* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download File - Dan Shaw
Survey
Document related concepts
Polysubstance dependence wikipedia , lookup
Pharmacognosy wikipedia , lookup
List of off-label promotion pharmaceutical settlements wikipedia , lookup
Compounding wikipedia , lookup
Neuropharmacology wikipedia , lookup
Pharmaceutical industry wikipedia , lookup
Drug design wikipedia , lookup
Drug discovery wikipedia , lookup
Electronic prescribing wikipedia , lookup
Theralizumab wikipedia , lookup
Prescription drug prices in the United States wikipedia , lookup
Drug interaction wikipedia , lookup
Prescription costs wikipedia , lookup
Adherence (medicine) wikipedia , lookup
Transcript
NM Pharmacology for First Responders Lesson Goal • Introduce drug names, forms, and indications for use, as well as how to assist patients with taking their prescribed medications Drug Names • Generic (scientific/chemical name) – Listed in U.S. Pharmacopeia – Example • Aspirin • Trade (brand) – Example • Bayer, Anacin Forms of Medication • Oral – Per os (PO) – Patient must be awake • Patient must be able to follow commands • Must be swallowed – Enters bloodstream through digestive system • Takes effect in 30-60 min Forms of Medication • Inhaled – Medication is inhaled into the lungs • Rapidly absorbed • Easy to administer – Inhaler or nebulizer Forms of Medication • Buccal – Between cheek and gums – Oral glucose Vital Drug Information • 6 pieces of information for every medication – Indications – Dosage – Administration – Actions – Side effects – Contraindications Vital Drug Information • Indications – Reason for administering medication – Nitroglycerin • Indicated for angina • Dosage – How much Vital Drug Information • Administration – Route • Actions – Desired effects • Nitroglycerin dilates coronary arteries to relieve chest pain Vital Drug Information • Side effects – Undesirable effects • Contraindications – Conditions in which medication must not be given • Nitroglycerin contraindicated for patients who have recently taken drug for erectile dysfunction Medication Examination • Correct medication – Seal intact – Color – No precipitate (floaters) • Correct concentration • Check expiration date Allowable Drugs • Administer the following drugs with Service Medical Director Approval – – – – – – – Oral glucose preparations Aspirin PO for adults with suspected cardiac chest pain IM auto-injector of atropine and or pralidoxime for treatment of chemical and/or nerve agent exposure Albuterol via inhaled administration Ipratopiem via inhaled administration, in combination with albuterol Epinephrine via auto-injector device Patient’s own bronchodilator using pre-measured or MDI device Metered Dose Inhaler (MDI) • You may assisted with a patient’s own bronchodilator using premeasured or MDI device – Need on-line medical control drug • Absorbed from alveoli into the pulmonary capillaries – Onset of action 1 - 3 minutes • Patient must be awake IM Auto-injection • Epinephrine • Nerve agent exposure – – Atropine Pralidoxime Acetylsalicylic Acid (ASA) • CLASS OF DRUG – Anti-inflammatory, analgesic, antipyretic, anticoagulant • INDICATIONS – Myocardial infarction patients, including suspected AMI patients. • CONTRAINDICATIONS – Hypersensitivity – Bleeding disorders – Asthma (Relative) • ADMINISTRATION – Adult: [160-325 mg] orally for AMI (prefer chewable) • SPECIAL NOTES – All patients with suspected AMI and without contraindications receive aspirin Albuterol • CLASS OF DRUG – Sympathomimetic, Beta 2 selective adrenergic bronchodilator • INDICATIONS – Albuterol is used to treat reversible airway obstruction caused by: • Wheezing associated with asthma, COPD (emphysema), chronic bronchitis • CONTRAINDICATIONS – Hypersensitivity • DRUG INTERACTION – Beta adrenergic agents - potentiates the effects – MAO inhibitors - may lead to hypertensive crisis – Beta adrenergic blockers - decreases the effectiveness • ADMINISTRATION – Nebulizer – Adult: [2.5-5.0 mg] (up to 10 mg) given over 5-15 minutes, may be repeated as necessary. – Pediatric: [1.25-2.5 mg] (up to 5 mg) given over 5-15 minutes, may be repeated as necessary. • SPECIAL NOTES – Most side effects are dosage related Ipratropium (Atrovent) • CLASS OF DRUG – • INDICATIONS – – • Few in the pre-hospital setting ADMINISTRATION – – • Hypersensitivity to the drug Acute treatment of bronchospasm where rapid response is required. DRUG INTERACTION – • Bronchial asthma Reversible bronchospasm associated with chronic bronchitis and emphysema CONTRAINDICATIONS – – • Anticholinergic Should be administered in conjunction with beta agonist therapy. Adult: 250 – 500mcg (.25 - .5 mg) via nebulization SPECIAL NOTES – – The vital signs must be monitored during therapy. Caution should be used when administering it to elderly patients and those with cardiovascular disease or hypertension. Epinephrine (1:1,000) • CLASS OF DRUG – Sympathomimetic • INDICATIONS – Severe Bronchospasm – Anaphylaxis • CONTRAINDICATIONS – None when indicated • DRUG INTERACTION – Reduced effects with Beta-adrenergic blocker • ADMINISTRATION – Auto-injector • SPECIAL NOTES – Increased cardiac workload can precipitate angina and/or AMI – Use with caution on patients with peripheral vascular insufficiency – Wheezing in the elderly is pulmonary edema or pulmonary embolus until proven otherwise Glucose (Dextose) • CLASS OF DRUG – Carbohydrate, nutrient, short acting osmotic diuretic • INDICATIONS – Symptomatic hypoglycemia • Known diabetic actively seizing • CONTRAINDICATIONS – Intra-cranial bleeds or suspected CVA (relative) – Unconscious (for oral glucose) • DRUG INTERACTION – None • ADMINISTRATION – Oral: [12-25 gm] of paste, may be spread with a tongue depressor. • SPECIAL NOTES – Attempts at documenting hypoglycemia via automatic glucometry should be made before administration. Oxygen • CLASS OF DRUG – Gas • INDICATIONS – Suspected hypoxia or respiratory distress from any cause • CONTRAINDICATIONS – None • DRUG INTERACTION – None • ADMINISTRATION – Adult & Pediatric Dosage • Low flow (NC 1 - 2 L/Min) • Moderate flow (NC 4 - 6 L/Min) • High flow (NRB 10 - 15 L/Min) • SPECIAL NOTES – BE PREPARED TO ASSIST VENTILATION, IF NEEDED. – Nasal prongs work equally well on nose and mouth breathers. – Giving 100 % oxygen to all patients is unnecessary. • If the patient has 96% O2 saturation and is in no acute distress, a NRB is not necessary. The Six Rights • • • • • • Right Right Right Right Right Right D R P A T S rug oute atient mount ime cribe Helps prevent medication errors! Allergies • Always ask about medication allergies before administering a medication! Sharps Control • Place syringe with needle immediately into sharps container Do NOT recap the needle Assessment of Effectiveness • After medication administration: – Reassess early & often • V/S • Patient assessment – Document findings/changes Summary • Many patients carry medications for chronic medical conditions • Know how to obtain drug information • On-line medical direction sometimes required • Patients must be re-evaluated Questions?