Pharmacology Final

Principles of Pharmacology

• The Pure Food and Drug Act of 1906 addressed accurate drug labeling
• A drug's brand name is its proprietary name
• The oral route is the slowest route of administration
• Insulin is derived from animals (non-synthetic)
• The "Five Rights" of medication administration do not include "Right provider"

Pharmacodynamics & Pharmacokinetics

• An agonist binds to a receptor and activates it
• Bioavailability is the proportion of a drug that enters circulation
• First-pass metabolism occurs primarily in the liver
• Elderly patients may need adjusted dosing due to reduced renal clearance
• Half-life is the time required for the body to eliminate 50% of a drug

Legal Considerations & Documentation

• Administering the wrong dose of epinephrine is considered a medication error
• Narrative documentation, signatures, and a witness are critical for refusals involving medications
• Controlled substances are categorized by the DEA in Schedules I-V
• Documentation after giving any medication must include dose, route, time, and patient response
• Protocol adherence is the primary legal safeguard for paramedics administering drugs

Applied Math – Multiplication, Division, Ratios, Fractions

• 3. 5 grams is equivalent to 3500 mg
• 0. 5 mg × 4 tablets = 2 mg
• A ratio of 1:10,000 equals 0.1 mg/mL
• ¾ × 4 = 3
• 3 divided by 0.25 = 12

Metric Conversions

• 1500 mcg is equivalent to 1.5 mg
• 1 L is equal to 1000 mL
• 2. 5 kg equals 2500 grams
• 0. 75 grams is equivalent to 750 milligrams
• 0. 25 L is equal to 250 mL

BLS Drug Review (Week 6)

• Aspirin's mechanism of action is as a platelet aggregation inhibitor
• Oral glucose is contraindicated in unresponsive patients without a gag reflex
• Albuterol acts on Beta-2 receptors
• The typical adult dose of aspirin in suspected ACS is 324 mg
• Naloxone is classified as an opioid antagonist

Enteral Administration

• The sublingual route bypasses the liver’s first-pass metabolism
• A drug given sublingually is absorbed through the oral mucosa
• Rectal administration is considered enteral
• A syringe is the most accurate dosing method for oral liquid medications
• Buccal absorption offers a rapid systemic onset

Parenteral Administration

• The IV route has the fastest onset
• The preferred site for IM injection in infants is the vastus lateralis
• A key advantage of the IO route is rapid access when IV access fails
• A 3 mL IM injection should be given in the gluteus maximus
• Subcutaneous injections are typically given at a 45° angle

Special Populations

• Pediatric dosages are most often calculated using weight in kilograms
• For a child weighing 20 kg, a drug dosed at 0.1 mg/kg would equal 2 mg
• The elderly may have increased drug half-lives due to renal insufficiency
• Plasma volume increases during pregnancy, increasing the volume of distribution
• A drug classified as Category X by the FDA is contraindicated in pregnancy

Drug Mechanisms & Case Applications

• Beta-blockers primarily affect Beta-1 receptors
• Epinephrine 1:1,000 is most often used for IM administration for anaphylaxis
• A sympathomimetic drug will typically cause bronchodilation
• Flumazenil antagonizes benzodiazepines
• Administering 5 mg of a 10 mg/mL solution requires giving 0.5 mL