignition

Activated Charcoal • Suspension used to absorb ingested poisons • Often combined with a laxative • Administered orally as a suspension

Oral Glucose • Glucose is used by cells for energy. • Patients with low blood glucose are hypoglycemic. • It is administered orally as a gel.

Aspirin • • • •

Reduces pain Reduces fever Reduces inflammation Cardiac uses

Assisted-Administration Medications

Epinephrine • Increases heart rate and blood pressure and decreases muscle tone of bronchi • Eases breathing problems in asthma or allergic reactions • May be delivered by MDI, SC, or IM

Administering Epinephrine by Injection • Sterilize skin. • Insert needle and draw plunger back. • Inject medication. • Dispose of needle.

Metered-Dose Inhaler • Medication should be delivered as the patient is inhaling. • Device may include spacer.

Nitroglycerin • Increases blood flow by relieving spasms and causing arteries to dilate • May decrease blood pressure • Available in tablet or spray

General Steps to Administer Medications (1 of 2) • Obtain orders from medical control. • Verify proper medication and prescription. • Verify form, dose, and route of the medication. • Check expiration date and condition of the medication.

General Steps to Administer Medications (2 of 2) • Reassess vital signs, especially heart rate and blood pressure, at least every 5 minutes or as the patient’s condition changes. • Document

Patient Medications • Clue you in to patient conditions • Especially helpful when patient has altered mental status • Include over-the-counter medications and dietary supplements