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Chapter 10

Pharmacology 422-467

Can Drugs help people? YES
Can drugs harm people? YES
Define Pharmacology: The Scientific study of how various Substances interact with or alter the function of living organisms.
How long have chemicals derived from plants and animals been used to cure disease and treat symptoms? Many Centuries
When did a more formal study of medications begin? Late 17th and the 18th century
What is the pharmaceutical industry like today? A highly profitable and regulated industry
What does "evidenced-based" guidelines mean with regard to the use of pharmacological agents? Medications now undergo extensive testing before wide spread use is permitted
What was the first significant regulation in the US, in 1906? Pure food and drug act which prohibited altering or mislabeling medications.
What happened in 1909? Opium was prohibited from being imported under the Opium Exclusion Act.
What happened in 1914? The Harrison Narcotic Act restricted the use of cocaine
What was enacted in 1938? What agency was created to oversee enforcement of rules pertaining to this act? The Food, Drug and Cosmetic Act. The FDA.
Is this agency still active today? To what extent? YES. Approval of all new medications and removing of unsafe ones.
What is meant by the term "off-label" regarding the use of a drug? Are there risks involved? "Used for a purpose not approved by the FDA; liability issues involved
What Act was established in 1970? what agency was created and enforces this Act? Controlled Substance Act. The US Drug Enforcement Agency.
What are the 5 "schedules" of controlled drugs? Give examples of each. Schedule 1- High abuse - Non Medical - Heroine, weed Schedule 2- High abuse - Some Medical - Cocaine, Fentanyl Schedule 3- Lower abuse than S2 - vicodin, codeine Schedule 4- Lower abuse than S3- valium Schedule 5- Lower abuse than S4 - Narcotic Cough
List sources and example of Medications: Plant - Atropine, Animal - Heparin, Microorganism - Antibiotics, Minerals - Iron and Mag sulfate
List common forms of Medications and provide examples: Capsule-Tylenol, Tablet-Aspirin, Powder-Glucagon, Drops-Afrin, Skin prep-Nitro or Fentanyl patch, Suppository-Tylenol, Liquid-Infant Tylenol, Inhaler-Albuterol or Nitro
According to your book, there are 3 distinct names for every drugs. (There are actually 4) What is the first name? Chemical Name
What name is next? Generic Name
What is a "stem" of a drug name? Links drugs together in the same class
What name is used to market the drug commercially? Brand Name
What is the 4th name? Code Name????? A shorthand version for the chemical name that is easy reference for researchers. Example: RU 486
What is a medication monograph? A document that gives detailed information about drugs
List common sources of information pertaining to medications. Medication Name, Class, Indications, Contraindications, Available Forms and dose
What are the "basics" as they pertain to storing medications? Stored in a manner that prevents damage, Placed in protected bins, Keep out of direct sunlight and heat, 15-30 degrees C.
Controlled substances require additional security such as.... Locks- these medications must be in locked storage or continuously held by on-duty EMS provider responsible for the administration, Disposal of partially used or damaged containers require verification of a witness or return to the department responsible for dispensing. Tampering - inspect vials etc. for subtle signs of tampering.
Define Pharmacodynamics: As a medication is administered, It begins to alter a function or process within the body.
Can drugs help patients? Yes
Can drugs hurt patients? (even when given properly?) Yes, and YES
Define Pharmacokinetics: The action of the body on a medication.
What are 4 elements of Pharmacokinetics? Absorption, distribution, Biotransformation and Elimination.
What is receptor? A specialized area in tissue that initiates certain actions after specific stimulation
List four things that can happen when a medication binds with a receptor? 1) Channels permitting the passage of ions. 2) A biochemical messenger becomes activated. 3) Normal cell function is prevented. 4) Normal function of the cell begins.
Define Endogenous: Those occurring naturally in the body
Define Exogenous: From outside the body
What is an Agonist Medication? Initiate or alter a cellular activity by attaching to receptor sites prompting cell response.
What is an Antagonist Medication? Prevents endogenous or exogenous agonist chemicals from reaching cell receptor sites
Define Affinity: the ability of a medication to bind with a particular receptor site
Define Threshold Level: In a pharmacologic context, the concentration of medication at which initiation or alteration of cellular activity begins
Define Potency: The amount of the drug needed to get cell response
Define Efficacy: The ability to initiate cell activity in a therapeutic manner
Are we allowed to use the practice of "Placebo Effect"? No, It violates ethical principles
What is Therapeutic (desired) Response? Describe different ways of achieving it. Medication is administered in a dose intended to produce a desired clinical response for the patient., single dose, continuous dose.
What is the term used to describe a reaction that is totally unexpected, and usually unique to a specific patient? Idiosyncratic
Therapeutic Index-is the ratio between....? The median effective dose and the median lethal dose
Immune-Mediated Medication Response. What are the severity degrees of this type of response? Anything from slight irritation to severe anaphylaxis
What are common things patients are allergic to? Latex, peanuts, shellfish, antibiotics like penicillin
What is Medication Tolerance? When a medication has less of an effect because the patient is used to taking it
What is "Cross-Tolerance"? When repeated exposure to a certain class of drugs such as opiates results in a tolerance to the same class drugs.
Medication Abuse & Dependence - What two groups of medications are most prone to abuse/misuse? Stimulants and depressants
What is Habitation? The tolerance to certain medications or chemicals
What is Dependence? The need to have a specific drug or chemical to maintain "normal" life function
What variables determine how the body changes, when a medication that has been administered? Onset is related to absorption. Peak is related to distribution. Duration of effect is related to medication metabolism and elimination.
Absorption and bioavailability of a drug is strongly influenced by...? The chosen route of administration determines the percentage of unchanged medication that reaches circulation.
Oral, Orogastric Tube, Nasogastric- By mouth into GI system
Endotracheal- No longer considered a reliable method of medication administration, but can still be used by EMS for administration of bronchodilator or mucolytic
Intranasal- Gaining popularity in pre-hospital settings. Liquid medications are converted to a fine mist that are sprayed into the nose. Absorption is rapid.
Intravenous- The preferred method used in pre-hospital setting
Intraosseous- This route is a viable alternative when IV access cannot be obtained. A needle is inserted under the skin into the bone.
Intramuscular- A needle is inserted into one of the patient's larger muscles.
Subcutaneous- Similar to intramuscular but shorted needle is injected into SC sites. Example: anterior part of abdomen.
Dermal/Transdermal A patch may alter a patient's clinical. Remember to ask.
Sublingual- Under the tongue; absorbs rapidly.
Inhaled or Nebulized- Pre -Hospital limited to oxygen and maybe amyl nitrate for cyanide exposure
Rectal- Can be used when patient is unconscious
Ophthalmic- Pre-Hospital limited to ocular anesthetic agents for chemical burns.
Other routes of Medication? Hemodialysis
List variables that affect how medications are distributed: Some pertain to the drug, and some pertain to physical structures in the body. Osmosis, Filtration, Facilitated Diffusion, and Active Transport all play a role.
What is Plasma Protein Binding? Molecules temporarily attach to protein in the blood plasma
What is Fat Binding? When molecules attach to fat cells
What is Volume of Distribution? The extent to which medication will flow through the body
What are four ways a drug can undergo "Biotransformation"?
Where does most biotransformation occur? The liver
Where are most drugs eliminated? The kidneys
What's the difference between Zero-order elimination and First order elimination? Zero order elimination eliminates a fixed amount, where First order elimination eliminated based on how much is in the system
What is meant by "half-life"? First order elimination amount
What are the keys to reducing medication errors? The 6 rights, and understanding medical teminology
How does age affect response to medications? The distribution and elimination of medicine continue to change as we age.
How does weight affect response to medications? Many doses change as the patients weight changes.
How does environment affect response to medications? Hypothermia or hyperthermia affect blood flow.
How does Genetic Factors affect response medications?
How does pregnancy affect response to medication
How do Psychosocial factors affect response to medication?
Created by: carsrock22