Chapter 18: General Pharmacology

EMS Medications

• Medications that EMTs can administer:
  • Aspirin
  • Oral Glucose
  • Oxygen
  • Activated Charcoal
  • Naloxone (Narcan)

Aspirin

• Indication: Suspected chest pain due to myocardial infarction (heart attack)
• Action: Reduces clotting factors in the blood

Oral Glucose

• Indication: Diabetic emergencies with low blood sugar
• Action: Raises blood sugar levels

Oxygen

• Action: Administered under medical direction or standing orders
• Common Usages: For patients under EMS care requiring oxygen

Activated Charcoal

• Action: Absorbs poisons in the body, preventing absorption into the bloodstream

Naloxone (Narcan)

• Indication: Narcotic overdoses
• Action: Binds to opioid receptors, blocking narcotics like heroin, morphine, fentanyl
• Side Effects: Severe vomiting, irritability

Assisting with Medications

• EMTs can assist with:
  • Metered Dose Inhalers (MDIs)
  • Nitroglycerin
  • Epinephrine

Metered Dose Inhalers (MDIs)

• Common Medication: Albuterol
• Usage: Asthma, emphysema, chronic bronchitis
• Side Effects: Increased heart rate, jitteriness

Nitroglycerin

• Indication: Chest pain
• Form: Spray (400 micrograms) or tablets (0.4 mg)
• Action: Vasodilation of blood vessels
• Contraindications: Low blood pressure, concurrent use of erectile dysfunction drugs
• Side Effects: Drop in blood pressure, check BP 5 minutes post-administration

Epinephrine Auto-Injectors

• Indication: Severe allergic reactions (anaphylaxis)
• Action: Vasoconstrictor, relaxes smooth muscles in airways
• Side Effects: Increased heart rate, blood pressure
• Administration: EMTs in Colorado with IV cert. can draw and inject directly

Force Protection Medications

• Example: Nerve agent antidotes (e.g., 2-PAM)
• Storage: Stored centrally, not on ambulances

Medication Information

• Names: Generic, chemical, trade names
• Indications: Conditions for giving the drug
• Contraindications: When not to give the drug
• Side Effects: Mild effects (e.g., BP drop from nitroglycerin)
• Untoward Effects: Severe effects (e.g., severe headache)

Forms of Medications

• Compressed Powders/Tablets: Aspirin
• Liquids: Epinephrine, Albuterol
• Gels: Oral Glucose
• Suspensions: Activated Charcoal
• Fine Powders: Albuterol
• Mist/Gases: Oxygen
• Sublingual Spray: Nitroglycerin

Medication Administration

• Understanding Medications:
  • Indications
  • Contraindications
  • Side Effects
  • Dosage
  • Effectiveness

Routes of Administration

• Oral: Swallowed (e.g., activated charcoal, oral glucose, aspirin)
• Rectal: Absorbed through digestive tract
• Sublingual: Under the tongue (e.g., nitroglycerin)
• Inhaled: Breathed into lungs (e.g., oxygen)
• Intranasal: Sprayed into nose (e.g., Narcan)
• Intravenous (IV): Into vein
• Intramuscular (IM): Into muscle (e.g., epinephrine)
• Subcutaneous: Under the skin
• Intraosseous: Into bone
• Endotracheal: Into trachea

Pharmacodynamics

• Study of medication effects on the body
• Factors Influencing Drug Action: Kidney/liver disease, other medications

Documentation

• Include: Doctor’s order, route of administration, dosage, patient’s reaction
• Mistakes: Report and document all actions taken to rectify errors

IV Therapy

• Saline Lock/Heparin Lock: For quick medication administration
• IV Bags: Connected to saline lock
• Tubing: Includes drip chamber, regulator, and ports for medication
• Flow Issues: Check tubing, constricting bands, IV site, and for kinks