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242 Cards in this Set
- Front
- Back
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2 divisions of CNS
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Sympathetic, Parasympathetic
|
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Sympathetic NS Receptors
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Adrenergic Dopimenergic
Alpha-Constricts Beta-Dialates |
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Parasympathetic NS Receptors
|
Cholinergic
Nicotinic-Skeletal Muscle Muscarinic-Smooth Muscle |
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Response expected with Beta-2 Receptor Stimulation
(Heart) |
Increased HR, Contractility and Conductivity
|
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Response expected with Beta-2 Receptor Stimulation
(Lungs) |
Vasodialation and bronchi relaxation
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Expected response with stimulation of Dopimenergic Receptors
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Dialation of Coronary, renal, mesenteric and visceral blood vessels
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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 |
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Sympathethetic NS Neurotransmitters
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Norepinephrine, Epinephrine
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Parasympathetic NS Neurotransmitter
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ACH - Acetylcholine
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Effect of Parasymphathetic stimulation on Bronchi
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Constriction, Increased secretion
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Effect of Parasympathetic stimulation of eye
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pupils constrict
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Effect of parasympathetic stimulation of salivary glands
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increased salivation
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Parasympathetic stimulation to heart causes
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decreased HR
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Parasympathetic stimulation of GI tract causes
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increased peristalsis, increased secretions
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SLUDGE
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Salivation, Lacrimation, Urination, Defecation, Gastric Upset, Emesis
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Sublingual rte of medication administration is slower than IV but faster than ?
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Oral Route
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Epinephrine stimulation of Beta 2 receptors will cause?
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Airway diameter to dialate
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Narcotic Control Act of 1956 did what?
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Increased penalties, made heroin illegal, outlawed marijuana
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Minimum storage requirements for a controlled substance:
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Securely locked, substantially constructed, no indication of contents
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Semisolid preperation for application to body
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Ointment
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Medication administration via Subq or IM route is effective in pts who:
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have inadequeste peripheral perfusion
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Elimination of remnants of medication is:
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Excretion
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Rate of absorbtion of med given IO compared to given IV is:
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Identical, both go into a noncollapsible channel w/ rapid flow into circulation
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Cylindrical gelatin container enclosing medication
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Capsule
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As a paramedic, you are responsible for ensuring that medication administration in the field is:
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Safe, therapeutic and effective
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Sublingual rte of medication administration is slower than IV but faster than ?
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Oral Route
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Epinephrine stimulation of Beta 2 receptors will cause?
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Airway diameter to dialate
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Narcotic Control Act of 1956 did what?
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Increased penalties, made heroin illegal, outlawed marijuana
|
|
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Minimum storage requirements for a controlled substance:
|
Securely locked, substantially constructed, no indication of contents
|
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Semisolid preperation for application to body
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Ointment
|
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Medication administration via Subq or IM route is effective in pts who:
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have inadequeste peripheral perfusion
|
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Elimination of remnants of medication is:
|
Excretion
|
|
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Rate of absorbtion of med given IO compared to given IV is:
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Identical, both go into a noncollapsible channel w/ rapid flow into circulation
|
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Cylindrical gelatin container enclosing medication
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Capsule
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As a paramedic, you are responsible for ensuring that medication administration in the field is:
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Safe, therapeutic and effective
|
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Onset of Medication given via IV route is as fast as
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IO Route
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After ACH Acetylcholine is synthesized by the body what happens?
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Acetylcholinesterase breaks the ACH down to acetate and choline
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Dominant Nervous System during rest
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Parasympathetic
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Functionally, the Nervous System is divided into:
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Central and Peripheral
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You should obtain a list of the pts medications for what reason?
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To avoid a dangerouse interaction with other drugs
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Medication that stimulates a response in a receptor site:
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Agonist
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Medications that lower BP by causing kidneys to excrete water/salt
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Diuretics
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An unwanted but predictable reaction to a drug
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Side effect
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Medication that are not made from animals, vegetables or minerals
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Synthetic
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Medications that inhibit the Sympathetic NS
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Sympatholytics
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Medications that mimic
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"metics" (sympathomimetic)
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A medication will most likely harm a pt if it is:
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Contraindicated
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Endotracheal meds in cardiac arrest are:
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Not recommended due to questionable absorbtion
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For a medication to carry the USP label it must:
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have active ingredient w/in 95% to what is stated on label
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Promethazine(phenergan) is used mainly for:
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Nausea
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Rate of absorbtion of medication via the transdermal rte will be quicker in a pt with what?
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fever
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Nicotinic receptors are stimulated by what neurotransmitter?
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Acetylcholine
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What is added to the name of a medication to make it official?
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USP
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Ultimate goal of emergency medication?
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for med to reach therapeutic concentration in bloodstream
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Unlike Schedule I drugs, Sch II drugs have?
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Accepted medical uses
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A drug that blocks the effect of another drug is referred to as:
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Antagonist
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Decreased drug responsiveness
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Tolerance
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The comnbined effects of two drugs which are greater than their individual effects:
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Synergism (1+1=3)
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Drugs that cause increased cardia force
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Inotropic
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IM, SC injections are contraindicated in pts with:
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decreased peripheral perfusion
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The chemical name of a drug:
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Describes the chemical makeup
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The unique name of drug under which the manufacturer registers new drug
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Trade name
- |
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General name for drug
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Generic name
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Drug name that contains USP
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Official name
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Schedule II drugs have this propensity for dependance and abuse
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Very high
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Sch III drugs have this propensity for dependance and abuse
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Medium abuse potential
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Which government agency determines the safety and efficacy of drugs?
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FDA
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Which government agency regulates biologic products like vaccines?
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Public Health Service
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Medicine absorbed directly through skin
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Transdermal
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Medicine absorbed under the tongue
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Sublingual
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Medicine absorbed through cheek
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Buccal
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Study of metabolism and actions of medicine in the body
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Pharmokinetics
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Effect that causes 2 drugs given to same pt to have same effect, doublin pt response
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Summation
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A unique response that is pt specific
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Idiosyncrasy effect
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How the medication causes it's intended effect
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Mechanism of Action
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Dermatologic drugs affect what system?
|
Integumentary
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A liquid, usually water, that contains one or more substances dissolved entirely:
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Solution
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Study of medications and their effect/actions on the body:
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Pharmacology
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Time it takes for a medication to reach a min effective level at its target tissue
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Onset of Action
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Amount of medication still active when it reaches its target organ
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Bioavailability
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Overstimulation of muscarinic receptors will cause:
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excessive lacrimation, bradycardia, diarhea, meosis
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Adrenergic nerve fibers release what:
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epinephrine and norepinephrine
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Larger dose of same cncentration drug intended to achieve therapeutic level quickly
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Loading dose
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Dilute alcoholic extract used as skin antiseptic
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Tincture
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Process of chemical signaling between cells
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Neurotransmission
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Analysis of a drug to evaluate its potency
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Assay
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Procedure for determining a drugs concentration
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Bioassay
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2 Types of Peripheral Nerves
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Afferent-body to brain
Efferent-brain to body |
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Drugs given via ET tube (NAVEL)
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Naloxone, Atropine, Vasopressin, Epi and Lidocaine
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Route of Medication through GI tract
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Enteral
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Any drug route that is not through skin, gi or mucous membranes
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Parenteral
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IM injection amts
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1-5 ml
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Sub Q injection amounts
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up to 2 ml
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Energy dependant transport
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Active transport-lower to higher concentrations
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Transport from higher to lower that does not require energy
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Passive Diffusion
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Biotransformation occurs in what 2 ways?
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med is transformed into metabolit or it becomes more water soluble
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Adverse reaction inadvertently induced in pt by a treatment given:
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iatrogenic response
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Incresed effect when med is given in several successive doses
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Cumulative
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Meds that relieve pain
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Analgesics
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Absence of the sensation of pain
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Analgesia
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Dermatologic drugs affect what system?
|
Integumentary
|
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A liquid, usually water, that contains one or more substances dissolved entirely:
|
Solution
|
|
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Study of medications and their effect/actions on the body:
|
Pharmacology
|
|
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Time it takes for a medication to reach a min effective level at its target tissue
|
Onset of Action
|
|
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Amount of medication still active when it reaches its target organ
|
Bioavailability
|
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Reverse the effect of opiod drugs/example
|
Opiod Antagonist/Narcan
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Induces a loss of sensation to touch or pain
|
Anesthetic
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Receptor site for Benzodiazapine drugs
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GABA receptors
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What type drugs release dopamine and norepinephrine?
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CNS Stimulants
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Drugs that cause extrapyramidal symptoms:
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Psychotherapeutic
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Drugs that affect the Somatic (motor) nervous system?
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Neuromuscular Blcoking agents
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Paralytic of choice for prehospital airway
|
succinylcholine
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Sympathomimetics stimulate what?
|
Adrenal medulla
|
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Which antiarrhythnic drugs reduce adrenergic response of receptors that increase hr?
|
Beta blockers
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Protease inhibitor drugs are used to treat what?
|
HIV
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All neuromuscular blocking agents affect:
|
parasympathetic NS and induce paralysis
|
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Which adrenergic receptor contrls the release of norepinephrine?
|
Alpha 2
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Which medication is not a nondepolorizing neuromuscular blocking agent?
|
Succinylcholine
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In order to relieve bronchospasms associated with asthma, you would give a?
|
Beta 2 agonist
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Chronotropic effect would affect what?
|
Heart Rate
|
|
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Dromotropic effect would target what?
|
Electrical conduction of heart
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3 types of skeletal mucsle relaxants:
|
central-cns depression
direct acting-target muscle neuromuscular blocking-produce paralysis |
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Class of medications derived from plants/example
|
cardiac glycosides/Digoxin
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Drugs that control sodium/water concentrations to lower BP
|
Thiazides
|
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Drugs that lower sodium/calcium concentrations to lower BP
|
Loop diuretics
|
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Drugs that have both anti-hypertensive and anti-arrythmic properties
|
Calcium channel blockers
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Drugs that interfere with collection of platelets
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Anti-platelets
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Drugs thatp revent thromi from forming
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Anti-coagulants
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Druds that control cholesterol
|
Reductase inhibitors (statins)
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@nd line respiratory emergency drugs?
|
Xanthines
|
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Dissolves a clot once formed
|
Thrombolytic
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Common glaucoma medications
|
Humorsol, Flropryl
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Common opthalmic medications
|
Tetracaine, Pontacaine
|
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Most commonly used medication pre-hospital
|
O2
|
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Common Benzodiazipines
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Midazaolam(Versed) and Diazapam (Valium)
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Common Barbiturate
|
Thiopental (Pentothal)
|
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Common non-barbiturate hypnotics
|
Etamidate(amidate) and Propofol (Diprivan)
|
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Hormone replacement drug used in hypothyroidism
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Synthroid
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Drugs used to treat adrenal cortex disorders
|
corticosteroids
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Drug used to facilitate labor
|
Pitocin (oxytocin)
|
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Drug used to suppress force of contractions
|
tocolyticcs-Mag Sulfate and Brethine
|
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Cancer drugs
|
Antineoplastic
|
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Antimalarial drugs
|
Larium, Mephaquin
|
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Anti TB Drugs
|
Isoniazid, rifampicin
|
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What do antihelmintics treat?
|
worms/parasites
|
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Gout medications
|
urisocuric
|
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What vitamin can be given IV before giving dextrose to facilitate metabolism?
|
Thiamin (B1)
|
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Sodium channel clockers work by:
|
slowing conduction through heart
|
|
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Calcium channel blockers work by:
|
provide incresed o2 to heart by coronary artery dialation and reduced peripheral vascular resistance
|
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Medications that relieve pain without the side effects of opiods are called:
|
opiod agonist/antagonist
|
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Condition in which pt rapidly becomes tolerant to a med:
|
tachyphylaxis
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Total body water is what % wt of adult man
|
60%
|
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Water inside cells and %
|
Intracellular 45%
|
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Water outside cells and %
|
Extracellular 15%
|
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2 types extracellular fluid and %
|
Interstial 10.5% spinal fluid
Intravascular 4.5% plasma |
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Two or more atoms make a :
|
Molecule
|
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Organic molecules contain what?
|
Carbon (sugars)
|
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Inorganic molecules do not contain?
|
Carbon (salts)
|
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|
Another name for electrolytes
|
Ions
|
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What stabilizes electrical charges
|
Water
|
|
|
Positive charged electrolytes
|
Cations
|
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Negative charged electrolytes
|
Anions
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Major cations in body
|
sodium, potassium, calcium and magnesium
|
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Major anions in body
|
bicarb, phosphorus, chloride
|
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Unit of measurement for electrolytes
|
milliequivalent mEq
|
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Principal extracellular cation
|
Sodium NA+
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Principal intracellular cation
|
Potassium K+
|
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|
Plays major role in neuromuscalur function
|
Potassium
|
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Cellular potassium levels are controlled by what?
|
Insulin
|
|
|
Hypo/Hyperkalemia
|
low/high potassium
|
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Principal cation for bone growth
|
Calcium Ca++
|
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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-)
|
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|
Primary determinate of stomach ph, also regulates extracellular fluid levels
|
Chloride
|
|
|
Important component of ATP/Energy
|
Phosphorus
|
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|
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)
|
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Internal environments resistance to change
|
Homeostasis
|
|
|
Solution with same osmolarity as body fluids
|
Isotonic 0.9% - NS, LR
|
|
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Solution with osmolarity less than body fluids
|
Hypotonic (cells burst) D5W
|
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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
|
