Chapter 12: Principles of Pharmacology - Emergency Care and Transportation of the Sick and Injured (12th Edition)

Introduction

• Understanding the significance and characteristics of general pharmacology is essential for EMTs.
• Proper usage of medications can alleviate pain and improve patient conditions; improper use 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 medication works on the body; includes effects and receptor interactions.
  • Agonist: Stimulates receptors.
  • Antagonist: Blocks other chemicals from attaching to receptors.
• Dose: Amount of medication given, depending on patient factors.
• Action: Therapeutic effect expected from medication.
• Pharmacokinetics: Actions of the body on the medication.
  • Onset: Time from administration to clinical effect.
  • Duration: Length of clinical effect.
  • Elimination: Removal of medication from the body.
  • Peak: Maximum clinical effect point.

Medication Considerations

• Indications: Conditions for which a medication is given.
• Contraindications: Situations where medication could harm or be ineffective.
  • Absolute: Should never be given.
  • Relative: Benefits may outweigh risks.
• Adverse Effects:
  • Unintended Effects: Undesirable but low risk.
  • Untoward Effects: Harmful effects.

Medication Names

• Generic Name: Simple, non-proprietary, not capitalized.
• Trade Name: Brand name given by manufacturer, capitalized.
• Prescription Drugs: Require physician's order.
• Over-the-Counter (OTC) Drugs: No prescription needed.

Routes of Administration

• Enteral Medications: Through digestive system; slow absorption.
• Parenteral Medications: Enter body by other means; faster and predictable.
• Absorption: Process of medication traveling through tissues into bloodstream.

Common Routes

• Per Rectum (PR): Reliable absorption.
• Oral (PO): By mouth, slow absorption (~1 hour).
• Intravenous (IV): Fastest delivery.
• Intraosseous (IO): Into bone marrow.
• Subcutaneous (SC): Injection into fatty tissue.
• Intramuscular (IM): Into muscle.
• Inhalation: Into lungs; quick absorption.
• Sublingual (SL): Under the tongue; rapid absorption.
• Transcutaneous/Transdermal: Through skin; prolonged effect.
• Intranasal (IN): Via mucosal atomizer device; quick absorption.

Medication Forms

• Tablets and Capsules: Common oral forms.
• Solutions and Suspensions: Liquid mixtures, need shaking for suspensions.
• Meter Dose Inhalers (MDI): For respiratory conditions.
• Topical Medications: Applied to skin.
• Transcutaneous Medications: Systemic effect through the skin.
• Gels: Semi-liquid, such as oral glucose.
• Gases: Oxygen, commonly used.

Administration Guidelines

• Nine Rights:
  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
• Cross-Check Procedures: Verifies correct drug administration.

Types of Medication Administration

• Peer-Assisted: Self or partner administration.
• Patient-Assisted: Helping patient with own medication.
• EMT Administration: Direct administration by EMT.

Specific Medications

• Oral Medications:
  • Oral Glucose: For hypoglycemia, given in gel form.
  • Aspirin: For heart attack, reduces platelet aggregation.
• Sublingual Medications:
  • Nitroglycerin: For angina pain, vasodilator.
• Intramuscular (IM) Medications:
  • Epinephrine: For anaphylaxis, increases heart rate and blood pressure.
  • Naloxone (Narcan): Reverses opioid overdose effects.
• Inhaled Medications:
  • Oxygen: Commonly administered for cellular function.
  • Meter Dose Inhalers/Small Volume Nebulizers: For respiratory issues.

Patient Medication Considerations

• Verify patient medications and consider implications for treatment.
• Medication Errors: Prevent through proper environment and procedure.

Conclusion

• Pharmacology chapter review covers EMT responsibilities and medication management.
• Understanding pharmacology is crucial for safe and effective emergency care.