Download In the prehospital setting, the goal of emergency pharmacology is to

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In the prehospital setting, the goal of emergency pharmacology is to use
medications to reverse, prevent, or control various diseases and illnesses, chronic
and acute.
Medications must always be delivered according to the six rights: the Right
patient, the Right dose, the Right route, the Right time, the Right medication, and
Right documentation on your PCR.
A medication is a drug that has been approved by the government agency that
regulates pharmaceuticals for the purpose of curing or reducing the symptoms of
an illness or medical condition or to assist in the diagnosis, treatment, or
prevention of a disease. A drug may also be given in an attempt to alter the
disease process.
The manufacture of pharmaceuticals in the United States and most other countries
is subject to a variety of laws and regulations that aim to prohibit manufacturers
from making false claims about their drugs’ benefits and advising patients to
administer the drugs incorrectly.
Drugs are derived from four principal sources: animal, vegetable, mineral, and
synthetic compounds.
Special considerations exist when administering medications to pregnant women,
children, and older people.
Paramedics are legally responsible for the appropriate use of medications and
documentation of medication therapy. Always have a clear understanding of
which medication you are administering and why you are administering it.
Medications administered as part of the care provided in the prehospital setting
exert their effects largely by acting on the nervous system.
The peripheral nervous system is separated into two divisions: the somatic
nervous system and the ANS. The ANS is particularly vulnerable to the
administration of prehospital medications. It is considered to be “automatic” or
involuntary because we cannot control its functioning or force functions under its
control to happen or not happen. The sympathetic nervous system, which gives
the fight-or-flight response, is the dominant system during periods of stress and
activity. The parasympathetic nervous system is the dominant system during
periods of rest and relaxation.
Neurotransmission is the process of chemical signaling between cells.
Receptors are unique molecular structures or sites on the surface or interior of a
cell that bind with substances such as hormones, drugs, and neurotransmitters.
Receptors are highly specialized and, in most cases, respond only to a particular
substance, much like a lock and key.
Normal neurotransmission can be altered by using drugs that mimic or inhibit
neurotransmission. Some medications inhibit the release of neurotransmitters, and
others work by blocking the receptor sites along the neural pathway.
Drugs adjust or influence the body’s existing functions by interacting with various
cells and tissues in the body, and they typically work through several mechanisms
of action rather than relying on a single action. In most cases, medications may
bind to a receptor site and trigger a stimulus; in some cases, they change the
chemical properties of cells and tissues. They may also combine with other
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chemicals within cells or organ systems to aid in elimination or bind to receptors
to alter the normal metabolic functions of cells and tissues.
Drugs are available in a wide array of forms, including liquids, solids, and vapors.
In the field, you use only a limited subset of drug forms.
The mode of administration affects the rate at which the body absorbs the drug,
and the route of administration affects the speed with which a drug works.
Local effects result from the direct application of a drug to a tissue. Systemic
effects occur after the drug is absorbed by any route and distributed by the
bloodstream.
The routes of administration are classified into three categories based on how the
medication is absorbed and distributed: percutaneous (applied to and absorbed
through the skin), enteral (absorbed somewhere along the gastrointestinal tract),
and parenteral (any route of administration that does not cause the drug to be
absorbed through the skin, mucous membranes, or gastrointestinal tract).
Every medication has varying effects on the body. The study of the metabolism
and action of medications within the body is called pharmacokinetics, which
focuses particularly on the time required for absorption, duration of action,
distribution in the body, and method of excretion.
A medication’s ability to reach a therapeutic concentration in the bloodstream
depends partially on the rate and extent to which the drug is absorbed. Rate and
extent are dependent on the ability of the medication to cross the cell membrane,
which occurs by active transport or passive diffusion.
Blood is the primary distribution vehicle for medications. Factors that change the
way blood flows through the body will change the way medications are
transported to the target tissue.
Biotransformation, or the way in which the body metabolizes medications, occurs
by transforming the medication into a metabolite or by making the medication
more water-soluble.
Excretion occurs primarily through the kidneys via glomerular filtration, tubular
secretion, and partial reabsorption.
Medications cause their action on the body by binding to a receptor site, changing
the physical properties of cells, chemically combining with other chemicals, or
altering a normal metabolic pathway.
The drug-response relationship correlates the amount of medication given and the
response it causes.
Factors affecting how patients react to medications include age, weight, sex,
environment, time of administration, condition of the patient (overall state of
health), genetic factors, and psychologic factors.
Every medication has some side effects that are known and anticipated, although
occasionally unanticipated adverse reactions (iatrogenic responses) are seen.
Extremes of temperature, exposure to direct sunlight, or excessive humidity may
decrease the potency of some medications or degrade the actual molecular
components and make the medication inactive.
Understanding drug profiles will help you select the most appropriate medication
for your patients.
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Classifications of drugs are based on the effect the drugs will have on a particular
part of the body or on a specific condition.