1. Chapter 6, Part 1 GENERAL PRINCIPLES OF PHARMACOLOGY

2. Part 1
Basic Pharmacology

3. Topics Drug Names Sources of Drug Products Drug Classifications
Food & Drug Administration
Medication Administration
Properties of Drugs

4. Drugs are chemicals used to diagnose, treat, and prevent disease.

5. Pharmacology is the study of drugs and their actions on the body.

6. Names of Drugs
Chemical…states its chemical composition and molecular structure.
Generic…usually suggested by the manufacturer.
Official…as listed in the U.S. Pharmacopeia.
Brand…the trade or proprietary name.

7. Names of Drugs Chemical Name
7-chloro-1, 3-dihydro-1, methyl-5-phenyl-2h-1
Generic Name
diazepam
Official Name
diazepam, USP
Brand Name
Valium®

8. Sources of Drugs
Plants
Animals
Minerals
Lab (Synthetic)

9. Sources of Drug Information
United States Pharmacopeia (USP)
Physician’s desk reference (PDR)
Drug information
Monthly prescribing reference
AMA drug evaluation
EMS field guides

10. Components of a Drug Profile
Name
Classification
Mechanism of Action
Indications
Pharmacokinetics
Side Effects
Routes of Administration
Contraindications
Dosage
How Supplied
Special Considerations

11. Most Frequently Include Generic and Trade Names

12. Classification
The broad group to which a drug belongs. Knowing classifications is essential to understanding the properties of drugs.

13. Mechanism of Action
The way in which a drug causes its effects; its pharmacodynamics.

14. Indications Conditions that enable the appropriate administration
of the drug (as approved by
the FDA).

15. Pharmacokinetics
How the drug is absorbed, distributed, and eliminated; typically includes onset and duration of action.

16. Side Effects/Adverse Reactions
The drug’s untoward or undesired effects.

17. Routes of Administration
How the drug is given.

18. Contraindications
Conditions that make it inappropriate to give the drug.
…means a predictable harmful event will occur if the drug is given in this situation.

19. Dosage
The amount of the drug that should be given.

20. How Supplied
This typically includes the common concentration of the available preparations; many drugs come in different concentrations.

21. Special Considerations
How the drug may affect pediatric, geriatric, or pregnant patients.

22. Legal
Knowing and obeying the laws and regulations governing medications and their administration is an important part of a paramedic’s career.
These include federal, state, and agency regulations.

23. Federal… Pure Food & Drug Act of 1906 Harrison Narcotic Act of 1914
Federal Food, Drug, & Cosmetic Act of 1938
Comprehensive Drug Abuse Prevention & Control Act of 1970

24. State vs. Local Standards
They vary widely.
Always consult local protocols and with medical direction for guidance in securing and distributing controlled substances.

25. Providing Patient Care Using Medications (1 of 4)
Know the precautions and contraindications for all medications you administer.
Practice proper technique.
Know how to observe and document drug effects.

26. Providing Patient Care Using Medications (2 of 4)
Maintain a current knowledge in pharmacology.
Establish and maintain professional relationships with other healthcare providers.
Understand pharmacokinetics and pharmacodynamics.

27. Providing Patient Care Using Medications (3 of 4)
Have current medication references available.
Take careful drug histories including:
Name, strength, dose of prescribed medications;
Over-the-counter drugs;
Vitamins;
Herbal medications/folk remedies;
Allergies.

28. Providing Patient Care Using Medications (4 of 4)
Evaluate the patient’s compliance, dosage, and adverse reactions.
Consult with medical direction as needed.

29. Know the 6 Rights of Medication Administration
Right Medication
Right Dosage
Right Time
Right Route
Right Patient
Right Documentation

30. Special Considerations
Pregnant Patients
Pediatric Patients
Geriatric Patients

31. Pregnant Patients
Ask the patient if there is a possibility that she could be pregnant.
Some drugs may have an adverse effect on the fetus of a pregnant female.
Teratogenic drug…is a medication that may deform or kill the fetus.

33. Pharmacokinetics
Absorption…a drug must find its way to the site of action.
Distribution…a drug must then be distributed throughout the body.

34. Pharmacokinetics
Biotransformation…the process of breaking down, or metabolizing, drugs.
Elimination…drugs must eventually be excreted
from the body.

35. Drug Routes (1 of 2) Enteral:
Deliver medications by absorption through the gastrointestinal tract.
Oral, orogastric/nasogastric, sublingual, buccal, rectal.

36. Drug Routes (2 of 2) Parenteral:
Delivers medications via routes other than the GI tract.
Include intravenous, endotracheal, intraosseous, umbilical, intramuscular, subcutaneously, inhalation, topical.

37. Enteral – examples (1 of 2)
Oral (PO) — good for self-administering drugs.
Orogastric (OG) / Nasogastric (NG) — alternate method to providing PO medications.
Sublingual (SL) — excellent absorption without problems of gastric acidity.

38. Enteral – examples (2 of 2)
Buccal — between the cheek/gum. Similar to sublingual.
Rectal (PR) — reserved for unconscious or vomiting patients.

39. Parenteral – examples (1 of 3)
Intravenous (IV) — preferred route in emergencies.
Endotracheal (ET) — alternate route in emergencies for select medications.
Intraosseous (IO) — alternative use in emergencies, mostly in pediatrics.

40. Parenteral – examples (2 of 3)
Umbilical — provides alternate access in newborns.
Intramuscular (IM) — slower absorption than IVs.
Subcutaneous (SQ) — slower absorption than IM.

41. Parenteral – examples (3 of 3)
Inhalation — very rapid absorption via the lungs.
Topical — delivers drugs directly to the skin.

42. Most emergency medications are given intravenously to avoid drug degradation in the liver.

43. Drug Forms Solid Forms: Liquid Forms:
Such as pills, powders, suppositories, capsules, tablets.
Liquid Forms:
Such as solutions, tinctures, suspensions, emulsions, spirits, elixirs, syrups.

44. Solid Forms Pills—drugs shaped spherically to be swallowed.
Powders—not as popular as they once were.
Tablets—powders compressed into disk-like form.
Suppositories—drugs mixed with a waxlike base that melts at body temperature.
Capsules—gelatin containers filled with powders or tiny pills.

45. Liquid Forms (1 of 2) Solutions—water or oil-based.
Tinctures—prepared using an alcohol extraction process.
Suspensions—preparations in which the solid does not dissolve in the solvent.
Emulsions—suspensions with an oily substance in the solvent.

46. Liquid Forms (2 of 2) Spirits—solution of a volatile drug in alcohol.
Elixirs—alcohol and water solvent; often with flavoring.
Syrups—sugar, water, and drug solutions.

47. Actions of Drugs Drugs that Act by Binding to a Receptor Site
Drugs that Act by Changing Physical Properties
Drugs that Act by Chemically Combining with Other Substances
Drugs that Act by Altering a Normal Metabolic Pathway

48. Responses to Drug Administration (1 of 5)
Side Effect—unintended response to a drug.
Allergic Reaction—hypersensitivity.
Idiosyncrasy—drug effect unique to an individual.

49. Responses to Drug Administration (2 of 5)
Tolerance—decreased response to the same amount.
Cross Tolerance—tolerance for a drug that develops after administration of a different drug.
Tachyphylaxis—rapidly occurring tolerance to a drug.

50. Responses to Drug Administration (3 of 5)
Cumulative effect—increased effectiveness when a drug is given in several doses.
Drug dependence—the patient becomes accustomed to the drug’s presence in his body.
Drug interaction—the effects of one drug alter the response to another drug.
Drug antagonism—the effects of one drug block the response to another drug.

51. Responses to Drug Administration (4 of 5)
Summation—also known as additive effect, two drugs with the same effect are given together — similar to 1+1=2.
Synergism—two drugs with the same effect are given together and produce a response greater than the sum of their individual responses — similar to 1+2=3.

52. Responses to Drug Administration (5 of 5)
Potentiation—one drug enhances the effect of another.
Interference—the direct biochemical interaction between two drugs; one drug affects the pharmacology of another drug.

53. Factors Affecting Drug Response
Age
Body Mass
Sex
Environment
Time of Administration
Pathology
Genetics
Psychology

54. Drug Interactions
Drug interactions occur whenever two or more drugs are available in the same patient.
The interaction can increase, decrease, or have no effect on their combined actions.

55. Summary Drug Names Sources of Drug Products Drug Classifications
Food & Drug Administration
Medication Administration
Properties of Drugs