Transcript Chp.-6-Powerpoint-Pt.-2 - McLaren

Division 1
Introduction to Advanced
Prehospital Care
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Chapter 6
General Principles of
Pharmacology
Part 2
Drug Classifications
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Topics
Anatomy & Physiology Related to
Pharmacology
Common Prehospital Medications
Common Patient Scenarios
Common Patient Medications
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Drugs Used to Affect the
Nervous System
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Functional organization of the
autonomic nervous system
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Central Nervous System
Medications
Analgesics & antagonists
Anesthetics
Anti-anxiety & sedative-hypnotic drugs
Antiseizure or anti-epileptic drugs
Central nervous system stimulants
Psychotherapeutic medications
Parkinson’s medications
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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Autonomic Nervous System
Medications
(1 of 2)
Drugs Affecting the Parasympathetic
System:
– Cholinergics
– Anticholinergics
– Ganglionic blocking agents
– Neuromuscular blocking agents
– Ganglionic stimulating agents
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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Autonomic Nervous System
Medications
(2 of 2)
Drugs Affecting the Sympathetic
System:
– 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., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Bledsoe et al., Essentials of Paramedic Care: Division 1
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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:
– Drugs used to treat hypertension
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Classifications of
Cardiovascular Drugs (2 of 2)
Hemostatic Agents:
– Drugs used to stop bleeding
Antihyperlipidemic Agents:
– Drugs used to treat high cholesterol
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Antihyperlipidemics
Drugs used to treat high blood
cholesterol
Examples:
– Lovastatin (Mevacor)
– Simvastatin (Zocor)
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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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:
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–
–
–
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Drugs Used to Aid Digestion
Several drugs are available to aid
digestion of carbohydrates 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., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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):
– Proscare
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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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.
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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:
– fluorouracil (Adrucil)
– mechlorethamine (Mustargen)
– vinblastine (Velban)
– vincristine (Oncovin)
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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.
– They include malaria, leprosy, and
helminthiasis.
– Tuberculosis, caused by bacteria, is
increasing in the United States.
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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Drugs Used to Treat Infectious
Diseases and Inflammation (3 of 3)
NSAIDs (non-steroidal antiinflammatory drugs)—Commonly used
as analgesics and antipyretics
Uricosuric drugs—Used to treat gout
Serums, vaccines, and other
immunizing agents
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Drugs Used to Affect the Skin
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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
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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© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Drugs Used to Supplement
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., Essentials of Paramedic Care: Division 1
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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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–
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–
–
Syrup of ipecac
Activated charcoal
Mucomyst
Atropine
Pralidoxime
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Summary
Anatomy and Physiology Related to
Pharmacology
Common Prehospital Medications
Common Patient Scenarios
Common Patient Medications
Bledsoe et al., Essentials of Paramedic Care: Division 1
© 2006 by Pearson Education, Inc. Upper Saddle River, NJ