Term
| What is a defining element of paramedic clinical practice? |
|
Definition
Medication administration.
p423 |
|
|
Term
| _______ is the scientific study of how various substances interact with or alter the function of living organisms. |
|
Definition
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|
Term
| During what centuries did formal scientific study of the effects of medication on the body begin to emerge? |
|
Definition
During the late 17th and 18th centuries.
p423 |
|
|
Term
| When was the first significant regulation enacted and what was it called? |
|
Definition
1906 and Pure Food and Drug act.
p423 |
|
|
Term
| What did the Pure Food and Drug act do? |
|
Definition
Prohibited altering or mislabeling medications.
p423 |
|
|
Term
| What agency is responsible for approving new medications and removing unsafe medications from use? |
|
Definition
|
|
Term
| What is it called when a medication is approved, but for a purpose not approved by the FDA? |
|
Definition
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|
Term
| The Comprehensive Drug Abuse Prevention and Control Act of 1970 is also know as? |
|
Definition
Controlled Substances Act
p424 |
|
|
Term
| The Controlled Substances Act is responsible for what? |
|
Definition
| Classifying certain medications with the potential of abuse into 5 categories (schedules) with corresponding security, dispensing, and record-keeping requirements. |
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|
Term
| What schedule may not be prescribed, dispensed, used, or administered for medical use? |
|
Definition
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|
Term
| What schedule has high abuse potential, highly addictive, and no recognized medical purpose? Examples are Heroin, marijuana, and LSD. |
|
Definition
|
|
Term
| Paramedics are likely to carry and administer what schedule medications? |
|
Definition
Schedule II and Schedule IV
p424 |
|
|
Term
| What Schedule has high abuse potential and legitimate medical purpose? examples are Fentanyl(Sublimaze), methylphenidate(Ritalin), and cocaine? |
|
Definition
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|
Term
| True or false. Only Schedule II medications require locked storage, significant record keeping, and controlled wasting procedures. |
|
Definition
False! All Schedule II through V medications require all of that.
p424 |
|
|
Term
| True or false. Only Schedule II medications require locked storage, significant record keeping, and controlled wasting procedures. |
|
Definition
False! All Schedule II through V medications require all of that.
p424 |
|
|
Term
| True or false. Only Schedule II medications require locked storage, significant record keeping, and controlled wasting procedures. |
|
Definition
False! All Schedule II through V medications require all of that.
p424 |
|
|
Term
| What Schedule has a lower abuse rate than schedule II and examples are Hydrocodone(Vicodin), acetaminophen with codeine, and ketamine? |
|
Definition
|
|
Term
| Has a lower potential for abuse than some of the other Schedule's and an example are narcotic cough medicines. |
|
Definition
|
|
Term
| How many names is each medication name given in the U.S? |
|
Definition
|
|
Term
| Describe the names given to each medication in the U.S. |
|
Definition
Chemical name(rarely used in clinical practice), Generic or nonproprietary name(regulated internationally to promote consistency and avoid duplication in drug names. Also include a "stem" that links them into other medications in the same class), 3rd name is the Brand name(chosen by the manufacturer and approved by the FDA)
p425 |
|
|
Term
| What source did these medications com from? Examples Atropine, aspirin, digoxin, morphine. |
|
Definition
|
|
Term
| What source did these medications com from? Examples Heparin, antivenom, thyroid preparations, insulin. |
|
Definition
|
|
Term
| What source did these medications com from? Examples are Streptokinase and numerous antibiotics. |
|
Definition
|
|
Term
| What source did these medications com from? Examples are iron, magnesium sulfate, lithium, phosphorus, calcium. |
|
Definition
|
|
Term
| What are 2 common medication reference sources available? |
|
Definition
United States Pharmacopeia-National Formulary(USP-NF) and Physicians' Desk Reference (PDR)
p.426 |
|
|
Term
| What is the main reason paramedics need to use caution when referencing the AMA publication? |
|
Definition
Because not every medication in the compendium has received FDA approval.
p426 |
|
|
Term
| According to the USP what is the recommended temperature that most medications should be kept at? |
|
Definition
|
|
Term
| The biochemical and physiologic effects and mechanism of action of a medication in the body. |
|
Definition
|
|
Term
| The fate of medications in the body, such as distribution and elimination. |
|
Definition
|
|
Term
| A process with 4 possible effects on a medication absorbed through the body:(1) An in active substance can become active, capable of producing desired or unwanted clinical effects.(2) An active medication can be changed into another active medication.(3) An active medication may be completely or partially inactivated.(4) A medication is transformed into a substance (active or inactive) that is easier for the body to eliminate. |
|
Definition
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|
Term
| When a medication binds with a receptor site, one of four possible actions will occur. List the four possible actions. |
|
Definition
(1) Channels permitting the passage of ions in cell walls may be opened or closed.(2) A biochemical messenger becomes activated, initiating other chemical reactions within the cell.(3) A normal cell function is prevented.(4) A normal or abnormal function of the cell begins.
p427 |
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|
Term
| The group of medications that initiates or alters a cellular activity by attaching to receptor sites, prompting a cellular response. (Goes With) |
|
Definition
|
|
Term
| The group of medications that prevent endogenous or exogenous agonist chemicals from reaching cell receptor sites and initiating or altering a particular cellular activity. (Goes Against) |
|
Definition
Antagonist Medications
p428 |
|
|
Term
| The ability of a medication to bind with a particular receptor site. |
|
Definition
|
|
Term
| In a pharmacologic context, the concentration of medication at which initiation or alteration of cellular activity begins. |
|
Definition
|
|
Term
| The relationship between the desired response of a medication and the dose required to achieve the response. |
|
Definition
|
|
Term
| As the _____ of a medication increases, the concentration or dose required for a particular cellular response decreases. |
|
Definition
|
|
Term
| In a pharmacological context, the ability of a medication to produce the desired effect. |
|
Definition
|
|
Term
| ______ medications bind with receptor sites, initiating or altering an action by the cell. |
|
Definition
|
|
Term
| Alpha (1) Agonist effect is? |
|
Definition
Vasoconstriction of arteries and veins.
p429 |
|
|
Term
| Alpha (2) Agonist effect is? |
|
Definition
Keep Alpha (1) in check, insulin restriction, glucagon secretion, inhibition of norepinephrine.
p429 |
|
|
Term
| Beta (1) Agonist effect is? |
|
Definition
Increased heart rate(Chronotropic effect), Increased myocardial contractility(Inotropic effect), Increased myocardial conduction(Dromotropic effect), and renin secretion for urinary retention.
p429 |
|
|
Term
|
Definition
Bronchus and bronchiole relaxation(Dilation), insulin secretion, uterine relaxation, arterial dilation in certain key organs.
p429 |
|
|
Term
| Dopaminergic agonist effect? |
|
Definition
Vasodilation of renal and mesenteric arteries (numerous receptor subtypes exist)
p429 |
|
|
Term
| Nicotinic agonist effect? |
|
Definition
Present at neuromuscular junction, allowing acetylcholine (ACh) to stimulate muscular contraction.
p429 |
|
|
Term
| Muscarinic-2 agonist effect? |
|
Definition
Present in the heart; activated by ACh to offset sympathetic stimulation, decreasing heart rate, contractility, and electrical conduction velocity.
p429 |
|
|
Term
| ______ medications bind with receptor sites to prevent a cellular response to agonist chemicals. |
|
Definition
|
|
Term
| Antagonists may be _________ or ________. |
|
Definition
Competitive or noncompetitive.
p429 |
|
|
Term
| The medications that temporarily bind with cellular receptor sites, displacing agonist chemicals. |
|
Definition
Competitive antagonists
p429 |
|
|
Term
| Medications that permanently bind with receptor sites and prevent activation by agonist chemicals. |
|
Definition
Noncompetitive antagonists
p429 |
|
|
Term
| A chemical that binds to the receptor site but does not initiate as much cellular activity or change as other agonists do; lowers the efficacy of other agonists chemicals present at the cells. |
|
Definition
|
|
Term
| The medications used to kill or suppress the growth of microorganisms. |
|
Definition
|
|
Term
| The medications used to fight infections by killing the microorganisms or preventing their multiplication to allow the body's immune system to overcome them. |
|
Definition
|
|
Term
| The medication used to treat fungal infections. |
|
Definition
|
|
Term
| Medications that bind with heavy metals in the body and create a compound that can be eliminated; used in cases of ingestion or poisoning. |
|
Definition
|
|
Term
| Characterized by the of a solvent, such as water, across a semipermeable membrane (for example, the cell wall) from an area of lower to higher concentration of solute molecules. |
|
Definition
|
|
Term
| A chemical that increases urinary output. |
|
Definition
|
|
Term
| The specified amount of a medication to be giving at specific intervals. |
|
Definition
|
|
Term
| Medications distribute into three primary types of body substances; what are they? |
|
Definition
Water, lipids or fats, and protein.
p430 |
|
|
Term
| The percentage of body fat is lowest in ______? |
|
Definition
|
|
Term
| The percentage of body water is highest in? |
|
Definition
Newborns, and steadily decreases throughout the life span
p430 |
|
|
Term
| When does the percentage of body proteins peak? |
|
Definition
Preteens, adolescents, and adults.
p430 |
|
|
Term
| Who has the lowest percentage of body proteins? |
|
Definition
Infants and elderly people
p430 |
|
|
Term
| A property that indicates a material can be dissolved in water. |
|
Definition
|
|
Term
| A hemoprotein involved in the detoxification of many drugs. |
|
Definition
Cytochrome P-450 system
p430 |
|
|
Term
| Medication metabolism in the liver is affected by the ________? |
|
Definition
Cytochrome P-450 system
p430 |
|
|
Term
| A decline in liver or kidney function, due to aging or other cause, requires a _______ in the dosage of many medications. |
|
Definition
|
|
Term
| Opposite from expected; Patients at extremes of age are disproportionately prone to _______ medication reactions. |
|
Definition
|
|
Term
| What is the major advantage of weight-based medication dosing? |
|
Definition
The amount of medication is proportional to the size of the patient.
p431 |
|
|
Term
| What is the formula for the ideal weight of a male? Weight is in kilograms(kg). |
|
Definition
50 + (2.3 times pt's height in inches over 5 feet)
p431 |
|
|
Term
| What is the formula for the ideal weight of a female? Weight is in kilograms(kg). |
|
Definition
45.5 + (2.3 times the pt's height in inches over 5 feet)
p431 |
|
|
Term
| Atropine sulfate and lidocaine are generally viewed as ineffective and are not indicated for _________ cardiac arrest. |
|
Definition
|
|
Term
| Fever also suppresses the function of the __________in the liver, which ultimately decreases the rate of metabolism of certain classes of medications. |
|
Definition
cytochrome P-450 system
p431 |
|
|
Term
| What are 3 genetic diseases that paramedics should be extremely careful when deciding whether to administer medications to pt's. |
|
Definition
Primary pulmonary hypertension, sickle cell disease, and glucose-6-phosphate dehydrogenase deficiency.
p431 |
|
|
Term
| Pt's with primary pulmonary hypertension may have ______ ______ when vasopressor medications are used. |
|
Definition
Acute decompensation
p431 |
|
|
Term
| What will happen if you administer salicylate medications(ex. aspirin) in pt's with glucose-6-phosphate dehydrogenase deficiency? |
|
Definition
May precipitate hemolysis.
p431 |
|
|
Term
| Medications that cause diuresis, such as furosemide(Lasix), or vasoconstriction, such as epinephrine or dopamine, may cause or worsen potentially fatal complications of what genetic disease? |
|
Definition
|
|
Term
| In pregnant pt's cardiac output and intravascular volume increase by how much? |
|
Definition
|
|
Term
| The percentage of red blood cells in a blood sample. |
|
Definition
|
|
Term
| In pregnant pt's, respiratory tidal volume and minute volumes ______, while the inspiratory and expiratory reserve volumes ______. |
|
Definition
|
|
Term
| GI motility ______ as pregnancy progresses. |
|
Definition
|
|
Term
| Renal blood flow and urinary elimination ______, roughly in proportion to cardiac output and intravascular volume. |
|
Definition
|
|
Term
| What are the factors that affect response to medications? |
|
Definition
Age,weight,environment,genetic factors,pregnancy, and psychosocial factors.
p430-432 |
|
|
Term
| What are the 5 FDA pregnancy catagories? |
|
Definition
A(ok to give),B(Animal related complications but not sevre),C(Animal related adverse effects on the fetus,Benefit out weighs risk),D(Positive evidence of human fetal risk),X(Harmful to mom & baby)
p432 |
|
|
Term
| What are some common prehospital meds known to cause fetal harm? |
|
Definition
Asprin, Valium, Versed.
p432 |
|
|
Term
| Several smaller doses of a particular medication capable of producing the same clinical effects as a single larger dose of that same medication. |
|
Definition
|
|
Term
| A severe, posibly fatal reaction that mimics a burn; may be due to a medication. |
|
Definition
Steve-Johnson syndrome
p434 |
|
|
Term
| The destruction of red blood cells by disruption of the cell membrane. |
|
Definition
|
|
Term
| In a pharmacologic context, abnormal susceptibility to a medication, possibly due to genetic traits or dysfunction of a metabolic enzyme, that is peculiar to an individual pt(and usually unexplained). |
|
Definition
|
|
Term
| The weight-based dose of a medication that caused death in 50% of the animals tested. |
|
Definition
Median lethal dose(LD50)
p434 |
|
|
Term
| The weight-based dose of a medication that demonstrated toxicity in 50% of the animals tested. |
|
Definition
Median toxic dose(TD50)
p434 |
|
|
Term
| The weight-based dose of a medication that was effective in 50% of the humans and animals tested. |
|
Definition
Median effective dose(ED50)
p434 |
|
|
Term
| The relationship between the median effective dose and the median lethal dose or median toxic dose; also known as the theraputic ration. |
|
Definition
|
|
Term
| An extreme systemic form of an allergic reaction involving 2 or more body systems. |
|
Definition
|
|
Term
| A mild to severe reaction after the first exposure to a medication or other substance, often with many of the same signs and symptoms as an immune-mediated reaction. |
|
Definition
medication sensitivity
p435 |
|
|
Term
| A condition that developes following repeated use by a patient of a medication that results in decreased efficacy or potency. |
|
Definition
|
|
Term
| The process in which a mechanism reducing available cell receptors for a particular medication results in tolerance. |
|
Definition
|
|
Term
| A process in which repeated exposure to a medication within a particular class causes a tolerance that may be "transferred" to other medications in the same class. |
|
Definition
|
|
Term
| A condition in which repeated doses of medication within a short period rapidly cause tolerance, making the medication virtually ineffective. |
|
Definition
|
|
Term
| What are the 2 distinct groups of medications that are prone to abuse and misuse? |
|
Definition
Stimulants and Deprssants
p435 |
|
|
Term
| A medication or chemical that temporarily enhances CNS and sympathetic nervous system functioning. |
|
Definition
|
|
Term
| A chemical or medication that decreases the performance of the CNS or sympathetic nervous system. |
|
Definition
|
|
Term
| One medication or chemical taken by a pt that undermines the effectiveness of another medication taken by or administered to a pt. |
|
Definition
|
|
Term
| The percentage of the unchanged medication that reaches systemic circulation. |
|
Definition
|
|
Term
| 2 medications with a similar effect combine, and the resulting effect is greater than the sum of the effects of the medications(ie,1+1=6) |
|
Definition
|
|
Term
| The effect of one medication is greatly enhanced by the presence of another medication, which does not have the ability to produce the same effect. |
|
Definition
|
|
Term
| 2 medications, each producing opposite effects, are present simultaneously, resulting in minimal or no clinical changes. |
|
Definition
Physiologic antagonism
p437 |
|
|
Term
| What is the bioavailability of the Intranasal route? |
|
Definition
|
|
Term
| What is the bioavailability of the intravenous route? |
|
Definition
|
|
Term
| Medications administered to stimulate the aympathetic nervous system. |
|
Definition
|
|
Term
| Medications administered to stimulate the aympathetic nervous system. |
|
Definition
|
|
Term
| What is the bioavailability of IM. |
|
Definition
|
|
Term
| List the 6 rights of medication administration. |
|
Definition
Right patient, right medication, right dose, right route, right time, and right documentation and reporting.
p444 |
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