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Questions and Answers
What is the primary organ responsible for drug metabolism?
What is the primary organ responsible for drug metabolism?
Which factor does NOT affect drug response?
Which factor does NOT affect drug response?
Which routes are primarily used for drug excretion?
Which routes are primarily used for drug excretion?
Which physiological barrier is mentioned as influencing drug distribution?
Which physiological barrier is mentioned as influencing drug distribution?
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What happens to drug metabolites after being formed in the liver?
What happens to drug metabolites after being formed in the liver?
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What is the primary purpose of standing orders in medical treatment?
What is the primary purpose of standing orders in medical treatment?
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Which type of medication order requires reconfirmation from medical direction for any repeat administration?
Which type of medication order requires reconfirmation from medical direction for any repeat administration?
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What does the term 'PRN' stand for in medication prescribing?
What does the term 'PRN' stand for in medication prescribing?
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What is essential for effective communication with medical direction?
What is essential for effective communication with medical direction?
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Enteral drug administration refers to medications administered through which route?
Enteral drug administration refers to medications administered through which route?
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What are the various forms of drug presentations?
What are the various forms of drug presentations?
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Which of the following is NOT a liquid drug form?
Which of the following is NOT a liquid drug form?
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What affects the rate of absorption of a drug?
What affects the rate of absorption of a drug?
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Which process describes how the body handles a drug over time?
Which process describes how the body handles a drug over time?
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What is affected by the site conditions during drug administration?
What is affected by the site conditions during drug administration?
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After absorption, how is the drug distributed throughout the body?
After absorption, how is the drug distributed throughout the body?
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Which of the following is a gaseous drug form?
Which of the following is a gaseous drug form?
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What is NOT one of the main factors affecting drug absorption?
What is NOT one of the main factors affecting drug absorption?
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Which method allows the administration of medication directly into muscle tissue?
Which method allows the administration of medication directly into muscle tissue?
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What device is used for administering intranasal medications?
What device is used for administering intranasal medications?
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How does the absorption rate of intranasal medications compare to intramuscular injections?
How does the absorption rate of intranasal medications compare to intramuscular injections?
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What is a consideration when using a metered dose inhaler (MDI)?
What is a consideration when using a metered dose inhaler (MDI)?
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When administering medications intranasally using a MAD, how does the required dose compare to IV medications?
When administering medications intranasally using a MAD, how does the required dose compare to IV medications?
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What is the maximum volume of medication that can be tolerated for an intramuscular injection in the deltoid muscle?
What is the maximum volume of medication that can be tolerated for an intramuscular injection in the deltoid muscle?
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Which site is preferred for intramuscular injections in infants?
Which site is preferred for intramuscular injections in infants?
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Why should the dorsogluteal injection site not be used in patients younger than 2 years?
Why should the dorsogluteal injection site not be used in patients younger than 2 years?
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What is the maximum volume of medication that can be tolerated for subcutaneous injections?
What is the maximum volume of medication that can be tolerated for subcutaneous injections?
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Which muscle group allows for the most rapid absorption of injected medications due to its blood supply?
Which muscle group allows for the most rapid absorption of injected medications due to its blood supply?
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Which method of drug administration is safest for patients with an altered level of consciousness?
Which method of drug administration is safest for patients with an altered level of consciousness?
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What is a significant advantage of sublingual medications?
What is a significant advantage of sublingual medications?
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Which of the following routes of drug administration is most common for paramedics?
Which of the following routes of drug administration is most common for paramedics?
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What is the main limitation of parenteral drug administration?
What is the main limitation of parenteral drug administration?
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Which of the following is NOT part of the '7 rights' of medication administration?
Which of the following is NOT part of the '7 rights' of medication administration?
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What is a characteristic of medications administered rectally?
What is a characteristic of medications administered rectally?
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Why is buccal medication administration limited to conscious patients?
Why is buccal medication administration limited to conscious patients?
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What does 'PO' stand for in medication administration?
What does 'PO' stand for in medication administration?
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Study Notes
EHS 2020 Pharmacology for EMS
- This is a pharmacology course for emergency medical services (EMS)
- The current week's tutorial focuses on drug administration
- Learning objectives for the lecturer include recalling drug presentations and describing routes of administration
Learning Outcomes
- Students should be able to identify various forms of drug presentations (e.g., solid, liquid, gaseous)
- Students should be able to describe different routes of drug administration
Drug Forms
- Drugs come in various forms including solids, liquids, and gases
- A selection of these forms are available in clinical practice
Liquid Drug Forms
- Solution
- Suspension
- Fluid extract
- Tincture
- Spirits
- Syrup
- Elixir
- Milk
- Emulsion
- Liniments & lotions
Solid Drug Forms
- Extract
- Powder
- Pill
- Capsule
- Tablet
- Suppository
- Pessary
- Ointment
- Patch
Gaseous Drug Forms
- Vapour
- Gas
Routes of Drug Administration
- The route of administration affects the speed of absorption and onset of the drug's effects
Pharmacokinetic Definitions
- Pharmacology: The study of how the body processes drugs over a specific time period.
- Includes:
- Absorption
- Distribution
- Metabolism
- Elimination
Absorption
- The movement of the drug from the site of entry to the bloodstream
- Influenced by:
- Route of administration
- Solubility of the drug
- Conditions at the site of administration
- pH of the drug
- Concentration of the drug or dosage
Distribution
- After absorption, the drug circulates throughout the body
- The drug moves out of circulation and into tissues
- Some drugs are specific to certain tissues, while others may be distributed in all body fluids
- Factors include plasma proteins, cardiovascular function, regional blood flow, and physiological barriers
Metabolism
- The process where a drug's effect ends
- Results from breakdown into less active forms
- Primarily occurs in the liver, though may also occur in the blood plasma, intestinal mucosa, and kidneys
Elimination
- The process where drug products are excreted from the body
- Major routes include:
- Kidneys (urine)
- Intestines (faeces)
- Lungs (exhaled air)
- Drugs' metabolites are excreted in bile, which then empties into the intestines
Factors affecting drug response
- Age
- Weight
- Gender
- Environment
- Route of administration
- Condition of the patient
- Genetic factors
- Psychological factors
Putting it all together
- How are medications prescribed within the community?
- What methods do paramedics use to administer medications?
How might medications be prescribed to patients?
- Standing Orders:
- Instructions for treatment, specific to the patient presentation
- May or may not require medical consultation
- Suitable for life-threatening situations
- One-Time Orders:
- Immediate drug intervention, guided by medical direction
- Cannot be repeated without consulting medical direction
Medication Prescribed-Continued
- As-Needed Orders (PRN):
- "Pro re nata" or "as the situation demands"
- For specific patient conditions (pain, heart rate, and blood sugar abnormalities)
- Other Types:
- Patients from diverse settings (community care, long-term care facilities)
- Paramedics need medication administration records
- Need to be aware of medical abbreviations
Communication with Medical Direction
- Communication must be concise and clear
- Paramedics should write down the order and read it back to medical direction
- The physician should confirm the order.
Enteral Drug Administration
-
Drugs are absorbed through the gastrointestinal (GI) tract
-
Most oral medications are in solid forms (pill, tablet, or capsule) or liquid
-
Not suitable for altered or unconscious patients
-
Often abbreviated as PO (per os) referring to by mouth
-
Buccal Medication: Medications placed in the cheek. Safe for conscious patients.
-
Sublingual Medication: Medications under the tongue. Very quick absorption.
-
Rectal Medication: Optimal for patients who cannot take oral medications, delivered by melting the medication to a liquid form
Parenteral Drug Administration
- Any drug administration route other than GI
- More effective in the pre-hospital setting
- IV lines deliver medications quickly
- Special training and equipment needed
- Routes include IV line, IM injection, intradermal injections, subcutaneous injections, IO infusion, transdermal/topical, inhalation, intranasal, and ET tube administration.
Equipment
- Syringes
- Used for injecting or withdrawing fluids
- Luer-lock and Non-Luer-lock types are used
- Needles
- Various sizes/gauges
- Hub, shaft, bevel,
- Safety features
- Never re-sheath a needle
- Dispose of needles properly
Intra-Venous (IV)
- IV delivery
Inhalation Medications
- Nebulizers and Metered Dose Inhalers (MDIs)
- Common inhaled medication is oxygen
- Medications include Beta2 agonists, Atrovent
Intranasal Medications
- Rapid absorption (fast onset compared to IM)
- Using a mucosal atomizer device (MAD)
- Drugs include naloxone, midazolam, and glucagon
Intramuscular Injections (IM)
-
Administered directly into muscle tissue
-
Needle size depends on injection location and muscle size
-
Deep insertion; avoid nerve damage
-
Deltoid (shoulder): Rapid absorption, 2 mL max
-
Thigh (vastus lateralis): More tolerant of volumes (5 mL), anterior thigh
-
Hip (Dorsogluteal): Avoid in children under 2
-
Ventrogluteal preferred for children
Subcutaneous Injections
- Injections between skin and muscle tissue
- Smaller volumes (<0.5 mL)
- Slower onset action; prolonged duration
- Usual sites: upper arms, upper back, scapular regions.
Intra-Osseous (IO)
- IO Access
Topical Medications
- Topical medications are applied directly to the skin for treating skin conditions
- Useful for conditions affecting the skin
- Applied to chest, upper arms, and flanks.
- Avoid shaving the area
- Use a tongue depressor to apply ointments and creams
- Topical patches are becoming popular. Proper storage is important.
ET Tube Medication Administration
- Accessible even before IV or IO
- Can deliver numerous drugs
- Requires 2-2.5x the dose used for IV
- For quick absorption, dilute medications in normal saline or sterile water.
Week 4 Videos
- Refer to provided links for week 4 videos.
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Description
This quiz covers the essential aspects of drug administration in the context of emergency medical services. Students will recall drug presentations and describe various routes of administration. The learning outcomes include identifying solid, liquid, and gaseous drug forms used in clinical practice.
