Pharmacology 422-467
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| Can Drugs help people? | YES
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| Can drugs harm people? | YES
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| Define Pharmacology: | The Scientific study of how various Substances interact with or alter the function of living organisms.
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| How long have chemicals derived from plants and animals been used to cure disease and treat symptoms? | Many Centuries
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| When did a more formal study of medications begin? | Late 17th and the 18th century
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| What is the pharmaceutical industry like today? | A highly profitable and regulated industry
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| 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
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| MEDICATION & DRUG REGULATION p.423 |
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| What was the first significant regulation in the US, in 1906? | Pure food and drug act which prohibited altering or mislabeling medications.
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| What happened in 1909? | Opium was prohibited from being imported under the Opium Exclusion Act.
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| What happened in 1914? | The Harrison Narcotic Act restricted the use of cocaine
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| 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.
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| Is this agency still active today? To what extent? | YES. Approval of all new medications and removing of unsafe ones.
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| 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
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| What Act was established in 1970? what agency was created and enforces this Act? | Controlled Substance Act. The US Drug Enforcement Agency.
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| 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
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| SOURCES OF MEDICATIONS p.424 |
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| List sources and example of Medications: | Plant - Atropine, Animal - Heparin, Microorganism - Antibiotics, Minerals - Iron and Mag sulfate
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| 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
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| MEDICATION NAMES p.425 |
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| According to your book, there are 3 distinct names for every drugs. (There are actually 4) What is the first name? | Chemical Name
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| What name is next? | Generic Name
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| What is a "stem" of a drug name? | Links drugs together in the same class
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| What name is used to market the drug commercially? | Brand Name
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| What is the 4th name? | Code Name????? A shorthand version for the chemical name that is easy reference for researchers. Example: RU 486
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| MEDICATION REFERENCE SOURCES p.426 |
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| What is a medication monograph? | A document that gives detailed information about drugs
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| List common sources of information pertaining to medications. | Medication Name, Class, Indications, Contraindications, Available Forms and dose
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| MEDICATION STORGE p.426 |
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| 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.
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| MEDICATIONS SECURITY p.427 |
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| 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.
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| THE PHYSIOLOGY OF PHARMCOLOGY p.427 |
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| Define Pharmacodynamics: | As a medication is administered, It begins to alter a function or process within the body.
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| Can drugs help patients? | Yes
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| Can drugs hurt patients? (even when given properly?) | Yes, and YES
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| Define Pharmacokinetics: | The action of the body on a medication.
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| What are 4 elements of Pharmacokinetics? | Absorption, distribution, Biotransformation and Elimination.
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| What is receptor? | A specialized area in tissue that initiates certain actions after specific stimulation
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| 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.
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| Define Endogenous: | Those occurring naturally in the body
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| Define Exogenous: | From outside the body
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| What is an Agonist Medication? | Initiate or alter a cellular activity by attaching to receptor sites prompting cell response.
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| What is an Antagonist Medication? | Prevents endogenous or exogenous agonist chemicals from reaching cell receptor sites
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| Define Affinity: | the ability of a medication to bind with a particular receptor site
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| Define Threshold Level: | In a pharmacologic context, the concentration of medication at which initiation or alteration of cellular activity begins
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| Define Potency: | The amount of the drug needed to get cell response
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| Define Efficacy: | The ability to initiate cell activity in a therapeutic manner
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| Are we allowed to use the practice of "Placebo Effect"? | No, It violates ethical principles
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| MEDICATION RESPONSES p. 433 |
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| 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.
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| What is the term used to describe a reaction that is totally unexpected, and usually unique to a specific patient? | Idiosyncratic
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| Therapeutic Index-is the ratio between....? | The median effective dose and the median lethal dose
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| Immune-Mediated Medication Response. What are the severity degrees of this type of response? | Anything from slight irritation to severe anaphylaxis
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| What are common things patients are allergic to? | Latex, peanuts, shellfish, antibiotics like penicillin
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| What is Medication Tolerance? | When a medication has less of an effect because the patient is used to taking it
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| 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.
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| Medication Abuse & Dependence - What two groups of medications are most prone to abuse/misuse? | Stimulants and depressants
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| What is Habitation? | The tolerance to certain medications or chemicals
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| What is Dependence? | The need to have a specific drug or chemical to maintain "normal" life function
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| PRINCIPLES OF PHARMACOKINETICS p.436 |
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| 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.
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| ROUTES OF MEDICATION ADMINISTRATION p.436 |
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| Absorption and bioavailability of a drug is strongly influenced by...? | The chosen route of administration determines the percentage of unchanged medication that reaches circulation.
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| Oral, Orogastric Tube, Nasogastric- | By mouth into GI system
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| Endotracheal- | No longer considered a reliable method of medication administration, but can still be used by EMS for administration of bronchodilator or mucolytic
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| Intranasal- | Gaining popularity in pre-hospital settings. Liquid medications are converted to a fine mist that are sprayed into the nose. Absorption is rapid.
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| Intravenous- | The preferred method used in pre-hospital setting
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| Intraosseous- | This route is a viable alternative when IV access cannot be obtained. A needle is inserted under the skin into the bone.
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| Intramuscular- | A needle is inserted into one of the patient's larger muscles.
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| Subcutaneous- | Similar to intramuscular but shorted needle is injected into SC sites. Example: anterior part of abdomen.
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| Dermal/Transdermal | A patch may alter a patient's clinical. Remember to ask.
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| Sublingual- | Under the tongue; absorbs rapidly.
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| Inhaled or Nebulized- | Pre -Hospital limited to oxygen and maybe amyl nitrate for cyanide exposure
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| Rectal- | Can be used when patient is unconscious
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| Ophthalmic- | Pre-Hospital limited to ocular anesthetic agents for chemical burns.
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| Other routes of Medication? | Hemodialysis
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| DISTRIBUTION OF MEDICATION p440 |
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| 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.
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| What is Plasma Protein Binding? | Molecules temporarily attach to protein in the blood plasma
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| What is Fat Binding? | When molecules attach to fat cells
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| What is Volume of Distribution? | The extent to which medication will flow through the body
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| MEDICATION METABOLISM p.442 |
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| What are four ways a drug can undergo "Biotransformation"? |
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| Where does most biotransformation occur? | The liver
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| MEDICATION ELIMINTION p.442 |
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| Where are most drugs eliminated? | The kidneys
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| 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
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| What is meant by "half-life"? | First order elimination amount
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| REDUCING MEDICATION ERRORS p. 443 |
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| What are the keys to reducing medication errors? | The 6 rights, and understanding medical teminology
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| How does age affect response to medications? | The distribution and elimination of medicine continue to change as we age.
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| How does weight affect response to medications? | Many doses change as the patients weight changes.
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| How does environment affect response to medications? | Hypothermia or hyperthermia affect blood flow.
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| How does Genetic Factors affect response medications? |
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| How does pregnancy affect response to medication |
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| How do Psychosocial factors affect response to medication? |
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