Introduction to essential Pharmacology for Advanced EMT and Paramedic Students. A bit long but a good lecture. Does not goo into individual drugs, that is later. This is JUST the introduction.
2. Learning Objectives
Describe pharmacological as a science and a
historical perspective
Differentiate chemical, generic, trade names of drug
List main sources of drug products
Describe how drugs are classified
List authoritative sources for drug information
List legislative acts controlling drug use, abuse in U.S.
Differentiate Schedule I, II, III, IV, V substances; list examples
Discuss standardization of drugs
Discuss paramedic’s s responsibilities and scope of
management pertinent to administration of
medications
4. Introduction
Drug :
Substance (chemical agents) intended to diagnose,
cure, relieve, treat, prevent disease
Affects structure/function of body
Pharmacology : Study of drugs
5. Things that make you go hmmmmm
Based on Greek:
pharmakon: poison in classic Greek; drug in
modern Greek";
- logia: "Study of"
6. Introduction
Written records of drug use date back to the ancient
Egyptians
Early writings on drugs were observational, and were not
based on science
Early pharmacologists focused on natural substances,
mainly plant extracts.
The theories of “Humors” were used for almost 2000
years.
It wasn’t until the19th century that Pharmacology
developed as a biomedical science that applied the
principles of scientific experimentation to therapeutic
contexts.
8. The Renaissance and Phamacology
After Roman Empire fall, most European
cultures reverted to folklore, tradition,
superstition
By contrast: Muslims, Greeks,
Italians/Romans, Jews combined knowledge
of math, science, created formularies
Monasteries became some of the earliest
learning centers for pharmacy, medicine
9. “Modern” Pharmacology
Pharmaceutical laws enacted late 19th, early 20th
century protecting public
Drugs developed improved chronic illness
treatment 1950-current, more changes in
pharmacology than any other time
11. Pharmacokinetics vs.
Pharmacodynamics
Pharmacokinetics describes the movement of the
drug throughout the body.
The body’s effect on the drug (e.g. half-
life and volume of distribution),
Pharmacodynamics described the effects of the
drug on the body, intentional or toxic
Side effects, MOA, desired effects, etc
12. Pharmacokinetics
When describing the pharmacokinetic properties of a
chemical, pharmacologists are often interested
in LADME:
Liberation - disintegration (for solid oral forms {breaking down into
smaller particles}), dispersal and dissolution
Absorption - How is the medication absorbed (through the skin,
the intestine, the oral mucosa)?
Distribution - How does it spread through the organism?
Metabolism - Is the medication converted chemically inside the
body, and into which substances. Are these active? Could they be
toxic?
Excretion - How is the medication eliminated (through the bile,
urine, breath, skin)?
14. Pharmacokinetics
Active Transport
Use of energy (typically ATP) across barrier (i.e.
membrane) into target tissue.
Also may involve other ions
Typically this is against a pressure gradient (or
else passive transport would work)
15. Pharmacokinetics
Facilitated diffusion (also known
as facilitated transport or passive-mediated
transport)
Passive transport “with a twist”
Cell walls have specific properties that allow
passive transport of certain molecules and not
others.
Polarity
Size
Protein assisted : “Channels”
17. Pharmacodynamics
Drugs may act in four different ways:
Bind to a receptor site
Change the physical properties of the cell
Chemically combine with other chemicals
Alter a normal metabolic pathway
19. Pharmacogenosy
The study of natural drug sources
Plants
Animals
Minerals
What are some common examples of each drug
source?
20. Did you know?
“Crude Drugs”:
A crude drug is any naturally occurring, unrefined substance
derived from organic or inorganic sources such as plant, animal,
bacteria, organs or whole organisms intended for use in
the diagnosis, cure, mitigation, treatment, or prevention of
disease in man or other animals.
Crude drugs are unrefined medications in their raw or natural forms.
Prior to the 1950s, every pharmacy student learned about crude
drugs in pharmacognosy class.
Pharmacognosy is the study of the
proper horticulture, harvesting and uses of the raw medications found
in nature.
By the 1980’s, this practice was discontinued in most western
pharmacology programs, increasing the reliance of pharmacist on
drug companies.
Raising, harvesting and selling crude drugs was how many large
pharmaceutical companies started out.
Companies such as Eli Lilly and Company sold crude drugs to
pharmacists to save them time and money, but the early pharmacy
graduate would know how to raise their own crude drugs if need be.
21. Plant Sources of Drugs
Oldest source of medications
Drugs may consist of using the entire plant,
leaves, roots, bulbs, stems, seeds, buds, or
blossoms
23. Animal Sources of Drugs
Body fluids or glands from animals can act as
sources for drugs
Hormones
Oils and fats
Enzymes
24. Mineral Sources of Drugs
Metallic and nonmetallic minerals provide various
inorganic materials
Occur naturally or are combined to form acids,
bases, or salts
25. Orphan Drugs
An orphan drug is a pharmaceutical agent that has been
developed specifically to treat a rare medical condition, the
condition itself being referred to as an orphan disease.
Development, production, and marketing of an orphan drug is
not considered profitable under traditional pharmaceutical
business models, and therefore would likely not occur without
incentives.
The assignment of orphan status to a disease and to any drugs
developed to treat it is a matter of public policy in many countries and
the World Health Organization (WHO), and has resulted in medical
breakthroughs that may not have otherwise been achieved due to the
economics of drug research and development.
In the US and EU it is easier to gain marketing approval for an
orphan drug, and there may be other financial incentives such as
extended exclusivity periods.
34. Drug Absorption
Drug’s progress from
its pharmaceutical
dosage form to a
biologically available
substance
Several factors affect
drug absorption
37. Bioavailability
Bioavailability (BA) is a subcategory of
absorption and is used to describe the fraction
of an administered dose of unchanged drug
that reaches the systemic circulation
By definition, when a medication is
administered intravenously, its bioavailability
is 100%.
However, when a medication is administered via
other routes (such as orally), its bioavailability
generally decreases
38. Bioequivalence
“The absence of a significant difference in the
rate and extent to which the active ingredient
or active moiety in pharmaceutical equivalents
or pharmaceutical alternatives becomes
available at the site of drug action when
administered at the same molar dose under
similar conditions in an appropriately designed
study” – The US FDA
39. Biotransformation
Biotransformation has two effects:
It can transform the drug into a more or less active
metabolite
It can make the drug more water soluble (or less
lipid-soluble) to facilitate elimination
40. Biotransformation
Can activate
metabolites to make
the drug active
(prodrugs)
Many processes
occur in the liver
First-pass effect
Body detoxifies and
disposes of toxins and
excess drug by
increasing water
solubility
41. First Pass Metabolism
The first-pass effect (AKA first-pass metabolism or presystemic
metabolism) is a phenomenon of drug metabolism whereby
the concentration of a drug is greatly reduced before it reaches the
systemic circulation.
It is the fraction of lost drug during the process of absorption which is
generally related to the liver and gut wall. Notable drugs that
experience a significant first-pass.
After a drug is swallowed, it is absorbed by the digestive system and
enters the hepatic portal system through the portal vein to the liver.
The liver metabolizes many drugs, sometimes to such an extent that
only a small amount of active drug emerges from the liver to the rest of
the circulatory system.
This first pass through the liver thus greatly reduces the bioavailability of
the drug.
Alternative routes administration like suppository , intravenous,
intramuscular, inhalational aerosol and sublingual avoid the first-pass
effect because they allow drugs to be absorbed directly into
the systemic circulation.
42. Distribution
Several factors affect
distribution:
Cardiovascular function
Regional blood flow
Drug storage reservoirs
Physiological barriers
44. BLOOD BRAIN BARRIER
The blood- brain barrier is located in endothelial
cells of capillaries of the brain.
The blood brain barrier is both a physical barrier
and a system of cellular transport mechanisms.
It maintains homeostasis by restricting the
entrances of potentially harmful chemicals from
the blood, and by allowing the entrance of
essential nutrients.
45. BLOOD BRAIN BARRIER
Lipid soluble molecules, (i.e.
ethanol , most opioids, and
caffeine) are able to penetrate
through the barrier relatively
easily via the lipid membranes
of the cells.
In contrast, water soluble
molecules such as sodium and
potassium ions are unable to
transverse the barrier without
the use of specialized carrier-
mediated transport
mechanisms.
46. BLOOD BRAIN
BARRIER
These endothelial cells of
capillaries in the brain are different
to those found in peripheral tissues
in various ways:
Brain endothelial cells are joined by
tight junctions of high electrical
resistance providing an effective
barrier against molecules.
In peripheral endothelial cells there
is good transcellular movement of
molecules. There is no such
movement in brain endothelial cells.
Brain capillaries are in contact with
foot processes of astrocytes which
essentially separate the capillaries
from the neurones.
51. Elimination
Can be affected by
Drug half-life
Accumulation
Clearance
Onset, peak, and
duration
52. Accumulation
Accumulation: a drug that is not re-
administered is eliminated almost completely
over time, but a regularly administered
remains constant.
When elimination is altered, accumulation
increases.
In some cases this results in a drug exceeding
its therapeutic window.
Tylonol is a common drug with this problem.
Opioids as well.
53. Half Life
Technically a biological half life or elimination
half-life
In a medical context, half-life may also
describe the time it takes for the blood plasma
concentration of a substance to halve
("plasma half-life") its steady-state.
The relationship between the biological and
plasma half-lives of a substance can be
complex, due to factors including
accumulation in tissues, active metabolites,
and receptor interactions.
54. Question
Is the Half Life of a drug is 6 hours, how long
does it take to eliminate 98% the drug from the
body?
55. KEY POINT
IT TAKES SIX HALF LIVES TO REACH 98%
ELIMINATION
So it would take 36 hours for the hypothetical
drug to be (mostly) eliminated
56. Basics
Drugs are eliminated in either their original form
or as metabolites
Drug excretion is the movement of a drug or its
metabolites from the tissues back into circulation
and from secretion into organs of excretion
58. Drug Forms
Usually consist of a powder
dissolved in a liquid
Solute: drug
Solvent: liquid in which it is dissolved,
typicaly water
Primary difference between one
preparation and another is the
solvent
What is a solution?
59. Drug Forms
Liquids
Solids
Suppositories
Inhalants
Sprays
Creams/lotions
Patches
Lozenges
60. Liquid Drugs
Solutions: preparations that
contain a drug dissolved in a
solvent, usually water.
Tinctures: drugs chemically
extracted from alcohol.
Suspensions: drugs that do not
remain dissolved in a solution.
Spirits: drugs that contain volatile
chemicals dissolved in alcohol.
• Solutions: preparations that contain a
drug dissolved in a solvent, usually
water.
• Tinctures: drugs chemically extracted
from alcohol.
• Suspensions: drugs that do not remain
dissolved in a solution.
• Spirits: drugs that contain volatile
chemicals dissolved in alcohol.
61. Liquid Drugs
Emulsions: an oily
substance is mixed
with a solvent into
which it doesn’t
dissolve.
Elixirs: a drug in an
alcohol solvent.
Syrups: drugs
suspended in sugar
and water to improve
the taste.
63. Solid Drugs
Administered orally or rectally
Pills: shaped into a form
Powders: dry, particulate form of drug
Capsules: gelatin container filled with powder
Tablets: compressed powder covered with sugar coating
Suppositories: carried in a solid base that melts at body
temperature
• Administered rectally or vaginally
• Produce local and systemic effects
64. Inhalants
Both powdered or liquid forms of a
drug given via the respiratory route
and absorbed by the capillaries in the
lungs.
Nebulizers
Metered-dose aerosols
Turbo inhalers
Vaporizers
68. Receptors
Drug receptors: proteins present on cell
membrane to which a drug must bind in order to
elicit a desired response
69. Receptors
Receptors are classified based on effects
Agonist
AKA “ –Memetic”
Antagonist
Competitive antagonist
Noncompetitive antagonist
AKA “ -lytic”
A drug attached to a receptor site displays affinity
71. Receptors
Efficacy: the power of a drug to
produce a therapeutic effect
Agonists have affinity and efficacy
Antagonists have affinity but not efficacy
Drug potency: relative amount of drug
required to produce the desired
response
72. Receptors
How do drugs bind to receptor sites?
Ionic bonds: chemical bonds in which ions are transferred from
one molecule to another so that one end is positive and the
other negative
Hydrogen bonds: bonds that share a hydrogen ion between
molecules
Hydrophobic bonds nonpolar bonds created between
molecules
Van der Waals forces: transient, weak electrical attraction of
one atom for another that allows a molecule to change shape
Covalent bonds: chemical bond between two atoms achieved
by sharing pairs of electrons
73. Receptors
Receptor sites
Several drugs may bind to the same receptor site,
thus creating different responses by the cells
Two main functions
Ligand binding
Message propagation
75. Neurotransmitters
The nervous system is
the body’s control
system, regulating all
bodily function via
electrical impulses
What are the two main
parts of the central
nervous system that
drugs can affect?
80. Neurotransmitters
No connection exists between two nerve cells or
a nerve cell and its target organ; instead there is
a space called a synapse
Neurotransmitters are specialized chemicals that
conduct impulses between nerve cells or between
a nerve cell and an organ
81. Neurotransmitters
Neurotransmitters of ANS:
Acetylcholine (Ach)
Norepinephrine (NE)
Synapses:
Cholinergic synapses: use acetylcholine
Adrenergic synapses: use norepinephrine
85. Neurotransmitters
Cholinergic receptors
Acetylcholine Interacts with receptors, physiologic
response
Sympathetic receptors (Adrenergic receptors)
When sympathetic division stimulated, adrenal
medulla stimulated, releases epinephrine into
circulatory system
Sympatho-mimetic
Sympatho-lytics
86. Neurotransmitters
Sympathetic Nervous System
Arises from the thoracic and lumbar regions of the
spinal cord
Results in direct stimulation of adrenal medulla and
release of norepinephrine (noradrenaline) and
epinephrine (adrenaline)
87. Neurotransmitters
Sympathetic Nervous System
Stimulation ultimately results in release of
norepinephrine from postganglionic nerves
Sympathetic stimulation also results in release of
epinephrine and norepinephrine from the adrenal
medulla
What is/are the chemical mediators of the SNS?
88. Neurotransmitters
Types of sympathetic receptors
What is the action of adrenergic receptors?
Alpha1 (a1)
Alpha2 (a2)
Beta1 (b1)
Beta2 (b2)
Of dopaminergic receptors?
91. Neurotransmitters
The Parasympathetic Nervous System
Arises from the brain stem and sacral segments of the
spinal cord
Synapse in parasympathetic ganglia
What is/are the chemical mediators of the PNS?
92. Neurotransmitters
Stimulation of the parasympathetic nervous
system results in:
Pupillary constriction
Secretion by digestive glands
Increased smooth muscle activity along GI
tract
Bronchoconstriction
Reduction in heart rate and contractile force
97. Legal Concerns
Legal regulations, standards, and legislation
International controls
United Nations World Health Organization provides technical
assistance and encourages new research for drug use
US Controls
The FDA and the DEA share responsibility and enforcement
98. The FDA
In the United States, the Food and Drug Administration (FDA) is
responsible for creating guidelines for the approval and use of
drugs. The FDA requires that all approved drugs fulfill two
requirements:
The drug must be found to be effective against the disease for which
it is seeking approval.
The drug must meet safety criteria by being subject to extensive
animal and controlled human testing.
Gaining FDA approval usually takes several years to attain.
Testing done on animals must be extensive and must include
several species to help in the evaluation of both the
effectiveness and toxicity of the drug. The dosage of any drug
approved for use is intended to fall within a range in which the
drug produces a therapeutic effect or desired outcome.
The safety and effectiveness of prescription drugs in the U.S. is
regulated by the federal Prescription Drug Marketing Act of 1987.
99. Legal Concerns
Legal regulations, standards, and
legislation
Controls in the U.S.
Testing (animals studies and clinical patient trials)
Legislative control
100. Legal Concerns
Legal regulations, standards, and legislation
“Truth in labeling”
Why might “truth in labeling” be important?
101. Legal Concerns
Legal regulations, standards, and legislation
Narcotics
Harrison Narcotic Act, 1914
Comprehensive Drug Abuse Prevention and Control Act, 1970
102. Schedule of Controlled Drugs
Category Examples
Schedule I
No recognized medical use;
high abuse potential
Opiates (heroin), hallucinogens (LSD),
depressants (methaqualone)
Schedule II
Written prescriptions required;
no telephone renewals
Opiates (codeine, morphine,
meperidine), stimulants
(amphetamines), depressants
Schedule III
Prescriptions rewritten after six months
or five refills
Opiates (codeine <1.8 g/dl), stimulants,
depressants, anabolic steroids
Schedule IV
Prescriptions rewritten after six months
or five refills
Opiates (propoxyphene), stimulants,
depressants (chloral hydrate)
Schedule V
Any non-
narcotic medication, OTC
Small amounts of opiates when uses as
antitussives or antidiarrheals
104. KEY NOTEs
The US scheduling system and the WHO
scheduling system is very similar, but still slightly
different.
The scheduling does not include distilled spirits,
wine, malt beverages, or tobacco
105. Split Schedule Drugs
gamma-Hydroxybutyric acid (GHB), which has
been used as a general anaesthetic and for
the treatment of narcolepsy and alcohol
withdrawal and controlled action but a limited
safe dosage range.
It was placed in Schedule I in March 2000
after widespread recreational use led to
increased emergency room visits,
hospitalizations, and deaths.
Uniquely, this drug is also listed in Schedule
III for limited uses, under the
trademark Xyrem;
106. Legal Concerns
Legal regulations, standards, and legislation
Canadian drug legislation
Under direct control of Department of National Health and Welfare
Food and Drug Act, 1941
Canadian Food and Drugs Act, 1953
107. Legal Concerns
Legal regulations, standards, and legislation
Canadian Narcotic Control Act and Regulations
Canadian Narcotic Control Act, 1965
Restricts sale, possession, and use of narcotics
Restricts narcotic distribution to authorized personnel
110. Need to Know
Legal regulations, standards, and legislation
Drug Standards
United States Pharmacopeia (USP) is official standard to maintain
uniformity
111. Drug Names and References
Drug Classification
Prescription (Rx)
Over-the-counter (OTC)
Herbal
Dietary Suppliments
112. Drug Names and References
Drug Names
Official: generally same as generic name
meperidine hydrochloride, USP
Chemical: anatomic and molecular structure
Ethyl 1-methyl-4-phenylisonipecotate hydrochloride
Generic: abbreviated version of chemical name
meperidine hydrochloride
Trade: name based on chemical name or problem used
to treat
Demerol hydrochloride
What is another term for a drug’s trade name?
Brand Name
113. Drug Approval by the FDA
A process must be approved by the FDA
Studies take place in four phases
Preclinical testing, research, and development
Clinical research and development
NDA Review
Postmarketing surveillance
114. Typical Trials (FDA)
Pre-Clinical
Animal and lab studies
Phase 0
Optional, Studying basic pharmokenetics/dynamics in humans
Phase 1
Studied in healthy volunteers
Phase 2
To determine efficacy on patients , small groups limits study of
safety
Phase 3
Final studies prior to FDA approval and marketing
Studied in real patients vs. control group
Primarily for safety
Phase 4
Long Term studies on real patients
115. Drug Names and References
Bringing a drug to market is a process that takes
several years and must be approved by the U.S.
Food and Drug Administration (FDA)
116. Drug Names and References
Studies take place in four phases
Preclinical testing, research and development
Clinical research and development
NDA Review
Postmarketing surveillance
117. Drug Names and References
New Drug Development
Phase I
Testing to determine the drug’s pharmacokinetics, toxicity, and
safe dosing in humans
Phase II
Determination of the therapeutic drug level and observation for
toxicity and side effects
Phase III
Refinement of the usual therapeutic dose and collection of relevant
data on side effects
Phase IV
Post marketing analysis during conditional approval
Drug’s manufacturer is required to monitor its performance
Expedited Drug Approval
118. Unlabeled uses of drugs
Unlabeled uses of drugs
AKA “Off Label”
FDA recognizes that a drug’s labeling does not always
contain the most current information on usage
120. Classifying Medications
Classified with other similar medications with
the same effects
Anatomical/Body system/disease used to treat
cardiac, respiratory, GI
Anti-arrhythmic, Anti-emetic
Chemical group
benzodiazepines, xanthine derivatives, nitrates, opioids,
TCA’s, SSRI’s
Receptor binding site
parasympathetic blocker, adrenergic, dopaminergic
121. AHA Classes of Recommendations
for Drug Therapies
Class I
Benefit >>> Risk
Procedure/treatment or diagnostic
test/assessment should be
performed/administered
Table 15-7
122. Classes of Recommendations
• Most previous classes retained with better clarifications and descriptions.
•“Class Indeterminate” recommendations, which were used in 2005, are not
included in the 2010 AHA Guidelines for CPR and ECC. The elimination of the
term “Class Indeterminate” is consistent with the ACCF–AHA Classes of
Recommendation.
•When the AHA writing groups felt that the evidence was insufficient to offer a
recommendation either for or against the use of a drug or intervention, no
recommendation was given.
124. KEY POINT:
“ A recommendation with Level of Evidence B or C does not imply
that the recommendation is weak. Many important clinical
questions addressed in the guidelines do not lend themselves to
clinical trials. Even though randomized trials are not available,
there may be a very clear clinical consensus that a particular test
or therapy is useful or effective.”
-2010 AHA ECC Guidelines
Circulation 2010;122;S657-S664
127. Patient Medication Rights
What are the six “rights” of patient medication
administration that ensure safe, proper, and
effective administration?
128. Patient Medication Rights
1. Right patient
2. Right medication
3. Right dose
4. Right route
5. Right time
6. Right documentation
129. Street Smart Medic Tip
Be Very Careful with multiple patients, Mutiple
providers, and Multiple Drugs
The complexity of ANY situation increases the
chance of a critical error in medication
administration.
In otherwords:
KEEP YOUR SH*T TIGHT!
Street Smart Medic Tip
• Be Very Careful with multiple patients,
Multiple providers, and Multiple Drugs
• The complexity of ANY situation
increases the chance of a critical error
in medication administration.
• In other words:
– KEEP YOUR SH*T TIGHT!
131. What Paramedics Need to Know
About Drugs
Comprehensive drug list based on protocol
Be familiar with AHA Guidelines for treating cardiac
patients
Know local protocol and drugs used in your region
134. Street Smart Medic:
Before giving any drug, several actions must
performed:
Oxygen and monitor should be started as
appropriate
Establish IV access with appropriate fluids started
135. Need to Know
Components of a drug
profile
Names
Classification
Mechanism of action
Indications
Pharmacokinetics
136. What Paramedics Need to Know About
Drugs
Components of a drug profile
Side effects/adverse reactions
Contraindications
Dosage
How supplied
Special considerations
137. Need to Know
Special considerations in drug
therapy
Pediatric patients
Geriatric patients
Pregnant and lactating patients
138. Need to Know
Use care administering
medications
Follow the medication
order
139. What Paramedics Need to Know
About Drugs
Preparation involves selecting the appropriate
sized needle and syringe
No compensation for dead space is necessary
when drawing up medications
140. What Paramedics Need to Know
About Drugs
Use different needles when reconstituting
medication to be drawn up
Use caution when mixing drugs in one syringe
ALWAYS use sterile technique
141. Need to Know
Medical control
As a paramedic, you operate under the licensure of a
medical director who is responsible for all of your
actions
The medical director determines which drugs you will
administer and the routes by which they are given
142. Need to Know
Reduce the potential for contamination
Identify allergies prior to contacting hospital
Obtain vital signs
Obtain and confirm/repeat order
Write the order and the time
143. Need to Know
Select the proper medication
Inspect the medication
Confirm the order and medication
Six rights of administration
Record drug, dose, volume, route, and time, and
obtain vital signs and effects
144. What Paramedics Need to Know
About Drugs
Storage and handling considerations
USP28-NF23, PF30 (6), p. 2118
“Storage of Drugs in Emergency Medical Services (EMS)
Vehicles”
Narcotics and controlled substances should be
secured according to local protocols
145. Need to Know
Important pharmacological terminology
What is antagonism?
What is cumulative action?
What is potentiation?
What is synergism?
146. Need to Know
Important
pharmacological
terminology
Contraindications
Hypersensitivity
Idiosyncrasy
Side effects
Untoward effects
147. Need to Know
Important pharmacological terminology
Bolus
Indication
Therapeutic action
Tolerance
148. Need to Know
Important pharmacological
terminology
Depressant
Habituation
Refractory
Stimulant
150. Preparation
Before starting each shift, make sure all medications
are
Stocked in the proper amount
Not expired
In good condition
Stored properly
151. Preparation
Make sure you have adequate supplies to administer
them
Including syringes, needles, or needleless systems
152. Narcotic Drugs
Follow local, state, and
federal regulations when
it comes to usage and
storage
153. Administration Procedures
Premedication procedures
Obtain a complete SAMPLE history
Obtain a full set of vital signs
Complete a detailed exam
Contact medical control for authorization
154. Consider the whole patient…
Complete a thorough
assessment
Look for medication bottles
and herbal preparations
Determine if the patient
has been compliant with
his or her medication
Consider the medications
the patient already has on
board before you give any
more….
155. Get Good Data
Get a FULL set of RELIABLE vitals before you
administer a medication
Be Prepared for adverse reactions
Know your situation…
157. Medical Asepsis During Medication
Administration
Medical asepsis is
keeping the environment
free of pathogens
Several ways to keep the
environment clean
include:
Sterilization
Medically clean
Disinfectants
Antiseptics
158. Disposal of Contaminated Material
Use sharps container
to dispose of anything
capable of piercing
the skin
Dispose of all
contaminated material
in the proper
biohazard container
161. Summary
In order to deliver exceptional patient care,
the paramedic must have a basic
understanding of the responsibilities and
scope of management prior to administration
of any drug