EMT pharmacology

How many different medicaitons can we administer or assist with and what are they?
6- Aspirin, Oral Glucose, Oxygen, Prescribed Bronchodilator inhalers, nitroglycerin, and epinephyine auto injectors.

What is pharmacology?
the study of drugs, their sources, their characteristics, and their effects.

What medications as an EMT will you cary on the ambulance?
Aspirin, Oral Glucose, and Oxygen.

What is Aspirin used for and how does it work?
is a medication used to reduce the clotting ability of blood to prevent and treat clots associated with myocardial infarction. (patients with chest pain of suspected cardiac origin.)

What is the concern with Aspirin?
Some patients do have allergies and others have gastrointestinal bleeding that can be made worse by the administration of aspirin. (use chewable cause no water on abmulance)

What is Oral Glucose used for and how does it work?
treatment for a conscious patient with an altered mental status (brain senestive to low levels of sugar) and a history of diabetes. Comes in a tube of gel, apply to tongue depressor and place between the cheek, gum or under the tongue.

What is Oxygen used for?
patient whose medical or traumatic condition causes him to be hypoxic, or danger or being hypoxic.

What is activated charcoal?
Is a powder prepared from charred wood, premixed with water, used to treat poisoning or overdose when a substance is swallowed and is in the patients digestive tract. It will absorb some poisons and help them from being absorbed into the body.

What are the prescribed medications that as an EMT we can assist with?
Prescribed inhaler, nitroglycerin, and epinephrine auto-injector.

What are reasons someone would use a bronchodilator inhaler?
diseases like asthma, emphysema, or chronic bronchitis- It is designed to enlarge, constricted bronchial tubes, making breathing easier.

What are examples of an inhaler?
Albuterol, (ventolin, proventil, volmax) and levalbuterol (Xopenex).

What is a side effect of many bronchodilators?
Increased heart rate and patient jutteriness.

What is Nitroglycerin and what is it used for?
Patients with history of heart attack or recurrent chest pain carry this in pills or spray form, it helps dilate the coronary vessels, which supply the heart muscle with blood. Common to take up to 3 pills at a time.

What does a patient not want to take nitro with?
Anything to treat erectile dysfunction, such as sildenafil (Viagra), verdenafil (Levitra), tadalafil (Cialis), etc. Serious negative interaction with these drugs.

What is epinephrine auto-injectors used for and what do they do?
Someone highly allergic to something. Medication that will help to constrict the blood vessels and relax airway passages. (Vasoconstrictor) Must be administered quickly.

Where do you inject it, and what are other effects?
thigh, (two doses), potent effect on the heart and vasular system, increased heart rate and blood pressure.

How long after we give medication should we reassess the patient?
2 minutes.

Every drug or medication is listed in a comprehensive government publication called?
U.S. Pharmacopoeia (USP)

How many names does a drug have?
Chemical name, generic name, and one or more trade names.

What is difference between indications and contraindictions?
specific signs, symtoms, or circumstances when it is either appropriate or not appropriate to adminster the drug to a patient. (ie: nitro not be given to someone with low blood pressure)

What is definition of “side effect”?
A result or any action of drug other than the desired action.

What is an “untoward effect”?
an effect of a medication in addition to its desired effect that may be potentially harmful to the patient.

What are two routes of medications?
parenteral (does not use gastrointestinal tract, like intravenous medication) and enteral- which used gastrointestinal tract like a pill.

When should medication administration only be undertaken?
After a thorough patient assessment

Who can authorize medications that can be administered and what two manners can authorization come from?
Medical Director.
1- Offline Medical Direction.(standing orders)
2- Online Medical Direction. (speak to physician)

Before adminstering a drug to a patient you will….?
Confirm the order, write it down, and check the “five rights”. (check medication not expired as well)

What are the “five rights”?
1- Do i have the right patient?
2- Is it the right time to administer this medication?
3- Is this the right medication?
4- Is this the right dose?
5- Am I giving this medication by the right route of adminstration?

Describe oral or swallowed route or medication adminstration?
Very safe, must be digested to take effect, and takes longer. (pills, tablets, liquids)

Describe Sublingual or dissolved under the tongue?
placed under tongue to dissolve and absorb by the vascular soft tissue of the mouth. Faster than pills, Diffcult of circulation is poor.

Describe Inhaled route?
Through respiratory system and into blood stream via the aveoli.

Describe the intravenous route?
Injected into a vein, beyong scope of EMT level.Very fast and precise way to adminster medications into the body.

Describe the intramuscular?
injects into muscle. Blood vessels can rapidly absorb medication and transfer to other parts of the body. Can be affected by poor circulation.

Describe the subcutaneous route?
Injected into the skin, medication into layers of skin. Slightly slower than intramuscular.

Describe Intraosseous route?
Injected into bone marrow cavity.

Describe endotracheal route?
Sprayed directly into tube inserted into trachea. Aborbed by tissues of lungs.

What is pharmacodynamics?
study of the effects of medications on the body. Smaller patient less medication, larger means more. Consider Age and weight.

What do we document when we adminster medication?
Name, dose, route, time, and effects of medication.

What other reference do many ambulances carry that may describe common medications?
PDR (Physician’s Desk Reference) Report any medications that patient used to Medical Direction and hospital personnel.

What are the 7 most common medications patients often take?
Analgesics- pain refielf
Antidysrhthmics- heath rhythm disorders
Antoconvulsants- Prevention and control Seizures.
Antihypertensives- Reduce high BP
Bronchodilators- Sooth muscles of bronchial tubes.
Antidiabetic agents- control hyperglycemia
Antidepressant agents- Emotional activity, etc

There are two ways fluids and medications may be administered into the vien. What are they?
Through a heparin or saline lock. (catheter into vein, and cap or lock placed over end of catheter) Usually used for IV access later. 2nd is via a traditional IV bag (consists of a drip chamber, dlowregulator, and drug or needle port.)

Can you inject IV into patient?
No, but you may assist paramedics in doing the IV set.

What will you assist with, with a IV bag?
Take out and inspect the fluid bag (cleasiness, tears, etc), Select proper adminstration set (uncoil tubing), Connect extension to administration set, Make sure flow regulator is closed, Remove protecting covering from port of fluid bag, hold fluid bag higher than drip chamber, open flow regulator to flush all air out, turn off flow.

What are common herbal agents or supplements?
Echinacea- Common Cold
Garlic- High Cholesterol
Ginger Root- nausea and vomitting
Hawthorn leaf- Heart Failure
Kava Kava- Anxiety
Valerian root- Insomnia.
Pg. 437 more

How do we as EMT’s maintain an IV?
Check and make sure constricting band removed.
Flow regulator may of been closed
Check if clamp may be closed on tubing.
Check if tubing has a kink.
Check if tubing caught under patient.

What can insuffiecent flow cause and what is sifficiant flow?
Can cause blood to clot in the catheter. 30 drops per min for a micro drop. 10 drops per min for a macrodrip. Too fast can overload patient.

What is dangerous with and IV?
Infiltration, ( not fully going into the vien or surrounding areas ) stop the flow. and remove, Paramedic will reinsert.

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