1. Chapter 16
General Pharmacology

2. Case History
You arrive at the home of a patient with chest pain. The patient informs you that her doctor has prescribed nitroglycerin, which she has never taken before.

3. Overview Medications can be lifesaving.
EMTs administer or assist in medication administration to:
Provide a clear airway
Ensure adequate oxygenation
Improve perfusion
Correct low blood glucose
Prevent absorption of poisons

4. Medication Forms Used by the EMT-Basic
Compressed powders or tablets (e.g., nitroglycerin)
Liquids for injection (e.g., epinephrine)
Gels (e.g., glucose)
Suspensions (e.g., activated charcoal)
Fine powder for inhalation
Gases (e.g., oxygen)
Aerosol or spray (e.g., nitroglycerin)

5. Medication Names Generic Trade Name listed in the U.S. Pharmacopoeia
Name assigned to drug before it becomes officially listed
Usually a simple form of the chemical name
Trade
Brand name manufacturer uses in marketing the drug

6. Medication Terms Indications Contraindications
Most common uses of the drug
Contraindications
Situations in which a drug should not be used
May cause harm to the patient
May have no effect in improving the patient's condition

7. Medication Terms Dose Administration Actions
How much of the drug should be given
Administration
Route by which the medication is administered
Actions
Desired effects a drug has on the patient/body systems

8. Medication Terms Side effects
Actions of a drug other than those desired

9. Dose Metric Conversions
Kilograms Grams Milligrams Micrograms
1 kg 1000 g
1 g mg
1 mg g

10. Dose Metric Conversions
Liters Milliliters
1 L mL
0.5 L mL
0.1 L mL
0.01 L mL
0.001 L mL
1000 mL
1 L

11. Four “Rights” of Medication Administration
Right patient
Right drug
Right dose
Right route of administration

12. Reassessment Strategies
After drug administration, reassess patient for:
Therapeutic effects
Side effects
Noticeable changes in patient condition
Document time of administration
Document times of ongoing assessments
Vital signs
Changes in patient condition
Therapeutic or side effects

13. Pediatric Considerations
Dosages must be administered based on body weight.
Patient may have difficulty with inhalation.
Consider spacer or extension tubing
Patient may be reluctant to take medication.
Enlist patient/parent cooperation

14. Geriatric Considerations
Patient may take several medications.
Prone to adverse effects, drug interactions, inadvertent overdose
When possible, transport all medications to hospital with patient.
May help hospital staff diagnose and manage patient condition

15. Medications Carried on the EMS Unit Activated Charcoal
Used for toxic ingestion
Binds to certain poisons
Prevents absorption
Not all brands are the same.
Some bind much more poison.
Consult medical direction about the brand to use

16. Medications Carried on the EMS Unit Oral Glucose
Used for altered mental status, suspected hypoglycemia
Absorbed in the oral mucosa
Provides needed glucose for patient with low blood sugar

17. Medications Carried on the EMS Unit Oxygen
Increases oxygen delivery to blood
Essential treatment for hypoxia and hypoperfusion
% of delivered oxygen (dose) determined by flow rates and delivery device

18. Medications EMT-Basic May Assist Prescribed Inhalers
Used to treat bronchoconstriction
Prescribed by patient’s physician
Administration is approved by medical direction and/or by local protocol.
May be carried in the ambulance in some EMS systems

19. Medications EMT-Basic May Assist Nitroglycerin
Used to treat ischemic chest pain
Dilates vessels to improve circulation through the coronary arteries
Decreases the workload of the heart by dilating peripheral vessels
Administered under the tongue by tablet or spray

20. Medications EMT-Basic May Assist Epinephrine
Used to treat severe allergic reaction
Blocks release of histamine
Increases vascular resistance to maintain blood pressure

21. Summary Medications play a critical role in EMS.
Care must be taken to assess patients to identify the need for medication.
Be familiar with the indications, contraindications, and side effects of administered medications.
Always contact medical direction and/or follow local protocols.
Remember the “rights” of medication administration.