General Pharmacology. Henry: EMT Prehospital Care, Revised 3 rd Edition Lecture Notes Chapter 16: General Pharmacology. Case History.

Transcription

1 Henry: EMT Prehospital Care, Revised 3 rd Edition Lecture Notes Chapter 16: General Pharmacology Chapter 16 General Pharmacology 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. 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 Slide 3 1

2 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) 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 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 Slide 6 2

3 Medication Terms Dose How much of the drug should be given Administration Route by which the medication is administered Actions Desired effects a drug has on the patient/body systems Slide 7 Medication Terms Side effects Actions of a drug other than those desired Slide 8 Dose Metric Conversions Kilograms Grams 1 kg 1000 g Milligrams Micrograms 1 g 1000 mg 1 mg 1000 µg Slide 9 3

4 Dose Metric Conversions Liters 1 L 0.5 L 0.1 L 0.01 L L Milliliters 1000 ml 500 ml 100 ml 10 ml ml 1 L L L L L 1 ml 1000 ml 1 L Slide 10 Four Rights of Medication Administration Right patient Right drug Right dose Right route of administration 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 Slide 12 4

5 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 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 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 Slide 15 5

6 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 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 Slide 17 Medications EMT-Basic May Assist Prescribed Inhalers Used to treat bronchoconstriction Prescribed by patient s s physician Administration is approved by medical direction and/or by local protocol. May be carried in the ambulance in some EMS systems Slide 18 6

7 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 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 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 fects of administered medications. Always contact medical direction and/or follow local protocols. Remember the rights of medication administration. Slide 21 7