Chapter 12: Principles of Pharmacology - Emergency Care and Transportation of the Sick and Injured

Introduction to Pharmacology

• Importance of medications for EMTs:
  • Alleviate pain and improve patient condition.
  • Incorrect administration can lead to severe consequences, including death.

Key Definitions

• Pharmacology: Science of drugs, including ingredients, preparation, uses, and actions on the body.
• Medication: Substance used to treat or prevent disease or relieve pain.
• Pharmacodynamics: How medications work on the body.
  • Agonist: Stimulates receptors.
  • Antagonist: Blocks receptors.
• Dose: Amount given based on patient’s weight, age, or desired action.
• Action: Therapeutic effect expected on the body.
• Pharmacokinetics: Actions of the body on the medication.
  • Onset: Time until clinical effects occur.
  • Duration: Length of time clinical effects persist.
  • Elimination: How medications are removed from the body.
  • Peak: Maximum clinical effect period.

Factors Affecting Medication Action

• Depends on the route and shock states.
• Indications: Reasons or conditions for giving medication.
• Contraindications:
  • Absolute: Never give if present.
  • Relative: Benefits may outweigh risks.
• Adverse Effects:
  • Unintended: Undesirable but low risk.
  • Untoward: Harmful effects.

Medication Names

• Generic Name: Non-proprietary, not capitalized (e.g., ibuprofen).
• Trade Name: Brand name, capitalized, multiple for one drug (e.g., Tylenol).

Types of Drugs

• Prescription vs. OTC (Over-The-Counter).
• Include recreational, herbal remedies, enhanced drugs, vitamin supplements, alternative medicines.

Routes of Administration

• Enteral Medications: Through digestive system, slow absorption, not common in emergencies.
• Parenteral Medications: Other means, faster absorption, more predictable.
• Absorption: Process of medications traveling through body tissues to bloodstream.

Common Routes

• PR (Per Rectum): Easy, reliable absorption.
• PO (Oral): By mouth, slow absorption.
• IV (Intravenous): Fastest delivery, not for all meds.
• IO (Intraosseous): Through bone marrow.
• SC (Subcutaneous): Into fatty tissue.
• IM (Intramuscular): Into muscle, quick absorption.
• Inhalation: Into lungs, quick bloodstream absorption.
• SL (Sublingual): Under tongue, quick absorption.
• Transcutaneous: Through the skin, longer-lasting effect.
• IN (Intranasal): Quick absorption through nasal mucosa.

Medication Forms

• Determines route and timing of administration.
• Tablets/Capsules: Common oral forms.
• Solutions: Liquid mixtures.
• Suspensions: Fine particles in liquid.
• Meter Dose Inhalers: For respiratory illnesses.
• Topical Medications: Applied to skin.
• Transcutaneous Medications: Systemic effect.
• Gels: Semi-liquids, e.g., oral glucose.
• Gases: Oxygen is common.

General Steps for Administering Medications

• Administer only under medical direction.
• Follow the "Nine Rights" of medication administration:
  1. Right patient
  2. Right medication and indication
  3. Right dose
  4. Right route
  5. Right time
  6. Right education
  7. Right to refuse
  8. Right response and evaluation
  9. Right documentation

Types of Medication Administration

• Peer-Assisted: Self or partner.
• Patient-Assisted: Helping patient with their own medication.
• EMT Administration: Administering directly to patient.

Administration Techniques

• Oral Medications: Confirm airway and swallowing ability.
• Sublingual Medications: Rapid absorption, e.g., nitroglycerin.
• Intramuscular: Quick access, e.g., Epinephrine.
• Intranasal: E.g., Narcan for opiate overdoses.
• Inhaled Medications: Oxygen, MDI, SVN for respiratory issues.

Patient’s Medications

• Obtain thorough medication history.
• Transport medications or list to emergency facility.

Medication Errors

• Avoid through organization and focus.
• Document and learn from errors.

Conclusion

• Understand and follow protocols for safe medication administration.
• Emphasize continuous learning and quality improvement in pharmacology practices.