2. Part 1 Topics
Drug Names
Sources of Drug Products
Drug Classifications
Food & Drug Administration
Medication Administration
Properties of Drugs
5. 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.
6. 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
7. State vs. Local Standards
They vary widely.
Always consult local protocols
and with medical direction for
guidance in securing and
distributing controlled
substances.
8. 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.
9. Names of Drugs
7-chloro-1, 3-dihydro-1,
Chemical Name
methyl-5-phenyl-2h-1
Generic Name diazepam
Official Name diazepam, USP
Valium®
10. Sources of Drug Information
United States Pharmacopeia (USP)
Physician’s desk reference (PDR)
Drug information
Monthly prescribing reference
AMA drug evaluation
11. Components of a Drug Profile
Name Routes of
Classification Administration
Mechanism of Contraindications
Action Dosage
Indications How Supplied
Pharmacokinetics Special
Side Effects Considerations
13. Classification
The broad group to which a
drug belongs. Knowing
classifications is essential to
understanding the properties
of drugs.
14. Mechanism of Action
The way in which a drug causes
its effects; its pharmacodynamics.
15. 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
22. Contraindications
Conditions that make it
inappropriate to give the drug.
…means a predictable harmful
event will occur if the drug is
given in this situation.
24. How Supplied
This typically includes the
common concentration of the
available preparations; many
drugs come in different
concentrations.
25. Drug Routes (1 of 2)
Enteral:
Deliver medications by absorption
through the gastrointestinal tract.
Oral, orogastric/nasogastric, sublingual,
buccal, rectal.
26. Drug Routes (2 of 2)
Parenteral:
Delivers medications via routes other
than the GI tract.
Include intravenous, endotracheal,
intraosseous, umbilical, intramuscular,
subcutaneously, inhalation, topical.
27. 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.
28. Enteral – examples
(2 of 2)
Buccal — between the cheek/gum.
Similar to sublingual.
Rectal (PR) — reserved for
unconscious or vomiting patients.
29. 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.
30. Parenteral – examples
(2 of 3)
Umbilical — provides alternate
access in newborns.
Intramuscular (IM) — slower
absorption than IVs.
Subcutaneous (SQ) — slower
absorption than IM.
31. Parenteral – examples
(3 of 3)
Inhalation — very rapid absorption
via the lungs.
Topical — delivers drugs directly to
the skin.
32. Most emergency
medications are given
intravenously to avoid drug
degradation in the liver.
33. Drug Forms
Solid Forms:
Such as pills, powders, suppositories,
capsules.
Liquid Forms:
Such as solutions, tinctures,
suspensions, emulsions, spirits, elixirs,
syrups.
34. Solid Forms
Pills—drugs shaped spherically to be
swallowed.
Powders—not as popular as they once were.
Tablets—powders compressed into disk-like
form.
Suppositories—drugs mixed with a waxlike
base that melts at body temperature.
Capsules—gelatin containers filled with
powders or tiny pills.
35. 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.
36. 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.
38. 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 drug…is a medication
that may deform or kill the fetus.
39.
40.
41. 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.
42. Providing Patient Care Using
Medications (2 of 4)
Maintain a current knowledge in
pharmacology.
Establish and maintain professional
relationships with other healthcare
providers.
Understand pharmacokinetics and
pharmacodynamics.
43. Providing Patient Care Using
Medications (3 of 4)
Have current medication references
available.
Take careful drug histories including:
Name, strength, dose of prescribed medications;
Over-the-counter drugs;
Vitamins;
Herbal medications;
Allergies.
44. Providing Patient Care Using
Medications (4 of 4)
Evaluate the patient’s
compliance, dosage, and
adverse reactions.
Consult with medical direction
as needed.
45. Know the 6 Rights of Medication
Administration
Right Medication
Right Dosage
Right Time
Right Route
Right Patient
Right Documentation
46. Responses to Drug Administration
(1 of 5)
Side Effect—unintended response
to a drug.
Allergic Reaction—hypersensitivity.
Idiosyncrasy—drug effect unique to
an individual.
47. 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.
48. 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.
49. 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+2=3.
50. 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.
51. Factors Affecting Drug Response
Age Time of Administration
Body Mass Pathology
Sex Genetics
Environment Psychology
52. Part 1 Summary
Drug Names
Sources of Drug Products
Drug Classifications
Food & Drug Administration
Medication Administration
Properties of Drugs
Notas del editor
Pure food – was enacted to imrove quality and labeling of drugs Federal food – empowered the FDA to set and enforce safety standards for drugs Comprehensive – replaced the harrison narcotic act, set a schedule of controlled substances from 1 to 5 with 1 being high abuse potential, severe dependance and no medical indications such as Heroin and LSD
SEMAC/REMAC
Untoward = side effects that are harmful to patient
1. Right drug check name of drug b. If the drug is unfamiliar, seek information from an authoritative source. c. Read labels of drug containers accurately. d. Question the prescribing physician about the order if it is unclear or if the drug seems inappropriate for the client's condition. 2. Right dose Calculate doses accurately. d. Measure doses accurately. e. Question the prescribing physician about the dosage if it seems inappropriate for the client or does not fall within the margin of safety. 3. Right route a. Check that the medication can be given by the route prescribed. b. Give medications only by the route prescribed. c. Use correct techniques for all routes of administration. 4. Right time a. Schedule administration of a drug to maximize therapeutic effects and minimize adverse effects. Ie epi every 5 min 5. Right client a. Check identification bands on institutionalized clients to ensure the name and number match exactly those on the medication administration record every time a medication is administered. 6. Right documentation Record the medication immediately following its administration on the official record. Reduce medication errors by following the 6 rights.
