Transcript Bledsoe_V1_ch09b

Chapter 9, Part 2
Drug Classifications
Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Part 2 Topics
Anatomy and Physiology Related to
Pharmacology
Common Prehospital Medications
Common Patient Scenarios
Common Patient Medications
Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Drugs Used to Affect the
Nervous System
Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
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Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Central Nervous System
Medications
Analgesics and antagonists
Anesthetics
Anti-anxiety and sedative-hypnotic
drugs
Antiseizure or anti-epileptic drugs
Central nervous system stimulants
Psychotherapeutic medications
Parkinson’s medications
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Autonomic Nervous System
Medications (1 of 2)
Drugs affecting the parasympathetic
system:
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Cholinergics
Anticholinergics
Ganglionic blocking agents
Neuromuscular blocking agents
Ganglionic stimulating agents
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Autonomic Nervous System
Medications (2 of 2)
Drugs affecting the sympathetic
system:
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Adrenergic receptors
Adrenergic agonists
Adrenergic antagonists
Skeletal muscle relaxants
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Distribution of Sympathetic
Post-Ganglionic Fibers
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Sympathetic Division
of Autonomic Nervous System
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Physiology of an Adrenergic
Synapse
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Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
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Drugs Used to Affect the
Cardiovascular System
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Blood Flow through the Heart
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Cardiac Conductive System
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Action Potential of
Cardiac Contractile Tissue
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Action Potential of
Cardiac Pacing Cells
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Reentrant Pathways
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Classifications of
Cardiovascular Drugs (1 of 2)
Antidysrhythmics
– Used to treat and prevent abnormal
cardiac rhythms
Antihypertensives
– Used to treat hypertension
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Classifications of
Cardiovascular Drugs (2 of 2)
Hemostatic agents
– Used to stop bleeding
Antihyperlipidemic agents
– Used to treat high cholesterol
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Antidysrhythmics
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Antihypertensives
Diuretics
Adrenergic inhibiting agents
Angiotensin converting enzyme
inhibitors
Angiotensin II receptor antagonists
Calcium channel blockers
Direct vasodilators
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Hemostatic Agents
Antiplatelets
– Drugs that decrease the formation of
platelet plugs
Anticoagulants
– Drugs that disrupt the clotting cascade
Thrombolytics
– Drugs that act directly on thrombi to
break them down
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Antihyperlipidemics
Drugs used to treat high blood
cholesterol
Examples
– Lovastatin (Mevacor)
– Simvastatin (Zocor)
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Drugs Used to Affect the
Respiratory System
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Anti-Asthmatic Medications
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Drugs Used for Rhinitis and
Cough
Nasal decongestants
Antihistamines
Antitussives
Expectorants
Mucolytic
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Drugs Used to Affect the
Gastrointestinal System
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Main Indications for GI Drug
Therapy
Peptic ulcers
Constipation
Diarrhea and emesis
Digestion
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Drugs Used to Treat Peptic Ulcer
Disease (1 of 2)
H2 receptor antagonists
– Cimetidine (Tagamet), ranitidine (Zantac),
Famotidine (Pepcid), Nizatidine (Axid)
Proton pump inhibitors
– Omeprazole (Prilosec), Lansoprazole
(Prevacid)
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Drugs Used to Treat Peptic Ulcer
Disease (2 of 2)
Antacids
– Aluminum, magnesium, or sodium
compounds
Anticholinergics
– Pirenzepine (Gastrozepine)
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Drugs Used to Treat
Constipation
Categories of laxatives
– Bulk-forming (methylcellulose or
Citrucel)
– Stimulant (phenolphthalein or Ex-Lax)
– Osmotic (Milk of Magnesia)
– Surfactant (Colace)
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Drugs Used to Treat Diarrhea
Although a nuisance, diarrhea is often
a helpful process.
Specific or non-specific agents may be
used.
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Drugs Used to Treat Emesis
Antiemetics
– Medication used to prevent vomiting
Serotonin antagonists
– Zofran
Dopamine antagonists
– Compazine, Phenergan, Inapsine,
Reglan
Cannabinoids
– Marinol, Cesamet
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Drugs Used to Aid Digestion
Several drugs are available to aid
digestion of carboyhydrates and fats.
Two such drugs are pancreatin
(Entozyme) and pancrelipase
(Viokase).
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Drugs Used to Affect the Eyes
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Drugs Used to Affect the Eyes
Ophthalmic drugs are used to treat
conditions involving the eyes, primarily
glaucoma and trauma.
– Medications used to treat glaucoma are
all aimed at reducing intraocular pressure
(IOP). Examples include timolol
(Timoptic) and betaxolol (Betoptic).
– Tetracaine (Pontocaine) is a local
anesthetic of the ester class.
Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
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Drugs Used to Affect the Ears
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Drugs Used to Affect the Ears
Most drugs used to treat conditions
involving the ear are aimed at
eliminating underlying bacterial or
fungal infections or at breaking up
impacted ear wax.
– Chloramphenicol (Chloromycetin Otic)
– Gentamicin sulfate (Garamycin)
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Drugs Used to Affect the
Endocrine System
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Drugs Affecting the Pituitary
Gland
Anterior pituitary drugs
– The only conditions treated with these
drugs are those associated with
abnormal growth such as dwarfism.
Posterior pituitary drugs
– The two drugs in this category are
oxytocin and antidiuretic hormone.
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Drugs Affecting the
Parathyroid and Thyroid Glands
Parathyroid glands are primarily
responsible for regulating calcium
levels.
Hypothyroidism leads to decreased
levels of calcium and Vitamin D.
Treatment is therefore through calcium
and Vitamin D supplements.
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Drugs Affecting the Adrenal
Cortex
The Adrenal Cortex synthesizes and
secretes 3 classes of hormones:
– Glucocorticoids
– Mineralocorticoids
– Androgens
Two diseases typify the disorders
associated with the adrenal cortex:
– Cushing’s disease
– Addison’s disease
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Drugs Affecting the Pancreas
Diabetes mellitus is the most important
disease involving the pancreas.
– Insulin
A substance that decreases blood glucose
level
– Glucagon
A substance that increases blood glucose
level
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Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
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Oral Hypoglycemics
Orinase (chlorpropamide)
Glucotrol (glipizide)
Micronase (glyburide)
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Hyperglycemic Agents
D50W is a sugar solution given
intravenously for acute hypoglycemia.
Glucagon is indicated for emergency
treatment when an IV is unobtainable.
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Drugs Affecting the Female
Reproductive System
Estrogens and progestins
Oral contraceptives
Uterine stimulants and relaxants
– Brethine, Yutopar
Infertility agents
– Clomid, Metrodin
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Drugs Affecting the Male
Reproductive System
Testosterone deficiency
– Metandren
Benign prostatic hypertrophy (BPH)
– Proscar
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Drugs Affecting Sexual
Behavior
L-dopa (Levodopa) has demonstrated
increased libido as a side effect.
Vardenafil (Levitra)
Tadalafil (Cialis)
Sildenafil (Viagra)
If you treat a patient with chest pain
who has taken Viagra recently, do NOT
give nitroglycerin or any other nitrate.
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Drugs Used to Treat Cancer
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Drugs Used to Treat Cancer
Drugs used to treat cancer are called
antineoplastic agents.
Examples include:
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Fluorouracil (Adrucil)
Mechlorethamine (Mustargen)
Vinblastine (Velban)
Vincristine (Oncovin)
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Drugs Used to Treat Infectious
Diseases and Inflammation
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Drugs Used to Treat Infectious
Diseases and Inflammation (1 of 3)
Antibiotics
– An antibiotic agent may either kill the
offending bacteria or so decrease the
bacteria’s growth that the patient’s
immune system can effectively fight the
infection.
Antifungal agents
– Fungi are parasitic microorganisms that
cannot synthesize their own food.
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Drugs Used to Treat Infectious
Diseases and Inflammation (2 of 3)
Antimicrobial and antiparasitic drugs.
– Although most diseases treated with
these drugs are uncommon in
developed countries, they are leading
causes of death in third-world countries.
Diseases include malaria, leprosy, and
helminthiasis.
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Drugs Used to Treat Infectious
Diseases and Inflammation (3 of 3)
Tuberculosis, caused by bacteria, is
increasing in the United States.
NSAIDs (non-steroidal antiinflammatory drugs)—commonly used
as analgesics and antipyretics.
Uricosuric drugs—used to treat gout.
Serums, vaccines, and other
immunizing agents.
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Recommended Childhood and
Adolescent Immunization Schedule
A recommended childhood immunization
schedule has been approved by the
Advisory Committee on Immunization
Practices, the American Academy of
Pediatrics, and the American Academy of
Family Physicians.
Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
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Drugs Used to Affect the Skin
Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
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Drugs Used to Affect the Skin
Dermatologic drugs are used to treat
skin irritations.
They are common over-the-counter
medications.
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Drugs Used to Affect the Diet
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Many disease processes affect the
production, distribution, and utilization of
essential dietary nutrients.
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Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
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Drugs Used to Treat
Poisoning and Overdoses
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Drugs Used to Treat
Poisoning and Overdoses
The treatment for poisoning and
overdose depends greatly on the
substance involved.
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Syrup of ipecac
Activated charcoal
Mucomyst
Atropine
Pralidoxime
Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Part 2 Summary
Anatomy and Physiology Related to
Pharmacology
Common Prehospital Medications
Common Patient Scenarios
Common Patient Medications
Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ