General Pharmacology

Key Term Pharmacology The study of drugs, their sources, characteristics, and effects 2

Types of Medication Names All listed in U.S. Pharmacopoeia Generic name: epinephrine Chemical name: B- (e, 4 dihydroxyphenyl) amethylaminoethanol Trade name: Epi-Pen® 3

Overview of Medications Used by the EMT–B 4

Medications Carried on the EMS Unit Activated charcoal – is used to treat a poisoning or overdose when a substance is swallowed. It will absorb some poisons keeping the medication from being absorbed by the body. In order to use you MUST call medical control. Generally, charcoal should be given within 2 hours of ingestion of the poison or drug. 5

Medications Carried on the EMS Unit Oral glucose – is a form of glucose taken by mouth to treat a conscious patient with an altered mental status and a history of diabetes. NOT TO BE USED ON AN UNCONSCIOUS PATIENT!!! Administer the entire tube of glucose. 6

Medications Carried on the EMS Unit Oxygen – Pure Oxygen is used as a drug to treat any patient whose medical or traumatic condition caused them to be hypoxic or in danger of becoming hypoxic. List ways you would administer O2 with appropriate liter flow. 7

Medications Carried on the EMS Unit Epi Pen – Used to help constrict blood vessels and relax airway passages. Used by patients with severe allergic reactions (anaphylaxis) from things such as bee stings, food allergies, and medications. Refer to protocol. These may also be prescribed to patients. Adult dose: .3 mg Child dose: .15 mg 8

Medications Carried on the EMS Unit Injected with an auto-injector syringe on the thigh – intramuscular After injection, hold the syringe in place for 10 seconds to allow all the medication to get into the patient. Dispose of auto-injector into a SHARPS container. 9

Medications Carried on the EMS Unit Albuterol (Proventil) – opens up the airways (bronchodilator). Used with individuals having an asthma attack. Reduces airway resistance. For use on individuals age 1-65 with a history of asthma Administered through a nebulizer. Oxygen flow rate should be set at 6 lpm Dose is 2.5 mg 12

Medications Carried on the EMS Unit For patients with angina, myocardial infarction or congestive heart failure, medical control must be contacted prior to administration of albuterol. Side Effects of Albuterol Increased pulse rate Nervousness Tremors 14

Medications Carried on the EMS Unit Aspirin – given to patients suffering chest pain with a cardiac history. If patient has not taken aspirin and has no history of aspirin allergy and no evidence of recent gastrointestinal bleeding, administer chewable baby aspirin – 160mg to 325 mg 16

Medications Prescribed to Patients Prescribed inhaler – used by patients having difficulty breathing and who have diseases such as asthma, emphysema and chronic bronchitis. Nebulizer – medicine is delivered as a fine mist mixed with oxygen. Used to treat breathing problems such as asthma. Provides greater exposure to the medication. 17

Medications Prescribed to Patients Nitroglycerin – causes blood vessels to dilate. Used by patients with chest pain. Complication: Pt’s blood pressure may drop. If this happens: Stop administration of NTG Lie the pt. flat, elevate legs Reassess their vital signs 18

What you need to know when giving a medication

Indication Specific sign, symptom, or circumstance that makes it appropriate to administer a drug example: nitro for chest pain. 20

Contraindication Specific sign, symptom, or circumstance in which it would be inappropriate, or harmful, to administer a drug – example: giving nitro to a patient with a low blood pressure (hypotensive). 21

Side Effects Any action of the drug other than the desired actions Some side effects are predictable (e.g., headache as a side effect of nitroglycerin). 22

Before Giving ANY Medication You Should Be Able to Answer the Following Questions

Dose Actions Route How much should be given to a patient Desired effects on a patient Route How the medication is administered (i.e., orally, sublingually, by injection) 24

What the EMT–B Needs to Know About Medications ~~~~~~~~~~~~~~~~~~~~~~ Medications Come in Many Different Forms 25

Compressed Powders or Tablets Example – Nitroglycerine Used for chest pain 26

Used in allergic reactions Liquids for Injection Example – Epi Pen Used in allergic reactions 27

Example – Instant Glucose Used in diabetics Gels Example – Instant Glucose Used in diabetics 28

Activated Charcoal used in overdoses Suspensions Example – Activated Charcoal used in overdoses 29

Fine Powder for Inhalation Example – Albuterol used in Asthma Attacks 30

Used for patients with Dyspnea Gases – oxygen Used for patients with Dyspnea 31

Sublingual Spray (under the tongue) Example: Nitroglycerine Spray 32

Liquid that is vaporized – Nebulized Albuterol 33

Routes of Administration Orally - swallowed Sublingual – dissolved under the tongue Inhaled – breathed into the lungs (aerosol or inhaler) Intravenous – injected into the vein *** Intramuscular – injected into the muscle *** Subcutaneous – injected under the skin *** ***EMT-B CAN’T DO THESE PROCEDURES***

Steps to Take When Administering a Medication

If the order was received from on-line medical direction, confirm the order with the doctor and write it down. 2. Check to make sure the medication has not expired. 3. Ask yourself (the 4 Rights): a. Do I have the right patient? b. Is this the right medication? c. Is this the right dose? d. Am I giving this medication by the right route?

4. Document the time the medication was administered. 5. Document any changes, if any, in the patient’s condition following administration of the medication. 6. Repeat vital signs.

Review Questions 2. List the forms of medications. 3. List the four rights in medication administration. 4. Why must patients be reassessed after medication has been given? 38

STREET SCENES What additional patient history should you obtain? Should you let the patient take nitroglycerin? Why or why not? 39

STREET SCENES Are vital signs important if nitroglycerin is going to be taken by the patient? What information do you want to know about nitroglycerin? 40

STREET SCENES How should the nitroglycerin be administered? When should vital signs be taken again? 41

Sample Documentation 42