EMT Pharmacology

Routes of administration

Per Rectum (PR)= most common for children, also when patient cant swallow or is unconscious

Oral (PO)= Noninvasive, less expensive, Can be unpredictable with how patient will absorb medication

Intravenous Injection (IV)= into vein, fastest way to deliver medication, cant be used for all chemicals ex: aspirin, oxygen and charcoal.

Intraosseous injection (IO)= Into bone, painful, most often used in unconscious patients, often used for children with difficult IV sites.

Subcutaneous injection (SC)= Under the skin, given between fatty tissue and muscle, usually slower, used for medications that cant be taken by mouth ex: insulin

Intramuscular injection (IM)= Into muscle, absorbed quickly, Negative to this is damage to muscle tissue and uneven unreliable absorption, mostly used via auto-injection ex: EpiPen

Inhalation= Into lungs, helps reduce medications effect on other body tissues.

Sublingual (SL)= Under tongue, enter through oral mucosa under the tongue, absorbed within min, faster then oral, protects against oral route

Transcutaneous (transdermal)= through skin ex: nicotine patch

Intranasal (IN)= relatively new, liquid medication pushed through device called mucosal atomized device (MAD), atomized and goes into nostril,

Six rights

1.Right patient= Make sure the medication if for the patient

2.Right medication= Verify the proper medication and prescription

3.Right dose= Verify the form and dose of the medication

4.Right route= Verify the route the medication should be administered

5.Right time= Check the expiration date and condition of the medication

6.Right documentation= The work is not done tell the paperwork is done.

Forms of medication

Capsules= mostly given orally, capsules are gelatin shells filled with medication.

Tablets= medication compressed under high pressure, contains other materials, some dissolve slow under tongue

Solution= liquid mixture of one or two substances, given by almost any route, may help give EpiPen.

Suspension=seperate if stand or filter in liquid unlike solution, shake well before administered, cannot be given by IV

Metered-Dose Inhalers= If liquid or solids are broken small enough can be used, mini spray canister must be shaken before use.

Topical medications= lotion, creams and ointment, lotions have most water and ointments least

Transcutaneous medications= absorbed through skin, or transcutaneously, intended for whole body,

gels= semiliquid substance, orally administered through tube.

Gases for inhalation= neither solid or liquid, most used is oxygen

EMT medication

Epinephrine (EpiPen)

Aspirin (Bayer)

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Naloxone (Narcan, EVZIO auto-injector)

Common fast-acting MDI medications (albuterol {proventil, ventolin})

Activated charcoal (Actidose with Sorbitol)

Action: Absorbs toxic substances in the digestive track

Indications: most oral poisonings

contraindications: decreased level of consciousness, overdose of corrosives, caustics, or petroleum substances

Routes: PO

Side effects: nausea, vomiting, constipation, black stool.

Interactions: bonds with and inactivates most medications/substances in the digestive tract

Adult dose: 1 to 2 g/kg

Administration Concerns: Stains cloths, do not give when giving other PO medications.

Action: Anti-inflammatory and Anti-fever agent.

Indications: Relief of mild pain

Contraindications: hypersensitivity, recent bleeding

Routes: PO

Side effects: Nausea, vomiting, Stomach pain, bleeding, allergic reactions.

Interactions: use caution if patient is taking anticoagulants

Adult dose: 160 to 325 mg, 160-325 mg chewable tablets

Admin concerns: dont used for trauma pain, or children fevers, chest pain patients must chew.

Action: Stimulates nervous system, causing bronchodilation

Indications: Asthma/ difficulty breathing with wheezing

Contraindications: Hypersensitivity, tachycardia, chest pain

Routes: Inhalation

Side effects: hypertension, tachycardia, anxiety, restlessness

Interactions: increase other nervous system stimulants

Adult Dose: 1 to 2 inhales, wait 5 min before reaping dose

Admin concerns: must inhale all in one breath, tell patient to hold breath for 5 sec after

Action: stimulates nervous system, causing bronchodilation.

Indications: Anaphylactic reaction

Contraindications: Chest pain of cardiac origin, Hypothermia, hypertension

Routes: IM

Side effects: hypertension, tachycardia, anxiety, restlessness

Interactions: increases effects of other nervous system stimulants

Adult Dose: .3 mg for the adult, .15 mg for children

Admin Concerns: medication will last about 5 min, only use 1 dose, have ALS en route

Action: Reverses respiratory depression secondary to opioid overdose.

Indications: Opioid poisoning

Contraindications: hypersensitivity

Routes: IM,IN

Side effects: nausea, vomiting

interactions: Additional doses may be required for severe opioid overdoses.

Adult Dose: .4mg auto-injection, 2mg IN

Admin Concerns: Patients may wake up combative

Nitroglycerin (Nitrostat, Nitromist)

Action: Dilates blood vessels

Indications: Chest pain of cardiac origin

contraindications: Hypotension, treatment for ED within 24 hr, head injury

Routes: SL tablet or spray

Side effects: headache, burning under tongue, hypotension, nausea

Interactions: Increases dilating effects of other blood vessel-dilating medications

Adult Dose: .3 to .4 mg SL, .4 mg spray

Admin concerns: Ensure ALS is en route

EMT Medication pt 2

Oral glucose (glutose)

Acetaminophen (tylenol)

Oxygen (no trade name)

Diphenhydramine (Benadryl)

ibuprofen (Advil, Motrin, Nuprin)

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Action: When absorbed, provides glucose for cell use

Indications: Low blood glucose (hypoglycemia)

contraindications: decreased level of consciousness, nausea, vomiting

Routes: PO

Side effects: Nausea, vomiting

Interactions: None

Adult Dose: 1/2 to 1 tube

Admin Concerns: must be awake, control of airway, and follow commands

Action: reverses hypoxia, provides oxygen

Indications: Hypoxia or suspected hypoxia

contraindications: rarely used in COPD pts, dont use near flame

Routes: Inhalation

Side effects: decreased respiratory efforts in rare COPD pts

interactions: can support combustion

Adult Dose: 28% to 100% oxygen

Admin concerns: no open flames near, dont withhold oxygen for pt with respiratory distress

Action: Analgesic and fever reducer

Indications: Relief of mild pain or fever, headache, muscle aches

contraindications: hypersensitivity

Routes: PO

Side effects: Allergic reaction

interactions: avoid potential overdose,

Adult Dose: 500 to 1,000 mg every 4 hr as needed, weight based for children

Admin concerns: weight of child is more important than age

Action: Antihistamine (blocks histamine)

Indications: mild allergic reaction

contraindications: asthma, glaucoma, pregnancy, hypertension, infants

Routes: PO

Side effects: sleepiness, dry mouth and throat

interactions: dont take with alcohol or MAO inhibitors

Adult Dose: 25 to 50 mg

admin concerns: can use in sever allergic reaction but epipen is given first

Action: Nonsteroidal anti-inflammatory drug that reduces inflammation and fever analgesic

Indications: Mild pain or fever, headache, muscle aches

contraindications: hypersensitivity

Routes: PO

Side effects: nausea, vomiting, stomach pain, bleeding, allergic reactions

interactions: Dont take with aspirin

Adult dose: 200 to 400 mg every 4 to 6 hours, dose is based on weight in children

admin concerns: dont not take for pain caused by trauma, child weight is more important the age