General Pharmacology and Respiratory Emergencies

• Pharmacology


  The general study of the interactions between a drug and the body
• Medication


  A substance used as a remedy for an illness (generally medication and drug are used interchangeably)
• Prescribed

  An EMT can only assist
• Medication


  • Prescription inhaler
  • Nitroglycerin
  • Epi-pen
  • Rectal valium
• Medication Name Types

  • Chemical name: describes chemical structure
  • Generic name: nonproprietary-similar to 1
  • Trade name: brand name
  • Official name: followed by US Por N.F
• Routes for Administration

  • Oral
  • Sublingual (under tongue)
  • Inhalation
  • Injection
• Medication Forms

  • Inhalants
  • Tablets
  • Liquid
  • Gels
  • Suspensions
  • Fine powder
  • Creams
  • Sprays
  • Nebulized liquids
• Medication Information

  • Indications: expected improvements after administration, clinical setting for intended use of drug
  • Contraindications: clinical conditions where drug can't be used due to coexisting problem
  • Dose: amount of drug administered
  • Administration route meds. were given
  • Actions: effects of drug on body
  • Side effects: known abnormalities caused by meds
• Verify patient's medication (only use theirs)
• Medication Administration

  1. Verify form, route, & dose

  2. The 5 Rights: right patient, meds & indication, route, dose, time/expiration date

  3. Education

  4. refuse

  5. Response & evaluation

  6. Documentation
• Note any changes
• Albuterol


  Standing orders for asthma, bronchospasm, active wheezing, consider CPAP
• Contraindications for Albuterol

  Allergy to albuterol
• Albuterol Dosage/Route

  2019, no age/cardiac limitation, Adult/pediatric 4-6 LPM, can admin. 3rd dose if told to
• Aspirin


  Blood thinner/anti-coagulant, standing orders
• Aspirin Indications

  Chest pain
• Aspirin Contraindications

  Allergy, recent GI bleed
• Aspirin Dosage/Route

  Adult Aspirin 325 mg, Baby Aspirin (81mg each) 324mg, Pt. has taken prior
• Rectal Valium

  Used in emergency situations to stop seizures, calm brain activity, used on patients who take meds for seizures
• Rectal Valium Side Effects

  Drowsiness, dizziness, high mood, uncoordinated, etc.
• Rectal Valium Administration

  Position PT on side, upper leg forward, separate butt to show anus, slowly count to 3 when inserting & when before you remove, keep PT on side
• Epinephrine


  1,000 concentration, intramuscular injection, allows more than 1 dose
• Epinephrine Indications

  All must be met: has signs/symptoms of anaphylaxis, meds is prescribed to patient, or your ambulance carries medication on board by the REMAC
• Epinephrine Actions

  Dilates bronchioles, constricts blood vessels
• Epinephrine Side Effects


  Rapid pulse, pale skin, dizziness, chest pain, headache, nausea, vomiting, excitability/anxiousness
• Epinephrine Auto-injector


  Standing orders for patients in severe respiratory distress, facial edema, & hypoperfusion
• Epinephrine Epi-pen Jr.

  Indications: anaphylaxis (severe allergic reaction)

  Dosage/Route: one dose via auto injections, 0.3 mg IM if >66 lbs, 0.15 mg IM if <66 lbs
• Glucose Paste

  Standing order, Indication: AMS secondary to low blood sugar, Contraindications: no gag reflex, allergy, Dosage/Route: One tube PO
• Metered Dose Inhaler

  Indication: asthma, Contraindications: not prescribed, allergy, steroidal base, Dosage/Route: 2 puffs as directed via RX, Shake vigorously, tell PT to hold breath for 10 sec
• Oxygen

  Indications: trouble breathing, Dosage/Route: non-rebreather (10-15 LPM), Nasal cannula (4-6 LPM)
• Nitroglycerin

  Indications: chest pain, Contraindications: allergy, not prescribed, systolic below 120, Dosage: 1 tablet sublingual, metered spray sublingual, can admin 3 doses if needed, 5min. apart
• Naloxone (Narcan)


  Used in drug overdoses for apnea, Dosage: 2mg, Adult/pediatric = let it rip, Document vitals every 5 min, Don't use if recent seizure, cardiac arrest, nasal obstruction, nasal trauma
• Respiratory Anatomy/Physiology
• Pharynx: Oropharynx, Nasopharynx
• Epiglottis prevents food from entering trachea
• Larynx, Cricoid cartilage
• Lungs: Trachea, Bronchi, Alveoli
• Diaphragm, Intercostal muscles
• Phrenic Nerve passes down between lung & diaphragm, important for breathing
• Gas exchange occurs at alveoli, CO2 goes to capillaries, which give up O2 to cells