CBT 925B Pharmacology

Pharmacology Presented by Mike Helbock, M.I.C.P., SEI Senior Paramedic, NREMT-P MSO – King County Medic One Manager – EMS Training and Education Seattle/King County EMS Course Objectives The student will learn 3 commonly prescribed drugs found in the categories of cardiac, respiratory, diabetes, seizures and ulcers. The student will identify the medications that they can give and those that they may assist with. Identify medications on the unit. Determine SICK/NOT SICK ! General Pharmacology You will be responsible for administering certain drugs. You will be responsible for assisting patients self-administer other drugs. Not understanding how medications work places the patient and yourself in danger. How Medications Work Dose Amount of medication given Action Therapeutic effects expected on the body Indications Therapeutic uses for a particular drug How Medications Work cont. Contraindications Conditions in which a medications should not be given Side effects Actions of a drug other than the desired effect Medication Names Trade name Brand name given by manufacturer Prescription drugs Prescription drugs.. by MD’s order Generic name Original chemical name Over the counter (OTC) drugs Available without a prescription Routes of Administration Intravenous (IV) injection Injected directly into the vein Oral (PO) Taken by mouth; enters body through digestive system Sublingual Placed under the tongue; absorbed by mucous membranes Routes of Administration Intramuscular (IM) injection Injection into the muscle Intraosseous (IO) Access to the inside of the bone Subcutaneous (SQ) injection Injection into tissue between skin and muscle Routes of Administration Transcutaneous Medications absorbed through the skin Inhalation Medications inhaled into the lungs Per rectum (PR) Administration by rectum Dosage Forms Tablets Materials mixed with medication and compressed under pressure Capsules Gelatin shells filled with powdered or liquid medication Solutions Liquid mixture of one or more substance Dosage Forms Suspensions Mixture of fine particles distributed throughout a liquid by shaking Metered-dose inhaler (MDI’s) Miniature spray canister, used to direct medication through the mouth into the lungs Topical medications Lotions, creams, and ointments Dosage Forms Transcutaneous medications Transdermal Designed to be absorbed through the skin Gels Semi-liquid substances administered orally Gases for inhalation Oxygen, Nitrous Oxide, Heliox Medications Carried on EMS Unit Oxygen Gaseous medication needed by all cells to function. Activated charcoal Suspension used to absorb ingested poisons Oral glucose Gel form glucose given orally Epinephrine (Epi-Pen) also carried on Assisted-Administration Medications unit Increases heart rate and blood pressure and decreases muscle tone of bronchi... used in severe anaphylaxis Metered-dose inhaler (MDI) Several medications are used to help dilate the bronchi...(Asthma, COPD) Assisted-Administration Medications cont. Nitroglycerin Increases blood flow by relieving spasms and causing arteries to dilate Available in tablet, spray, or paste General Steps to Administering Medications Obtain orders (Med control or standing) Verify proper medication and prescription. Verify form, dose, and route of the medication. Check expiration date and condition medication of General Steps for Administering Medications cont. Reassess vital signs after every administration of medication. Document any medication given and changes in patient’s condition. Commonly Prescribed Drugs Asthma Anxiety / Depression Diabetes Seizures Ulcers Pain Control Cardiac Related Asthma Proventil Theodur Azmacort Atrovent Brethine Brand Generic Albuterol Theophylline Triamcinoline Ipratropium Terbutaline Anxiety or Depression Xanax Prozac Elavil Tofranil Brand Generic Alprazolam Fluoxene Amitriptyline Imipramine Diabetes NPH, Lente Brand Generic Insulin Diabinase Orinase Micronase Glucotrol Oral preps Chlorpropamide Tolbutamide Glyburide Glipizide Seizure Dilantin Tegretol Phenobarbital Depakote Brand Generic Phenytoin Carbamazepine Phenobarbital Valproic Acid Ulcers Zantac Tagamet Brand Generic Ranitidine Cimetidine Pain Control Motrin/ Advil Percocet Lortab Brand Generic Ibuprofen Oxycodone/aceta.. Hydrocodone Cardiac...Angina Nitro-stat Isordil Brand Generic Nitroglycerin Isosorbide Cardiac...Rapid Heart Rates Lanoxin Calan Cardizem Brand Generic Digoxin Verapamil Diltiazem Cardiac... High Blood Press. Brand Procardia Capoten Cardizem Tenormin Hydrodiuril Generic Nifedipine Captopril Diltiazem Atenolol Hydrochlorothiazide Diuretics (Control CHF) Lasix Bumex Hydrodiuril Brand Generic Furosemide Bumetanide Hydrochlorothiazide (HCTZ) Cardiac..overview Nitro-stat NTG Lanoxin Digoxin Procardia Nifedipine Vasotec Enalapril Cardizem Diltiazem Brand Generic Condition Angina CHF Angina, ^BP’s CHF, ^BP Angina,^BP Cardiac (continued) Brand Calan Inderal ^BP Dyazide Lopressor Generic Verapamil Propranolol HCTZ Metoprolol Condition Rhythms Angina, CHF, ^BP Angina,^BP Cardiac (continued) Brand Lasix Micro K Quinidex Coumadin Generic Furosemide Potassium Quinidine Warfarin Condition CHF, ^BP CHF, ^BP Rhythms Clotting How Drugs Work Drug Receptor Cell wall Drug Interaction with Receptor on the Cell Wall Illegal Drug Overdoses Methamphetamine Cocaine LSD, PCP Heroin- #1 (Black Tar) in King County *Methadone (used illegally) Prescription Drug Overdose Codeine Darvocet Demerol Percodan Valium Sleeping Pills Halcion Restoril Prescription Drug Overdose... Tricyclics Pamelor/Asendin Sinequan/Doxepin Elavil/Amitriptyline Tofranil/Imipramine Norpramin/Desipramine Brand / Generic “Over the Counter” OTC Drug Overdose Aspirin Tylenol Diet Pills Sominex Nyquil Prescription Labels Read the name of the drug, strength and dose ( spell correctly) Look at expiration date Confirm that the patient is taking the medication as directed Confirm when last taken? How much? With any other medication? Always remember to bring or send ALL pill bottles and associated medications to the hospital! Drugs EMT’s can administer O2 Ipecac Oral Glucose Epinephrine…(Epi-pen) Drugs EMT can assist with NTG Epinephrine…(Epi-pen) Inhalers Determine SICK/NOT SICK ! Photos from: Emergency Care of the Sick and Injured; 7th Ed: JB Publishers 1998 Emergency Care of the Sick and Injured; 7th Ed: 1998 King County EMS CBT: 1999