Mosby Ch 8: Pharmacology Objectives

Front 1

Explain what a drug is

Back 1

A drug is any substance taken by mouth; injected into a muscle, blood, vessel, or cavity of the body; or applied topically to treat or prevent a disease or condition

Front 2

Identify four types of drug names

Back 2

Chemical, Generic, Trade, Official

Front 3

Outline drug standards and legislation and the enforcement agencies pertinent to the paramedic profession

Back 3

Sherley Amendment: prohibit fraudulent claims, Harrison Narcotic Act: control sale of narcotics (first use of term), Food, Drug, and Cosmetic Act: requires testing and listing of ingredients, Durham-Humphrey Amendment: required prescriptions, Kefauver-Harris Amendment: required efficacy proved, Controlled Substances Act: classified substances according to abuse potential. DEA is the nation’s sole drug regulatory agency. FDA, FTC, Public Health Service are others involved

Front 4

Describe the paramedic’s responsibilities in drug administration

Back 4

Use correct precautions and techniques, Observe and document effects, Keep knowledge and skills current, Establish and maintain professional relationships, Carefully evaluate patients to identify indications and contraindications, Take HX with prescriptions, OTC’s, vitamins, alternative drugs, adverse reactions, Seek medical direction

Front 5

Differentiate among the four types of allergic reactions to drugs

Back 5

Type I (anaphylactic): hives, itching, sometimes severe CV and Resp. – Penicillins, cephalosporins, iodines / Type II (cytotoxic): hemolytic reactions and destruction of platelets-- guanidine, procainamide, hydrazaline / Type III (serum sickness): hives, joint pain, swollen lymph nodes, fever-- phenytoin, horse serum / Type IV (contact dermatitis): e.g., poison ivy rash-- latex, sunscreen

Front 6

Discuss factors that influence drug absorption

Back 6

Nature of cell membrane, blood flow to the site of administration, solubility, pH of drug environment, drug concentration, dosage form, route

Front 7

Discuss factors that influence drug distribution

Back 7

Tissue-binding, plasma protein binding, permeability of capillaries, barriers

Front 8

Discuss routes of drug elimination

Back 8

Kidneys, intestine, lungs, sweat and salivary, mammary

Front 9

Describe how drugs react with receptors to produce their desired effects

Back 9

Lock-and-key. The drug that best fits one receptor site best produces a specific response

Front 10

List the variables that can influence drug interactions

Back 10

Intestinal absorption, competition for plasma protein binding, biotransformation, action at the receptor site, renal excretion, alteration of electrolyte balance

Front 11

Identify special considerations for administering pharmacological agents to pregnant patients

Back 11

Any agent given to a pregnant woman can cross the placental barrier and cause untoward effects to the fetus

Front 12

Identify special considerations for administering pharmacological agents to pediatric patients

Back 12

Age: effects are unpredictable on infants. Absorption: lowered peripheral perfusion in infants, liquid medications absorbed quicker in children. Distribution: higher water concentration, reduced plasma protein binding ability. Biotransformation: slower liver metabolism in infants. Elimination: <1yr renal activity immature—slowing excretion.

Front 13

Identify special considerations for administering pharmacological agents to older patients

Back 13

Age: decline in functional capability. Absorption: changes in nutritional habits, greater consumption of OTC’s, changes in gastric emptying. Distribution: changes in body composition, reduced plasma protein binding potential due to reduction in serum albumin. Biotransformation: possible liver dysfunction. Elimination: renal activity slows due to loss of nephron functioning and reduced blood flow. Drug administration noncompliance due to forgetfulness, expense, disappearance of symptoms, errors, deliberate noncompliance.