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Chapter 6General Principles of PharmacologyPart 1Basic Pharmacology : 

Chapter 6General Principles of PharmacologyPart 1Basic Pharmacology Galveston College EMS Paramedic 2009

Topics : 

2/54 Topics Drug Names Sources of Drug Products Drug Classifications Food & Drug Administration Medication Administration Properties of Drugs

Slide 3: 

3/54 Drugs are chemicals used to diagnose, treat, and prevent disease.

Slide 4: 

4/54 Pharmacology is the study of drugs and their actions on the body.

Names of Drugs : 

5/54 Names of Drugs Chemical States its chemical composition and molecular structure Generic Usually suggested by the manufacturer Official As listed in the U.S. Pharmacopeia Brand The trade or proprietary name

Slide 6: 

6/54 Names of Drugs

Sources of Drug Information : 

7/54 Sources of Drug Information United States Pharmacopeia (USP) Physician’s Desk Reference (PDR) Drug information Monthly prescribing reference AMA drug evaluation EMS field guides

Components of a Drug Profile : 

8/54 Components of a Drug Profile Name Classification Mechanism ofaction Indications Pharmacokinetics Side effects Routes of administration Contraindications Dosage How supplied Special considerations

Names : 

9/54 Names Most frequently include generic and trade names

Classification : 

10/54 Classification The broad group to which a drug belongs. Knowing classifications is essential to understanding the properties of drugs.

Mechanism of Action : 

11/54 Mechanism of Action The way in which a drug causes its effects; its pharmacodynamics

Indications : 

12/54 Indications Conditions that enable the appropriate administration of the drug (as approved by the FDA)

Pharmacokinetics : 

13/54 Pharmacokinetics How the drug is absorbed, distributed, and eliminated; typically includes onset and duration of action

Side Effects/Adverse Reactions : 

14/54 Side Effects/Adverse Reactions The drug’s untoward or undesired effects

Routes of Administration : 

15/54 Routes of Administration How the drug is given

Contraindications : 

16/54 Contraindications Conditions that make it inappropriate to give the drug A predictable harmful event will occur if the drug is given in this situation.

Dosage : 

17/54 Dosage The amount of the drug that should be given

How Supplied : 

18/54 How Supplied This typically includes the common concentration of the available preparations; many drugs come in different concentrations.

Legal : 

19/54 Legal Knowing and obeying the laws and regulations governing medications and their administration is an important part of a paramedic’s career. These include federal, state, and agency regulations.

Federal : 

20/54 Federal Pure Food & Drug Act of 1906 Harrison Narcotic Act of 1914 Federal Food, Drug, & Cosmetic Act of 1938 Comprehensive Drug Abuse Prevention & Control Act of 1970

State vs. Local Standards : 

21/54 State vs. Local Standards They vary widely. Always consult local protocols and with medical direction for guidance in securing and distributing controlledsubstances.

New Drug Development : 

22/54 New Drug Development

Providing Patient Care Using Medications (1 of 4) : 

23/54 Providing Patient Care Using Medications (1 of 4) Know the precautions and contraindications for all medications you administer. Practice proper technique. Know how to observe and document drug effects.

Providing Patient Care Using Medications (2 of 4) : 

24/54 Providing Patient Care Using Medications (2 of 4) Maintain a current knowledge in pharmacology. Establish and maintain professional relationships with other health care providers. Understand pharmacokinetics and pharmacodynamics.

Providing Patient Care Using Medications (3 of 4) : 

25/54 Providing Patient Care Using Medications (3 of 4) Have current medication referencesavailable. Take careful drug histories including: Name, strength, dose of prescribed medications Over-the-counter drugs Vitamins Herbal medications Allergies

Providing Patient Care Using Medications (4 of 4) : 

26/54 Providing Patient Care Using Medications (4 of 4) Evaluate the patient’s compliance, dosage, and adverse reactions. Consult with medical direction as needed.

The Six Rights of Medication Administration : 

27/54 The Six Rights of Medication Administration Right medication Right dosage Right time Right route Right patient Right documentation

Special Considerations : 

28/54 Special Considerations Pregnant patients Pediatric patients Geriatric patients

Pregnant Patients : 

29/54 Pregnant Patients Ask the patient if there is a possibility that she could be pregnant. Some drugs may have an adverse effect on the fetus of a pregnant female. Teratogenic drugs are medications that may deform or kill the fetus.

Slide 30: 

30/54 FDA Pregnancy Categories

Slide 31: 

31/54 A Broselow tape is useful for calculating drug dosage for pediatric patients.

Pharmacokinetics (1 of 2) : 

32/54 Pharmacokinetics (1 of 2) Absorption A drug must find its way to the site of action. Distribution A drug must then be distributed throughout the body.

Pharmacokinetics (2 of 2) : 

33/54 Pharmacokinetics (2 of 2) Biotransformation The process of breaking down, or metabolizing, drugs. Elimination Drugs must eventually be excreted from the body.

Drug Routes (1 of 2) : 

34/54 Drug Routes (1 of 2) Enteral Deliver medications by absorption through the gastrointestinal tract Oral, orogastric/nasogastric, sublingual, buccal, rectal

Drug Routes (2 of 2) : 

35/54 Drug Routes (2 of 2) Parenteral Deliver medications via routes other than the GI tract Include intravenous, endotracheal, intraosseous, umbilical, intramuscular, subcutaneous, inhalation, topical

Enteral – Examples (1 of 2) : 

36/54 Enteral – Examples (1 of 2) Oral (PO) Good for self-administering drugs Orogastric (OG) / Nasogastric (NG) Alternate method to providing PO medications Sublingual (SL) Excellent absorption without problems of gastric acidity

Enteral – Examples (2 of 2) : 

37/54 Enteral – Examples (2 of 2) Buccal Between the cheek and gum Similar to sublingual Rectal (PR) Reserved for unconscious or vomiting patients

Parenteral – Examples (1 of 3) : 

38/54 Parenteral – Examples (1 of 3) Intravenous (IV) Preferred route in emergencies Endotracheal (ET) Alternate route in emergencies for select medications Intraosseous (IO) Alternative use in emergencies, mostly in pediatrics

Parenteral – Examples (2 of 3) : 

39/54 Parenteral – Examples (2 of 3) Umbilical Provides alternate access in newborns Intramuscular (IM) Slower absorption than IVs Subcutaneous (SQ) Slower absorption than IM

Parenteral – Examples (3 of 3) : 

40/54 Parenteral – Examples (3 of 3) Inhalation Very rapid absorption via the lungs Topical Delivers drugs directly to the skin

Most emergency medicationsare given intravenously to avoiddrug degradation in the liver. : 

41/54 Most emergency medicationsare given intravenously to avoiddrug degradation in the liver.

Drug Forms : 

42/54 Drug Forms Solid forms Pills, powders, suppositories, capsules, and so on Liquid forms Solutions, tinctures, suspensions, emulsions, spirits, elixirs, syrups, and so on

Solid Forms : 

43/54 Pills Drugs shaped spherically to be swallowed Powders Not as popular as they once were Tablets Powders compressed into disklike form Suppositories Drugs mixed with a waxlike base that melts at body temperature Capsules Gelatin containers filled with powders or tiny pills Solid Forms

Liquid Forms (1 of 2) : 

44/54 Liquid Forms (1 of 2) Solutions Water or oil-based Tinctures Prepared using an alcohol extraction process Suspensions Preparations in which the solid does not dissolve in the solvent Emulsions Suspensions with an oily substance in the solvent

Liquid Forms (2 of 2) : 

45/54 Liquid Forms (2 of 2) Spirits Solution of a volatile drug in alcohol Elixirs Alcohol and water solvent; often with flavoring Syrups Sugar, water, and drug solutions

Actions of Drugs : 

46/54 Actions of Drugs Drugs that act by binding to a receptor site Drugs that act by changing physical properties Drugs that act by chemically combining with other substances Drugs that act by altering a normal metabolic pathway

Responses to Drug Administration (1 of 5) : 

47/54 Responses to Drug Administration (1 of 5) Side effect Unintended response to a drug Allergic reaction Hypersensitivity Idiosyncrasy Drug effect unique to an individual

Responses to Drug Administration (2 of 5) : 

48/54 Responses to Drug Administration (2 of 5) Tolerance Decreased response to the same amount Cross tolerance Tolerance for a drug that develops after administration of a different drug Tachyphylaxis Rapidly occurring tolerance to a drug

Responses to Drug Administration (3 of 5) : 

49/54 Responses to Drug Administration (3 of 5) Cumulative effect Increased effectiveness when a drug is given in several doses Drug dependence The patient becomes accustomed to the drug’s presence in his body Drug interaction The effects of one drug alter the response to another drug Drug antagonism The effects of one drug block the response to another drug

Responses to Drug Administration (4 of 5) : 

50/54 Responses to Drug Administration (4 of 5) Summation Also known as additive effect; two drugs with the same effect are given together Similar to 1+1=2 Synergism Two drugs with the same effect are given together and produce a response greater than the sum of their individual responses Similar to 1+1=3

Responses to Drug Administration (5 of 5) : 

51/54 Responses to Drug Administration (5 of 5) Potentiation One drug enhances the effect of another Interference The direct biochemical interaction between two drugs; one drug affects the pharmacology of another drug

Factors AffectingDrug Response : 

52/54 Factors AffectingDrug Response Age Body mass Sex Environment Time of administration Pathology Genetics Psychology

Drug Interactions : 

53/54 Drug Interactions Drug interactions occur whenever two or more drugs are available in the same patient. The interaction can increase, decrease, or have no effect on their combined actions.

Summary : 

54/54 Summary Drug Names Sources of Drug Products Drug Classifications Food & Drug Administration Medication Administration Properties of Drugs

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