GENERAL PRINCIPLES OF PHARMACOLOGY

1. GENERAL PRINCIPLES OF PHARMACOLOGY

2. Drug Names Sources of Drug Products Drug Classifications Food & Drug Administration Medication Administration Properties of Drugs Part 1 Topics

3. Drugs are chemicals used to diagnose, treat, and preventdisease.

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

5. 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. Names of Drugs

6. Names of Drugs

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

8. Name Classification Mechanism of Action Indications Pharmacokinetics Side Effects Routes of Administration Contraindications Dosage How Supplied Special Considerations Components of a Drug Profile

9. Names Most Frequently Include Generic and Trade Names

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

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

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

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

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

15. How the drug is given. Routes of Administration

16. Conditions that make it inappropriate to give the drug. …means a predictable harmful event will occur if the drug is given in this situation. Contraindications

17. The amount of the drug that should be given. Dosage

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

19. 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. Legal

20. 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 Federal…

22. They vary widely. Always consult local protocols and with medical direction for guidance in securing and distributing controlled substances. State vs. Local Standards

23. New Drug Development

24. 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 (1 of 4)

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

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

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

28. Right Medication Right Dosage Right Time Right Route Right Patient Right Documentation Know the 6 Rights of Medication Administration

29. Pregnant Patients Pediatric Patients Geriatric Patients Special Considerations

30. Ask the patient if there is a possibility that she could be pregnant. Some drugs may have an adverseeffect on the fetus of a pregnant female. Teratogenic drug…is a medicationthat may deform or kill the fetus. Pregnant Patients

33. Absorption…a drug must find itsway to the site of action. Distribution…a drug must then be distributed throughout the body. Pharmacokinetics

34. Biotransformation…the process of breaking down, or metabolizing, drugs. Elimination…drugs must eventually be excreted from the body. Pharmacokinetics

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

36. Parenteral: Delivers medications via routes other than the GI tract. Include intravenous, endotracheal, intraosseous, umbilical, intramuscular, subcutaneously, inhalation, topical. Drug Routes (2 of 2)

37. Oral (PO) — good for self-administering drugs. Orogastric (OG) / Nasogastric (NG) — alternate method to providing POmedications. Sublingual (SL) — excellent absorption without problems of gastric acidity. Enteral – examples(1 of 2)

38. Buccal— between the cheek/gum.Similar to sublingual. Rectal (PR) — reserved forunconscious or vomiting patients. Enteral – examples(2 of 2)

39. Intravenous(IV) — preferred route inemergencies. Endotracheal (ET) — alternate route in emergencies for select medications. Intraosseous (IO) — alternative use inemergencies, mostly in pediatrics. Parenteral – examples(1 of 3)

40. Umbilical— provides alternate access in newborns. Intramuscular (IM) — slower absorption than IVs. Subcutaneous (SQ) — slower absorption than IM. Parenteral – examples(2 of 3)

41. Inhalation— very rapid absorption via the lungs. Topical— delivers drugs directly to the skin. Parenteral – examples(3 of 3)

42. Most emergency medications are given intravenously to avoid drug degradation in the liver.

43. Solid Forms: Such as pills, powders, suppositories, capsules. Liquid Forms: Such as solutions, tinctures, suspensions, emulsions, spirits, elixirs, syrups. Drug Forms

44. Pills—drugs shaped spherically to be swallowed. Powders—not as popular as they once were. Tablets—powders compressed into disk-likeform. Suppositories—drugs mixed with a waxlikebase that melts at body temperature. Capsules—gelatin containers filled withpowders or tiny pills. Solid Forms

45. Solutions—water or oil-based. Tinctures—prepared using an alcoholextraction process. Suspensions—preparations in which the solid does not dissolve in the solvent. Emulsions—suspensions with an oilysubstance in the solvent. Liquid Forms (1 of 2)

46. Spirits—solution of a volatile drug in alcohol. Elixirs—alcohol and water solvent; often with flavoring. Syrups—sugar, water, and drugsolutions. Liquid Forms (2 of 2)

47. 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 Actions of Drugs

48. Side Effect—unintended response to a drug. Allergic Reaction—hypersensitivity. Idiosyncrasy—drug effect unique to an individual. Responses to Drug Administration(1 of 5)

49. Tolerance—decreased response tothe same amount. Cross Tolerance—tolerance for a drugthat develops after administration ofa different drug. Tachyphylaxis—rapidly occurringtolerance to a drug. Responses to Drug Administration (2 of 5)

50. Cumulative effect—increased effectiveness when a drug is given in several doses. Drug dependence—the patient becomesaccustomed to the drug’s presence in hisbody. 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 (3 of 5)