1. GENERAL PRINCIPLES OF PHARMACOLOGY

2. Part 2 Topics  Anatomy & Physiology Related to Pharmacology  Common Prehospital Medications  Common Patient Scenarios  Common Patient Medications

3. Drugs Used to Affect the Nervous System

5. Central Nervous System Medications  Analgesics & Antagonists  Anesthetics  Anti-anxiety & Sedative-Hypnotic Drugs  Antiseizure or Anti-epileptic Drugs  Central Nervous System Stimulants  Psychotherapeutic Medications  Parkinson’s Medications

6. Autonomic Nervous System Medications (1 of 2)  Drugs Affecting the Parasympathetic System:  Cholinergics  Anticholinergics  Ganglionic Blocking Agents  Neuromuscular Blocking Agents  Ganglionic Stimulating Agents

7. Autonomic Nervous System Medications (2 of 2)  Drugs Affecting the Sympathetic System:  Adrenergic Receptors  Adrenergic Agonists  Adrenergic Antagonists  Skeletal Muscle Relaxants

8. Distribution of Sympathetic Post-Ganglionic Fibers

9. Sympathetic Division of Autonomic Nervous System

10. Physiology of an Adrenergic Synapse

13. Drugs Used to Affect the Cardiovascular System

14. Blood Flow Through the Heart

15. Cardiac Conductive System

16. Action Potential of Cardiac Contractile Tissue

17. Action Potential of Cardiac Pacing Cells

18. Reentrant Pathways

19. Classifications of Cardiovascular Drugs (1 of 2)  Antidysrhythmics:  Used to treat and prevent abnormal cardiac rhythms.  Antihypertensives:  Drugs used to treat hypertension.

20. Classifications of Cardiovascular Drugs (2 of 2)  Hemostatic Agents:  Drugs used to stop bleeding.  Antihyperlipidemic Agents:  Drugs used to treat high cholesterol.

21. Antidysrhythmics

22. Antihypertensives  Diuretics  Adrenergic inhibiting agents  Angiotensin converting enzyme inhibitors  Angiotensin II receptor antagonists  Calcium channel blockers  Direct vasodilators

23. Hemostatic Agents  Antiplatelets:  Drugs that decrease the formation of platelet plugs.  Anticoagulants:  Drugs that disrupt the clotting cascade.  Thrombolytics:  Drugs that act directly on thrombi to break them down.

24. Antihyperlipidemics  Drugs used to treat high blood cholesterol.  Examples:  Lovastatin (mevacor).  Simvastatin (zocor).

25. Drugs Used to Affect the Respiratory System

26. Antiasthmatic Medications

27. Drugs Used for Rhinitis and Cough  Nasal Decongestants  Antihistamines  Antitussives  Expectorants  Mucolytic

28. Drugs Used to Affect the Gastrointestinal System

29. Main Indications for GI Drug Therapy  Peptic Ulcers  Constipation  Diarrhea and Emesis  Digestion

30. Drugs Used to Treat Peptic Ulcer Disease (1 of 2)  H 2 Receptor Antagonists:  Cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), nizatidine (Axid).  Proton Pump Inhibitors:  Omeprazole (Prilosec), lansoprazole (Prevacid).

31. Drugs Used to Treat Peptic Ulcer Disease (2 of 2)  Antacids:  Aluminum, magnesium, or sodium compounds.  Anticholinergics:  Pirenzepine (Gastrozepine).

32. Drugs Used to Treat Constipation  Categories of Laxatives:  Bulk–forming (methylcellulose or Citrucel).  Stimulant (phenolphthalein or Ex-Lax).  Osmotic (Milk of Magnesia).  Surfactant (Colace).

33. Drugs Used to Treat Diarrhea  Although a nuisance, diarrhea is often a helpful process.  Specific or non-specific agents may be used.

34. Drugs Used to Treat Emesis  Antiemetics:  Medication used to prevent vomiting.  Serotonin Antagonists:  Zofran.  Dopamine Antagonists:  Compazine, Phenergan, Inapsine, Reglan.  Cannabinoids:  Marinol, Cesamet.

35. Drugs Used to Aid Digestion  Several drugs are available to aid digestion of carboyhydrates and fats.  Two such drugs are pancreatin (Entozyme) and pancrelipase (Viokase).

36. Drugs Used to Affect the Eyes

37.  Opthalmic drugs are used to treat conditions involving the eyes, primarily glaucoma and trauma.  Medications used to treat glaucoma are all aimed at reducing intraocular pressure (IOP). Examples include timolol (Timoptic) and betaxolol (Betoptic).  Tetracaine (Pontocaine) is a local anesthetic of the ester class.

38. Drugs Used to Affect the Ears

39.  Most drugs used to treat conditions involving the ear are aimed at eliminating underlying bacterial or fungal infections or at breaking up impacted ear wax.  Chlorampenicol (Chloromycetin otic).  Gentamicin sulfate (Garamycin).

40. Drugs Used to Affect the Endocrine System

42. Drugs Affecting the Pituitary Gland  Anterior Pituitary Drugs—The only conditions treated with these drugs are those associated with abnormal growth such as dwarfism.  Posterior Pituitary Drugs—The two drugs in this category are oxytocin and antidiuretic hormone.

43. Drugs Affecting the Parathyroid and Thyroid Glands  Parathyroid glands are primarily responsible for regulating calcium levels.  Hypothyroidism leads to decreased levels of calcium and Vitamin D.  Treatment is therefore through calcium and Vitamin D supplements.

44. Drugs Affecting the Adrenal Cortex  The Adrenal Cortex synthesizes and secretes 3 classes of hormones: glucocorticoids, mineralocorticoids, and androgens.  Two diseases typify the disorders associated with the Adrenal Cortex: Cushing’s disease and Addison’s disease.

45. Drugs Affecting the Pancreas  Diabetes mellitus is the most important disease involving the pancreas.  Insulin—a substance that decreases blood glucose level.  Glucagon—a substance that increases blood glucose level.

47. Oral Hypoglycemics  Orinase (chlorpropamide)  Glucotrol (glipizide)  Micronase (glyburide)

48. Hyperglycemic Agents  D50W is a sugar solution given intravenously for acute hypoglycemia.  Glucagon is indicated for emergency treatment when an IV is unobtainable.

49. Drugs Affecting the Female Reproductive System  Estrogens and Progestins  Oral contraceptives  Uterine stimulants and relaxants:  Brethine, Yutopar.  Infertility agents:  Clomid, Metrodin.

50. Drugs Affecting the Male Reproductive System  Testosterone deficiency:  Metandren.  Benign Prostatic Hypertrophy (BPH):  Proscare.

51. Drugs Affecting Sexual Behavior  L-dopa (Levodopa) has demonstrated increased libido as a side effect.  Sildenafil (Viagra) was approved in 1998 for patients suffering erectile dysfunction.  NOTE: If you treat a patient with chest pain who has taken Viagra recently, do NOT give nitroglycerin or any other nitrate.

52. Drugs Used to Treat Cancer

53.  Drugs used to treat cancer are called antineoplastic agents.  Examples include:  fluorouracil (Adrucil)  mechlorethamine (Mustargen)  vinblastine (Velban)  vincristine (Oncovin)

54. Drugs Used to Treat Infectious Diseases and Inflammation

55. Drugs Used to Treat Infectious Diseases and Inflammation (1 of 3)  Antibiotics.  An antibiotic agent may either kill the offending bacteria or so decrease the bacteria’s growth that the patient’s immune system can effectively fight the infection.  Antifungal Agents.  Fungi are parasitic microorganisms that cannot synthesize their own food.

56.  Antimicrobial and Antiparasitic Drugs.  Although most diseases treated with these drugs are uncommon in developed countries, they are leading causes of death in third-world countries.  They include malaria, leprosy, and helminthiasis. Drugs Used to Treat Infectious Diseases and Inflammation (2 of 3)

57.  Tuberculosis, caused by bacteria, is increasing in the United States.  NSAIDs (non-steroidal anti- inflammatory drugs)—Commonly used as analgesics and antipyretics.  Uricosuric drugs—Used to treat gout.  Serums, vaccines, and other immunizing agents. Drugs Used to Treat Infectious Diseases and Inflammation (3 of 3)

59. Drugs Used to Affect the Skin

60.  Dermatologic drugs are used to treat skin irritations.  They are common over-the- counter medications.

61. Drugs Used to Affect the Diet

62. Many disease processes affect the production, distribution, and utilization of essential dietary nutrients.

64. Drugs Used to Treat Poisoning and Overdoses

65.  The treatment for poisoning and overdose depends greatly on the substance involved.  Syrup of Ipecac  Activated Charcoal  Mucomyst  Atropine  Pralidoxime

66. Part 2 Summary  Anatomy and Physiology Related to Pharmacology  Common Prehospital Medications  Common Patient Scenarios  Common Patient Medications