Pharmacology part 1

1. GENERAL
PRINCIPLES OF
PHARMACOLOGY

2. Part 1 Topics
 Drug Names
 Sources of Drug Products
 Drug Classifications
 Food & Drug Administration
 Medication Administration
 Properties of Drugs

3. Pharmacology is the study
of drugs and their actions
on the body.

4. Drugs are chemicals used to
diagnose, treat, and prevent
disease.

5. Legal
Knowing and obeying the laws and
regulations governing medications
and their administration is an
important part of a paramedic’s
career.
These include federal, state, and
agency regulations.

6. Federal…
 Pure Food & Drug Act of 1906
 Harrison Narcotic Act of 1914
 Federal Food, Drug, & Cosmetic
Act of 1938
 Comprehensive Drug Abuse
Prevention & Control Act of 1970

7. State vs. Local Standards
 They vary widely.
 Always consult local protocols
and with medical direction for
guidance in securing and
distributing controlled
substances.

8. Names of Drugs
 Chemical…states its chemical
composition and molecular structure.
 Generic…usually suggested by the
manufacturer.
 Official…as listed in the
U.S. Pharmacopeia.
 Brand…the trade or proprietary name.

9. Chemical Name
7-chloro-1, 3-dihydro-1,
methyl-5-phenyl-2h-1
Generic Name diazepam
Official Namediazepam, USP







B
r
a
n
d

N
a
m
e
Valium®
Names of Drugs

10. Sources of Drug Information
 United States Pharmacopeia (USP)
 Physician’s desk reference (PDR)
 Drug information
 Monthly prescribing reference
 AMA drug evaluation
 EMS field guides

11. Components of a Drug Profile
 Name
 Classification
 Mechanism of
Action
 Indications
 Pharmacokinetics
 Side Effects
 Routes of
Administration
 Contraindications
 Dosage
 How Supplied
 Special
Considerations

12. Names
Most Frequently Include Generic
and Trade Names

13. Classification
The broad group to which a
drug belongs. Knowing
classifications is essential to
understanding the properties
of drugs.

14. Mechanism of Action
The way in which a drug causes
its effects; its pharmacodynamics.

15. Actions of Drugs
Drugs that Act by Binding to a
Receptor Site
Drugs that Act by Changing Physical
Properties
Drugs that Act by Chemically
Combining with Other Substances
Drugs that Act by Altering a Normal
Metabolic Pathway

16. Indications
Conditions that enable the
appropriate administration
of the drug (as approved by
the FDA).

17. Pharmacokinetics
How the drug is absorbed,
distributed, and eliminated;
typically includes onset and
duration of action.

18. Pharmacokinetics
Absorption…a drug must find its
way to the site of action.
Distribution…a drug must then be
distributed throughout the body.

19. Pharmacokinetics
Biotransformation…the process
of breaking down, or metabolizing,
drugs.
Elimination…drugs must
eventually be excreted
from the body.

20. Side Effects/Adverse Reactions
The drug’s untoward or
undesired effects.

21. Routes of Administration
How the drug is given.

22. Contraindications
Conditions that make it
inappropriate to give the drug.
…means a predictable harmful
event will occur if the drug is
given in this situation.

23. Dosage
The amount of the drug that
should be given.

24. How Supplied
This typically includes the
common concentration of the
available preparations; many
drugs come in different
concentrations.

25. Drug Routes (1 of 2)
 Enteral:
Deliver medications by absorption
through the gastrointestinal tract.
Oral, orogastric/nasogastric, sublingual,
buccal, rectal.

26. Drug Routes (2 of 2)
 Parenteral:
Delivers medications via routes other
than the GI tract.
Include intravenous, endotracheal,
intraosseous, umbilical, intramuscular,
subcutaneously, inhalation, topical.

27. Enteral – examples
(1 of 2)
Oral (PO) — good for self-administering
drugs.
Orogastric (OG) / Nasogastric (NG) —
alternate method to providing PO
medications.
Sublingual (SL) — excellent absorption
without problems of gastric acidity.

28. Buccal — between the cheek/gum.
Similar to sublingual.
Rectal (PR) — reserved for
unconscious or vomiting patients.
Enteral – examples
(2 of 2)

29. Parenteral – examples
(1 of 3)
Intravenous (IV) — preferred route in
emergencies.
Endotracheal (ET) — alternate route
in emergencies for select
medications.
Intraosseous (IO) — alternative use in
emergencies, mostly in pediatrics.

30. Umbilical — provides alternate
access in newborns.
Intramuscular (IM) — slower
absorption than IVs.
Subcutaneous (SQ) — slower
absorption than IM.
Parenteral – examples
(2 of 3)

31. Inhalation — very rapid absorption
via the lungs.
Topical — delivers drugs directly to
the skin.
Parenteral – examples
(3 of 3)

32. Most emergency
medications are given
intravenously to avoid drug
degradation in the liver.

33. Drug Forms
 Solid Forms:
Such as pills, powders, suppositories,
capsules.
 Liquid Forms:
Such as solutions, tinctures,
suspensions, emulsions, spirits, elixirs,
syrups.

34. Pills—drugs shaped spherically to be
swallowed.
Powders—not as popular as they once were.
Tablets—powders compressed into disk-like
form.
Suppositories—drugs mixed with a waxlike
base that melts at body temperature.
Capsules—gelatin containers filled with
powders or tiny pills.
Solid Forms

35. Liquid Forms (1 of 2)
Solutions—water or oil-based.
Tinctures—prepared using an alcohol
extraction process.
Suspensions—preparations in which
the solid does not dissolve in the
solvent.
Emulsions—suspensions with an oily
substance in the solvent.

36. Liquid Forms (2 of 2)
Spirits—solution of a volatile drug
in alcohol.
Elixirs—alcohol and water solvent;
often with flavoring.
Syrups—sugar, water, and drug
solutions.

37. Special Considerations
 Pregnant Patients
 Pediatric Patients
 Geriatric Patients

38. Pregnant Patients
Ask the patient if there is a possibility
that she could be pregnant.
Some drugs may have an adverse
effect on the fetus of a pregnant
female.
Teratogenic drug…is a medication
that may deform or kill the fetus.

41. Providing Patient Care Using
Medications (1 of 4)
 Know the precautions and
contraindications for all medications
you administer.
 Practice proper technique.
 Know how to observe and document
drug effects.

42. Providing Patient Care Using
Medications (2 of 4)
 Maintain a current knowledge in
pharmacology.
 Establish and maintain professional
relationships with other healthcare
providers.
 Understand pharmacokinetics and
pharmacodynamics.

43. Providing Patient Care Using
Medications (3 of 4)
 Have current medication references
available.
 Take careful drug histories including:
Name, strength, dose of prescribed medications;
Over-the-counter drugs;
Vitamins;
Herbal medications;
Allergies.

44. Providing Patient Care Using
Medications (4 of 4)
Evaluate the patient’s
compliance, dosage, and
adverse reactions.
Consult with medical direction
as needed.

45. Know the 6 Rights of Medication
Administration
 Right Medication
 Right Dosage
 Right Time
 Right Route
 Right Patient
 Right Documentation

46. Responses to Drug Administration
(1 of 5)
Side Effect—unintended response
to a drug.
Allergic Reaction—hypersensitivity.
Idiosyncrasy—drug effect unique to
an individual.

47. Responses to Drug Administration
(2 of 5)
Tolerance—decreased response to
the same amount.
Cross Tolerance—tolerance for a drug
that develops after administration of
a different drug.
Tachyphylaxis—rapidly occurring
tolerance to a drug.

48. Responses to Drug Administration
(3 of 5)
Cumulative effect—increased effectiveness
when a drug is given in several doses.
Drug dependence—the patient becomes
accustomed to the drug’s presence in his
body.
Drug interaction—the effects of one drug
alter the response to another drug.
Drug antagonism—the effects of one drug
block the response to another drug.

49. Responses to Drug Administration
(4 of 5)
Summation—also known as additive
effect, two drugs with the same effect
are given together — similar to 1+1=2.
Synergism—two drugs with the same
effect are given together and produce
a response greater than the sum of
their individual responses — similar
to 1+2=3.

50. Responses to Drug Administration
(5 of 5)
Potentiation—one drug enhances
the effect of another.
Interference—the direct
biochemical interaction between
two drugs; one drug affects the
pharmacology of another drug.

51. Factors Affecting Drug Response
 Age
 Body Mass
 Sex
 Environment
 Time of Administration
 Pathology
 Genetics
 Psychology

52. Part 1 Summary
 Drug Names
 Sources of Drug Products
 Drug Classifications
 Food & Drug Administration
 Medication Administration
 Properties of Drugs