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Chapter 10
Pharmacology 422-467
| Question | Answer |
|---|---|
| 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 |
| MEDICATION & DRUG REGULATION p.423 | |
| 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 |
| SOURCES OF MEDICATIONS p.424 | |
| 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 |
| MEDICATION NAMES p.425 | |
| 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 |
| MEDICATION REFERENCE SOURCES p.426 | |
| 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 |
| MEDICATION STORGE p.426 | |
| 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. |
| MEDICATIONS SECURITY p.427 | |
| 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. |
| THE PHYSIOLOGY OF PHARMCOLOGY p.427 | |
| 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 |
| MEDICATION RESPONSES p. 433 | |
| 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 |
| PRINCIPLES OF PHARMACOKINETICS p.436 | |
| 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. |
| ROUTES OF MEDICATION ADMINISTRATION p.436 | |
| 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 |
| DISTRIBUTION OF MEDICATION p440 | |
| 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 |
| MEDICATION METABOLISM p.442 | |
| What are four ways a drug can undergo "Biotransformation"? | |
| Where does most biotransformation occur? | The liver |
| MEDICATION ELIMINTION p.442 | |
| 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 |
| REDUCING MEDICATION ERRORS p. 443 | |
| 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? |
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carsrock22
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