Transcript Chapter_016 462KB Jan 14 2015 08:21:50 AM

Chapter 16
General Pharmacology
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Slide 1
Case History
You arrive at the home of a patient with chest
pain. The patient informs you that her doctor
has prescribed nitroglycerin, which she has
never taken before.
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Slide 2
Overview

Medications can be lifesaving.

EMTs administer or assist in medication administration to:





Provide a clear airway
Ensure adequate oxygenation
Improve perfusion
Correct low blood glucose
Prevent absorption of poisons
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Slide 3
Medication Forms Used by the
EMT-Basic







Compressed powders or tablets (e.g., nitroglycerin)
Liquids for injection (e.g., epinephrine)
Gels (e.g., glucose)
Suspensions (e.g., activated charcoal)
Fine powder for inhalation
Gases (e.g., oxygen)
Aerosol or spray (e.g., nitroglycerin)
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Slide 4
Medication Names

Generic

Name listed in the U.S.
Pharmacopoeia
 Name assigned to drug before it
becomes officially listed
 Usually a simple form of the
chemical name

Trade

Brand name manufacturer uses in
marketing the drug
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Slide 5
Medication Terms

Indications


Most common uses of the drug
Contraindications

Situations in which a drug should
not be used
 May cause harm to the patient
 May have no effect in improving
the patient's condition
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Slide 6
Medication Terms

Dose


Administration


How much of the drug should be given
Route by which the medication is
administered
Actions

Desired effects a drug has on the
patient/body systems
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Slide 7
Medication Terms

Side effects

Actions of a drug other
than those desired
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Slide 8
Dose
Metric Conversions
Kilograms
1 kg
Grams
1000 g
1g
Milligrams
Micrograms
1000 mg
1 mg
1000 g
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Slide 9
Dose
Metric Conversions
Liters
1L
0.5 L
0.1 L
0.01 L
0.001 L
Milliliters
1000 mL
500 mL
100 mL
10 mL
1 mL
1000 mL
1L
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 10
Four “Rights” of Medication
Administration




Right patient
Right drug
Right dose
Right route of administration
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 11
Reassessment Strategies

After drug administration, reassess patient for:

Therapeutic effects
 Side effects
 Noticeable changes in patient condition

Document time of administration

Document times of ongoing assessments

Vital signs
 Changes in patient condition
 Therapeutic or side effects
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 12
Pediatric Considerations

Dosages must be administered based on body
weight.

Patient may have difficulty with inhalation.


Consider spacer or extension tubing
Patient may be reluctant to take medication.

Enlist patient/parent cooperation
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 13
Geriatric Considerations

Patient may take several medications.


Prone to adverse effects, drug interactions, inadvertent
overdose
When possible, transport all medications to hospital
with patient.

May help hospital staff diagnose and manage patient
condition
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 14
Medications Carried on the EMS Unit
Activated Charcoal




Used for toxic ingestion
Binds to certain poisons
Prevents absorption
Not all brands are the same.


Some bind much more poison.
Consult medical direction about the brand to use
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 15
Medications Carried on the EMS Unit
Oral Glucose

Used for altered mental status,
suspected hypoglycemia

Absorbed in the oral mucosa

Provides needed glucose for patient
with low blood sugar
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 16
Medications Carried on the EMS Unit
Oxygen

Increases oxygen delivery to blood

Essential treatment for hypoxia and
hypoperfusion

% of delivered oxygen (dose)
determined by flow rates and delivery
device
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 17
Medications EMT-Basic May Assist
Prescribed Inhalers

Used to treat bronchoconstriction

Prescribed by patient’s physician

Administration is approved by medical
direction and/or by local protocol.

May be carried in the ambulance in some
EMS systems
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 18
Medications EMT-Basic May Assist
Nitroglycerin

Used to treat ischemic chest pain

Dilates vessels to improve circulation
through the coronary arteries

Decreases the workload of the heart
by dilating peripheral vessels

Administered under the tongue by
tablet or spray
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 19
Medications EMT-Basic May Assist
Epinephrine

Used to treat severe allergic
reaction

Blocks release of histamine

Increases vascular resistance
to maintain blood pressure
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 20
Summary

Medications play a critical role in EMS.

Care must be taken to assess patients to identify the need for
medication.

Be familiar with the indications, contraindications, and side effects of
administered medications.

Always contact medical direction and/or follow local protocols.

Remember the “rights” of medication administration.
Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 21