Introduction to Paramedic Pharmacology PDF

I N T RO D U C T I O N TO PA R A M E D I C P H A R M AC O LO G Y VVC PARAMEDIC ACADEMY  P H A R M AC O K I N E T I C S Based on four processes: How drugs are transported Absorption into and out of the body Distr...

I N T RO D U C T I O N TO PA R A M E D I C P H A R M AC O LO G Y VVC PARAMEDIC ACADEMY  P H A R M AC O K I N E T I C S Based on four processes: How drugs are transported Absorption into and out of the body Distribution Determines the duration and Biotransformation intensity of a drug’s effect Elimination ABSORPTION Routes of Administration and Peak Effects: Intravenous: 30-60 seconds Intraosseous: 30-60 seconds Endotracheal: 2-3 minutes Inhalation: 2-3 minutes Sublingual: 3-5 minutes Intramuscular: 10-20 minutes Subcutaneous: 15-30 minutes Rectal: 5-30 minutes Ingestion: 30-90 minutes Transdermal: variable (minutes to hours) DIFFUSION AND OSMOSIS  DISTRIBUTION Factors that effect drug distribution: Concentration of drug transporters in Blood-brain Barrier Located in CNS blood Cells are packed tightly so that only non-protein- pH bound, highly lipid-soluble drugs can cross into the CNS Perfusion Body water composition Placental Barrier Can prevent drugs from reaching a fetus Body fat composition Delivery of drugs to fetus requires them to be Certain disease conditions lipid soluble, nonionized, and non-protein bound.  B I OT R A N S F O R M AT I O N A series of reactions alter the chemical structures of these substances The enzymes that catalyze these Biotransformation has two effects on most drugs: reactions can cause the substrate to become inactive, active, and even toxic. 1. It can transform the drug into a more or less active metabolite Many biotransformation processes 2. It can make the drug more water occur in the liver soluble (or less lipid soluble) to First-pass effect thru the liver can facilitate elimination. alter or inactivate the drug completely  E L I M I N AT I O N Renal excretion occurs through two major processes: Glomerular filtration Factors that effect drug Results from blood pressure and blood flow elimination: through the kidneys Liver function Tubular secretion Secretion and reabsorption Blood pressure conditions Process of tubule secretion can have a big Protein binding impact on the speed that a drug is Urine pH eliminated from the body Urine flow Other route drugs can be secreted: Breath, blood sweat, saliva, and breast milk  D R U G RO U T E S Enteral Routes- Deliver Parenteral Subcutaneous (SC) medications by absorption Routes- Use of Inhalation/Nebulized through GI tract needles to enter Topical Oral (PO) circulatory system or Transdermal tissues Nasal Orogastric (OG) Intravenous (IV) Instillation Nasogastric (NG) Endotracheal (ET) Intradermal Sublingual (SL) Intraosseous (IO) Buccal Umbilical Rectal (PR) Intramuscular (IM) DRUG FORMS  DRUG FORMS  P H A R M A C O DY N A M I C S Drugs can act in four different ways: Study of what the drug does to the 1. Bind to the receptor site body 2. Change the physical properties of Study of a drug's molecular, cells biochemical, and physiologic effects 3. Chemically combine with other or actions chemicals 4. Alter a normal metabolic pathway B I N D I N G TO R E C E P TO R SITES Agonist- bind to receptor and initiate expected response Antagonist- bind to receptor site and block/prevent expected response Agonist-antagonist- can do both initiating or blocking the expected response R E S P O N S E S TO DRUG A D M I N I S T R AT I O N Allergic reaction Drug interaction Idiosyncrasy Drug antagonism Tolerance Summation Cross tolerance Synergism Tachyphylaxis Potentiation Cumulative effect Interference Drug dependence  D R U G - R E S P O N S E R E L AT I O N S H I P Onset of Action- time when drug reaches its minimum effective concentration Duration of action- length of time the amount of drug remains above the minimum effective concentration Termination of action- when drug levels drops below the minimum effective concentration until its eliminated from the body Therapeutic index- medication is effective without unacceptable adverse events Half-life- time the body takes to clear one-half of the drug FA C T O R S A LT E R I N G D R U G RESPONSE Age Body mass Sex Environmental Time of administration Pathology Genetics Psychology M E D I C AT I O N A D M I N I S T R AT I O N Right Right Patient Right Dosage Right Route Medication Right Right Client Right Time Right to Refuse Documentation Education Right Right Assessment Evaluation  Pure Food and Drug Act of 1906 Federal Food, Drug and M E D I C AT I O N L E G I S L AT I O N Cosmetic Act Harrison Narcotic Act of 1914 DRUG E N F O RC E M E N T AGENCY  C O NT ROL S U B S TA N C E ACT  Wet hair can make you sick https://youtu.be/pDMUsvQ wau0?si=xH03EG7Q7XOhs w8i Pee on a Jellyfish sting OLD https://youtu.be/RzsFmxx4r WIVES VM?si=joKxMMO1ide4ehCF TA L E S Waiting 30 minutes after eating to swim https://youtu.be/ZBPZBYLskz Q?si=T4jLxEflFJq8Cl0a Eating carrots to improve your eyesight Any others? D E V E LO P M E N T O F PHARMACEUTIC ALS Apothecaries Physicians Organization Modern Legislation discoveries in approval medicine processes S O U RC E S O F Plants Animals Minerals Synthetic/semi -synthetic DRUGS Extracts Alkaloids Genetic  F O O D A N D D R U G A D M I N I S T R A T I O N A P P R O V A L P R O C E S S