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242 Cards in this Set

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2 divisions of CNS
Sympathetic, Parasympathetic
Sympathetic NS Receptors
Adrenergic Dopimenergic

Alpha-Constricts Beta-Dialates
Parasympathetic NS Receptors
Cholinergic

Nicotinic-Skeletal Muscle
Muscarinic-Smooth Muscle
Response expected with Beta-2 Receptor Stimulation
(Heart)
Increased HR, Contractility and Conductivity
Response expected with Beta-2 Receptor Stimulation
(Lungs)
Vasodialation and bronchi relaxation
Expected response with stimulation of Dopimenergic Receptors
Dialation of Coronary, renal, mesenteric and visceral blood vessels
Dopamine Low Dose/Use
Dopamine Med Dose/Use
Dopamine High Dose/Use
2.5 mcg/min - Renal Dilation
5-10 mcg/min-Cardiac Beta Effect
10-20mcg/min-Alpha Effect-Vasoconstriction
Sympathethetic NS Neurotransmitters
Norepinephrine, Epinephrine
Parasympathetic NS Neurotransmitter
ACH - Acetylcholine
Effect of Parasymphathetic stimulation on Bronchi
Constriction, Increased secretion
Effect of Parasympathetic stimulation of eye
pupils constrict
Effect of parasympathetic stimulation of salivary glands
increased salivation
Parasympathetic stimulation to heart causes
decreased HR
Parasympathetic stimulation of GI tract causes
increased peristalsis, increased secretions
SLUDGE
Salivation, Lacrimation, Urination, Defecation, Gastric Upset, Emesis
Sublingual rte of medication administration is slower than IV but faster than ?
Oral Route
Epinephrine stimulation of Beta 2 receptors will cause?
Airway diameter to dialate
Narcotic Control Act of 1956 did what?
Increased penalties, made heroin illegal, outlawed marijuana
Minimum storage requirements for a controlled substance:
Securely locked, substantially constructed, no indication of contents
Semisolid preperation for application to body
Ointment
Medication administration via Subq or IM route is effective in pts who:
have inadequeste peripheral perfusion
Elimination of remnants of medication is:
Excretion
Rate of absorbtion of med given IO compared to given IV is:
Identical, both go into a noncollapsible channel w/ rapid flow into circulation
Cylindrical gelatin container enclosing medication
Capsule
As a paramedic, you are responsible for ensuring that medication administration in the field is:
Safe, therapeutic and effective
Sublingual rte of medication administration is slower than IV but faster than ?
Oral Route
Epinephrine stimulation of Beta 2 receptors will cause?
Airway diameter to dialate
Narcotic Control Act of 1956 did what?
Increased penalties, made heroin illegal, outlawed marijuana
Minimum storage requirements for a controlled substance:
Securely locked, substantially constructed, no indication of contents
Semisolid preperation for application to body
Ointment
Medication administration via Subq or IM route is effective in pts who:
have inadequeste peripheral perfusion
Elimination of remnants of medication is:
Excretion
Rate of absorbtion of med given IO compared to given IV is:
Identical, both go into a noncollapsible channel w/ rapid flow into circulation
Cylindrical gelatin container enclosing medication
Capsule
As a paramedic, you are responsible for ensuring that medication administration in the field is:
Safe, therapeutic and effective
Onset of Medication given via IV route is as fast as
IO Route
After ACH Acetylcholine is synthesized by the body what happens?
Acetylcholinesterase breaks the ACH down to acetate and choline
Dominant Nervous System during rest
Parasympathetic
Functionally, the Nervous System is divided into:
Central and Peripheral
You should obtain a list of the pts medications for what reason?
To avoid a dangerouse interaction with other drugs
Medication that stimulates a response in a receptor site:
Agonist
Medications that lower BP by causing kidneys to excrete water/salt
Diuretics
An unwanted but predictable reaction to a drug
Side effect
Medication that are not made from animals, vegetables or minerals
Synthetic
Medications that inhibit the Sympathetic NS
Sympatholytics
Medications that mimic
"metics" (sympathomimetic)
A medication will most likely harm a pt if it is:
Contraindicated
Endotracheal meds in cardiac arrest are:
Not recommended due to questionable absorbtion
For a medication to carry the USP label it must:
have active ingredient w/in 95% to what is stated on label
Promethazine(phenergan) is used mainly for:
Nausea
Rate of absorbtion of medication via the transdermal rte will be quicker in a pt with what?
fever
Nicotinic receptors are stimulated by what neurotransmitter?
Acetylcholine
What is added to the name of a medication to make it official?
USP
Ultimate goal of emergency medication?
for med to reach therapeutic concentration in bloodstream
Unlike Schedule I drugs, Sch II drugs have?
Accepted medical uses
A drug that blocks the effect of another drug is referred to as:
Antagonist
Decreased drug responsiveness
Tolerance
The comnbined effects of two drugs which are greater than their individual effects:
Synergism (1+1=3)
Drugs that cause increased cardia force
Inotropic
IM, SC injections are contraindicated in pts with:
decreased peripheral perfusion
The chemical name of a drug:
Describes the chemical makeup
The unique name of drug under which the manufacturer registers new drug
Trade name
-
General name for drug
Generic name
Drug name that contains USP
Official name
Schedule II drugs have this propensity for dependance and abuse
Very high
Sch III drugs have this propensity for dependance and abuse
Medium abuse potential
Which government agency determines the safety and efficacy of drugs?
FDA
Which government agency regulates biologic products like vaccines?
Public Health Service
Medicine absorbed directly through skin
Transdermal
Medicine absorbed under the tongue
Sublingual
Medicine absorbed through cheek
Buccal
Study of metabolism and actions of medicine in the body
Pharmokinetics
Effect that causes 2 drugs given to same pt to have same effect, doublin pt response
Summation
A unique response that is pt specific
Idiosyncrasy effect
How the medication causes it's intended effect
Mechanism of Action
Dermatologic drugs affect what system?
Integumentary
A liquid, usually water, that contains one or more substances dissolved entirely:
Solution
Study of medications and their effect/actions on the body:
Pharmacology
Time it takes for a medication to reach a min effective level at its target tissue
Onset of Action
Amount of medication still active when it reaches its target organ
Bioavailability
Overstimulation of muscarinic receptors will cause:
excessive lacrimation, bradycardia, diarhea, meosis
Adrenergic nerve fibers release what:
epinephrine and norepinephrine
Larger dose of same cncentration drug intended to achieve therapeutic level quickly
Loading dose
Dilute alcoholic extract used as skin antiseptic
Tincture
Process of chemical signaling between cells
Neurotransmission
Analysis of a drug to evaluate its potency
Assay
Procedure for determining a drugs concentration
Bioassay
2 Types of Peripheral Nerves
Afferent-body to brain
Efferent-brain to body
Drugs given via ET tube (NAVEL)
Naloxone, Atropine, Vasopressin, Epi and Lidocaine
Route of Medication through GI tract
Enteral
Any drug route that is not through skin, gi or mucous membranes
Parenteral
IM injection amts
1-5 ml
Sub Q injection amounts
up to 2 ml
Energy dependant transport
Active transport-lower to higher concentrations
Transport from higher to lower that does not require energy
Passive Diffusion
Biotransformation occurs in what 2 ways?
med is transformed into metabolit or it becomes more water soluble
Adverse reaction inadvertently induced in pt by a treatment given:
iatrogenic response
Incresed effect when med is given in several successive doses
Cumulative
Meds that relieve pain
Analgesics
Absence of the sensation of pain
Analgesia
Dermatologic drugs affect what system?
Integumentary
A liquid, usually water, that contains one or more substances dissolved entirely:
Solution
Study of medications and their effect/actions on the body:
Pharmacology
Time it takes for a medication to reach a min effective level at its target tissue
Onset of Action
Amount of medication still active when it reaches its target organ
Bioavailability
Reverse the effect of opiod drugs/example
Opiod Antagonist/Narcan
Induces a loss of sensation to touch or pain
Anesthetic
Receptor site for Benzodiazapine drugs
GABA receptors
What type drugs release dopamine and norepinephrine?
CNS Stimulants
Drugs that cause extrapyramidal symptoms:
Psychotherapeutic
Drugs that affect the Somatic (motor) nervous system?
Neuromuscular Blcoking agents
Paralytic of choice for prehospital airway
succinylcholine
Sympathomimetics stimulate what?
Adrenal medulla
Which antiarrhythnic drugs reduce adrenergic response of receptors that increase hr?
Beta blockers
Protease inhibitor drugs are used to treat what?
HIV
All neuromuscular blocking agents affect:
parasympathetic NS and induce paralysis
Which adrenergic receptor contrls the release of norepinephrine?
Alpha 2
Which medication is not a nondepolorizing neuromuscular blocking agent?
Succinylcholine
In order to relieve bronchospasms associated with asthma, you would give a?
Beta 2 agonist
Chronotropic effect would affect what?
Heart Rate
Dromotropic effect would target what?
Electrical conduction of heart
3 types of skeletal mucsle relaxants:
central-cns depression
direct acting-target muscle
neuromuscular blocking-produce paralysis
Class of medications derived from plants/example
cardiac glycosides/Digoxin
Drugs that control sodium/water concentrations to lower BP
Thiazides
Drugs that lower sodium/calcium concentrations to lower BP
Loop diuretics
Drugs that have both anti-hypertensive and anti-arrythmic properties
Calcium channel blockers
Drugs that interfere with collection of platelets
Anti-platelets
Drugs thatp revent thromi from forming
Anti-coagulants
Druds that control cholesterol
Reductase inhibitors (statins)
@nd line respiratory emergency drugs?
Xanthines
Dissolves a clot once formed
Thrombolytic
Common glaucoma medications
Humorsol, Flropryl
Common opthalmic medications
Tetracaine, Pontacaine
Most commonly used medication pre-hospital
O2
Common Benzodiazipines
Midazaolam(Versed) and Diazapam (Valium)
Common Barbiturate
Thiopental (Pentothal)
Common non-barbiturate hypnotics
Etamidate(amidate) and Propofol (Diprivan)
Hormone replacement drug used in hypothyroidism
Synthroid
Drugs used to treat adrenal cortex disorders
corticosteroids
Drug used to facilitate labor
Pitocin (oxytocin)
Drug used to suppress force of contractions
tocolyticcs-Mag Sulfate and Brethine
Cancer drugs
Antineoplastic
Antimalarial drugs
Larium, Mephaquin
Anti TB Drugs
Isoniazid, rifampicin
What do antihelmintics treat?
worms/parasites
Gout medications
urisocuric
What vitamin can be given IV before giving dextrose to facilitate metabolism?
Thiamin (B1)
Sodium channel clockers work by:
slowing conduction through heart
Calcium channel blockers work by:
provide incresed o2 to heart by coronary artery dialation and reduced peripheral vascular resistance
Medications that relieve pain without the side effects of opiods are called:
opiod agonist/antagonist
Condition in which pt rapidly becomes tolerant to a med:
tachyphylaxis
Total body water is what % wt of adult man
60%
Water inside cells and %
Intracellular 45%
Water outside cells and %
Extracellular 15%
2 types extracellular fluid and %
Interstial 10.5% spinal fluid
Intravascular 4.5% plasma
Two or more atoms make a :
Molecule
Organic molecules contain what?
Carbon (sugars)
Inorganic molecules do not contain?
Carbon (salts)
Another name for electrolytes
Ions
What stabilizes electrical charges
Water
Positive charged electrolytes
Cations
Negative charged electrolytes
Anions
Major cations in body
sodium, potassium, calcium and magnesium
Major anions in body
bicarb, phosphorus, chloride
Unit of measurement for electrolytes
milliequivalent mEq
Principal extracellular cation
Sodium NA+
Principal intracellular cation
Potassium K+
Plays major role in neuromuscalur function
Potassium
Cellular potassium levels are controlled by what?
Insulin
Hypo/Hyperkalemia
low/high potassium
Principal cation for bone growth
Calcium Ca++
Low calcium level: name and effects on body
hypocalcemia, can cause overstimulation of nerve cells, decreased bp, cramps
Controls neuromuscular irratibility and plays role in metabolism of proteins/carbs
Magnesium
Determining factor between acidosis and alkalosis
sodium bicarb level (HCO3-)
Primary determinate of stomach ph, also regulates extracellular fluid levels
Chloride
Important component of ATP/Energy
Phosphorus
Prevents loss of water from kidneys by causing reabsorbtion in renal tubules
ADH-Antidiuretic Hormone
Name for effects of osmotic pressure on a cell
Tonicity (sodium/water movement)
Internal environments resistance to change
Homeostasis
Solution with same osmolarity as body fluids
Isotonic 0.9% - NS, LR
Solution with osmolarity less than body fluids
Hypotonic (cells burst) D5W
Solution with greater osmalrity than body fluids
Hypertonic 2% saline
Do not give LR to pts with what?
Liver disease
Dialysis pts may need what solution
Hypotonic
Replacement rule for isotonic crystalloid solutions is:
3/1 3 ml solution to replace 1 ml blood loss
Bolus what volume fluid to maintain perfusion
20ml/kg
Bodys internal blood clotting mechanism
hemostasis
LR/NS replace volume but cannot carry what?
O2
Most important part of IV therapy
Sterilty
Once solution is unwrapped it must be used within?
24 hrs
2 types of iv delivery sets
microdrip 60 gtts/min
macrodrip 10/15 gtts/min
6 rights of medication administration
Right medication, dose, time, pt and documentation
Name for the liver's partial or complete inactivation of a drug before it reaches systemic circulation
First pass effect
Drug that prevents conversion of angiotensin I into angiotensin !!
ACE inhibitors for HTN and CHF
Selective serotonin reuptake inhibitors are prescribed for what?
depression and antipsychotic
Blocks reuptake of norepinephrine and serotonin, prescribed for depression
TCA tricyclic antidepressants
2 types of iv delivery sets
microdrip 60 gtts/min
macrodrip 10/15 gtts/min
6 rights of medication administration
Right medication, dose, time, pt and documentation
Name for the liver's partial or complete inactivation of a drug before it reaches systemic circulation
First pass effect
Drug that prevents conversion of angiotensin I into angiotensin !!
ACE inhibitors for HTN and CHF
Selective serotonin reuptake inhibitors are prescribed for what?
depression and antipsychotic
Lactated ringers solution is generally used in the field for pts who:
have lost alot of blood
When inserting IV catheter, the needle should be at what degree angle from the skin?
45
When starting an external jugular line you should always:
place pt supine, head down, feel for carotid pulse and occlude jugular vein with finger
Infiltration is caused by:
IV passes through vein, pt moves excessively, iv becomes loose or disclodged
Signs of circulatory overload include:
JVD, pedal edema and dyspnea
S/S of air embolus
cyanosis, even with high flow O2, shock and resp. distress
Care for air emobolus pt:
left side, head down, assist ventilations
To avoid catheter sheer:
Never rethread an iv catheter
To calculate IV drip rate:
vol x gtts divided by time in min
Calculate concentration of drug
mg divided by ml
calculate gtts/min
dose needed x gtts divided by concentration
Practice of preventing contamination of pt
medical asepsis
rectal drug for seizures
Valium/diastat
most syringes are marked with
10 calibrations per ml/0.1ml
most commonly used syringe
3ml
Syringe selection based on:
volume of med to administer
needle lengths
3/8' to 2"
Gauge of needle refers to
diameter
smaller the needle:
larger the diameter
common needle gauges
18-26
Needle gauge used depends on
rt of administration
injecting sterile water into vial of med;
drug reconstitution
intradermal inj specifics
10-15 degrees, 3/8-1' needle less than 1 ml
intradermal injection site to avoid
areas w/superficial vessels
intradermal inj. sites
anterior forearm, upper back
sc shots are given where/
between dermis and muscle
volume for Sc
1 ml or less
sc sites
upper arm, ant thigh, stomach
Sc specifics
1/2-1', 45 degree angle, pinch skin
Im volume
up to 5 ml
Im sites/specifics
lat thigh, ant thigh, glutes, deltoid
flush for bolus
20 ml
sleeve place around iv bag to force fluid out
pressure infuser device
potential complication with IO rt
compartment syndrome
Adult/ear
Ped/ear
pull up and back
pull down and back
intranasal meds
narcan and versed
most common inhalation med
O2
With MDI, pt holds breath for:
3-5 sec
Essential when adm. beta agonist drug
cardiac monitor
ET med adm requires what?
2-2.5x standard dose
O2 amt w/ nebulizer
6L