Pharmacology

Routes of Administration

Nine rights of medication

Medication Forms

The science of drugs, including their ingredients, preparation, uses, and actions on the body.

Right Time

Right Education

Right Route

Right to Refuse

Right Dose

Right Response and Evaluation

Right Medication and Indication

Right Documentation

Right Patient

This right is self-evident. The medication must be administered to the patient for whom it is prescribed. Patient identity must be confirmed using a minimum of two facility approved identifiers.

Administration of the correct drug. This requires careful review of the medication because many medications have similar names.

Ensuring that the prescribed dose is accurately transcribed and administered.

Administration of medication using the prescribed route.

Check the expiration date and condition of the medication.

Inform the patient of the medication you intend to administer.

Patients with decision-making capacity can decline or refuse proposed intervention or medication.

Monitor the patient's vital signs, mental status, signs of perfusion, and respiratory effort after medication administration

The work is not done until the paperwork is done.

topical medications

Transcutaneous Medications

metered-dose inhaler

gels

solutions and suspensions

gaseous medications

tablets and capsules

a liquid mixture that cannot be separated by filtering for allowing the mixture to stand

a mixture of ground particles that are distributed evenly throughout a liquid but do not dissolve

a miniature spray canister through which droplets or particles of medication may be inhaled through the mouth and into the lungs

a medication delivery route by lotions, cream, and ointments that are applied to the surface of the skin and affect only that area

Capsules are gelatin shells filled with powdered or liquid. Tablets are designed to be dissolved in small amounts of liquid.

a medication delivery route by through the skin, or transcutaneous.

a semiliquid substance that is administered orally in capsule form or through plastic tubes

Neither solid or liquid

Pharmacodynamics

The process by which a medication works on the body.

Enteral

Parenteral

Per Rectum (PR)

By Mouth (PO)

Sublingual (SL)

Intravenous (IV)

Intraosseous (IO)

Inhalation

Intranasal (IN)

Intramuscular (IM)

Subcutaneous

Transcutaneous

a medication delivery route through the rectum; commonly used with children for nausea and vomiting

a medication delivery route taken by mouth and enter the bloodstream through the digestive system; takes 1 hour, non invasive, with unpredictable medication absorption

medications that enter the body through the digestive system, usually in a pill or liquid form, tends to absorb slowly

medications that enter the body by a route other than the digestive track, skin, or mucous membranes; in liquid form and administered using syringes and needles, absorbs more quickly and offer a more predictable response

situated or administered under the tongue

a medication delivery route by injection directly into a vein

a medication delivery route into the bone; reaches the bloodstream through the bone marrow, requires drilling a needle into the outer layer of the bone

a medical delivery route by injection into the tissue between the skin and muscle; absorbed slowly, but effects last longer

a medication delivery route by injection into a muscle; absorbed quickly

a medication that is inhaled into the lungs so that they can be absorbed into the blood stream more quickly.

a medication administered by way of the nasal structures.

a medication delivered through the skin,

EMT's scope of pharmacological intervention

Circumstances to administer

Medication overview

Patient-assisted

EMT-administered

Peer-assisted

when the EMT administers medication to themselves or to a partner

when the EMT assist the patient with the administration of their own medication

when the EMT directly administers the medication to the patient

Generic/Trade

Anti-inflammatory agent and antifever agent; prevents platelets from clumping ,thereby decreasing formation of new clots

Aspirin (Bayer)

Ipratropium (Atrovent)

Epinephrine (EpiPen)

Naloxone (Narcan, EVZIO auto-injector)

Nitroglycerin (Nitrostat, Nitromist)

Oral glucose (Glutose)

Oxygen

Common over-the-counter medications

Medication allowed to administer or assist in administering

Action

Indication

Contraindication

Routes

Adverse effects

Interactions

Adult Dose

Administration Concern

Acetaminophen (Tylenol)

Relief of mild pain, headache, muscle aches, fever; chest pain of cardiac origin

Hypersensitivity; recent bleeding

PO

Nausea, vomiting, stomach pain, bleeding, allergic reaction

Caution should be used in patients who are taking anticoagulants

160 to 325 mg; 160 to 325 mg chewable tablets for chest pain

Diphenhydramine (Benadryl)

Do not administer for pain caused by trauma or for fevers in children; patients with chest pain must be able to chew tablets

Ibuprofen (Advil, Motrin Nuprin)

Common fast acting MDI medications (albuterol [Proventil, Ventolin])

Stimulates nervous system, causing bronchodilation

Asthma/difficulty breathing with wheezing

Inhalation

Hypersensitivity; tachycardia (relative); chest pain of cardiac origin

Hypertension, tachycardia, anxiety, restlessness

increase effects of other nervous system stimulants

1 to 2 inhalations wait 5 minutes before repeating dose

Stimulates nervous system, causing bronchodilation

Anaphylactic reaction

chest pain of cardiac origin; hypothermia; hypertension

IM

hypertension, tachycardia, anxiety, restlessness

increase effects of other nervous system simulants

0.3 mg for adults; 0.15 for children

medication will last approximately 5 minutes; do not repeat dose; ensure ALS is en route for continuing treatment

Reverses respiratory depression secondary to opioid overdose

opioid poisoning

Hypersensitivity

IM, IN

Nausea, vomiting

additional doses may be required for severe opioid overdoses

2 mg IN or IM auto-injector

Patient may wake up combative

Dilates blood vessels

chest pain of cardiac origin

hypotension; use of sildenafil (Viagra) or another treatment for erectile dysfunction within the previous 24 hours; head injury

SL tablet or spray

Headache, burning under tongue, hypotension, nausea

increases dilating effects of other blood vessel-dilating medication

0.3 mg to 0.4 mg SL; 0.4 mg spray

Ensure ALS is en route

when absorbed, provides glucose for cell use

low blood glucose (hypoglycemia)

decrease level of consciousness; nausea; vomiting

PO

Nausea, vomiting

none

1/2 to 1 tube

patient must be awake, have control of airway, and be able to follow commands

Reverses hypoxia; provides oxygen to be absorbed by lungs

Hypoxia or suspected hypoxia

very rarely used in patients with COPD; do not use near flames, as oxygen will support combustion

inhalation

Decreased respiratory efforts in rare cases in patients with COPD

can support combustion

use oxygen delivery devices to administer 28% to 100% oxygen

no open flames nearby; do not withhold oxygen from patients in respiratory distress

NSAID that reduces inflammation and fever; analgesic

Analgesic and fever reducer

Relief of mild pain and fever, headache, muscle aches

Hypersensitivity

PO

Allergic reaction

Take caution to avoid potential overdosing; many OTC medications contain acetaminophen

500 to 1,000 mg every 4 hours as needed; dose is weight-based for children

weight of child is more important than age

Antihistamine (blocks histamine)

mild allergic reactions

asthma; glaucoma; pregnancy; hypertension; infants

PO

Sleepiness (although can stimulate children), dry mouth and throat

Do not take with alcohol or MAO inhibitors ( a type of psychiatric medication

25 to 50 mg

can use in severe allergic reaction; however, epinephrine is administered first

mild pain or fever, headache, muscle aches

Hypersensitivity

PO

Nausea, vomiting, stomach pain, bleeding, allergic reaction

Do not take with aspirin

200 to 400 mg every 4 to 6 hours; dose is weighted based in children

Do not take for pain caused by trauma; weight of child is more important than age

Pharmacokinetic

The process that the body performs on a medication.

Duration

Elimination

Onset of action

Peak

Time from medication administration until clinical effect.

Length of time that clinical effects persist

How medication or chemicals are removed from the body

The point or period when the maximum clinical effect is achieved

Agonist

Antagonist

A medication that causes simulation of receptors

A medication that binds to receptors and blocks other medication