Pharmacology

1
Pharmacology

• Chapter 17

2
Drugs

• Chemical agent used in the prevention, treatment,
  or diagnosis of disease
• Use dates back to ancient Egypt
• Many derived from natural sources
• Used for performance enhancement or recreation

3
Administration routes

• Internal
• Inhalation
• Intradermal / subcutaneous
• Intramuscluar
• Intranasal
• Intraspinal
• Intravenous
• Oral
• Sublingual / buccal

• External
• Inunctions
• Ointments
• Pastes
• Plasters
• Transdermal patches
• Solutions
• Drug vehicle inactive substance that transports
  the drug

4
Absorption of drugs

• Bioavailability how completely its absorbed
• Distribution reaching target tissue
• Efficacy capability to produce effect
• Potency dose needed for effect
• Half-life rate at which the drug metabolizes
• Steady state when amount taken equals amount
  metabolized (5 half-lives)

5
Legal considerations

• Administering single dose
• Dispensing multiple doses
• Record keeping
• Medication administration log
• Labeling requirements
• Re-packaging
• Prescription medications?

6
Drugs to combat infection

• Antiseptics vs. Disinfectants
• Alcohol (isopropyl)
• Phenol (Lysol)
• Halogens (Betadine)
• Oxidizing agents (hydrogen peroxide)
• Antifungals (Tinactin)
• Antibiotics
• Penicillin, erythromycin
• Tetracycline, sulfonamides

7
Drugs to combat pain and inflammation

• Local pain relievers (ice, menthol, lydocaine)
• Narcotics (codeine, morphine, demerol)
• Non-narcotic (acetaminophen)
• Aspirin
• NSAIDS
• Corticosteroids

8
Drugs to combat GI disorders, colds, and allergies

• Antacids
• Antiemetics
• Carminatives
• Cathartics
• Antidiarrheals
• Histamine-2 blockers (Tagamet, Zantac)
• Proton pump inhibitors (Prilosec)
• Decongestants (pseudoephedrine)
• Antihistamines (Benadryl)
• Epinephrine (Epipen)

9
Performance enhancing drugs

• Stimulants
• Amphetamines
• Caffeine
• Narcotic analgesics
• Beta blockers
• Diuretics
• Anabolic steroids
• Androgenic effects
• Anabolic effects
• Androstenedione
• Human growth hormone
• Blood doping

10
Tobacco and alcohol

• Psychological vs. physical dependence
• Tobacco use
• Cigarette smoking
• Smokeless tobacco
• Passive smoke

• Alcohol is the most abused drug in the USA
• 66 of adults are social drinkers
• 20 of drinkers are alcoholics
• Alcoholism is treatable, but not curable
• Factor in 40 of MVAs (78 of fatal injuries)
• Factor in 50 of criminal arrests

11
Alcohol emergencies

• CNS depressant
• Causes stupor, coma, death
• Rapidly absorbed in stomach and intestines (30
  min-2 hours)
• 2/3 ounce metabolized every hour
• Concentrated in the blood and brain
• Alcoholism
• Alcoholics use alcohol in all forms
• Usually dependent on other drugs as well
• Also may have underlying psychiatric problems
• Abstinence causes withdrawal and/or the delirium
  tremens

12
Special drugs

• Phencyclidine
• PCP is a hallucinogen
• Stored in body fat
• Causes agitation, no response to pain,
  frothing, jumpy eyes
• Severe reactions cause schizophrenia, paranoia,
  memory loss, death
• To treat call EMS, protect yourself, keep
  lights dim, treat their injuries if you can

• Cocaine
• 1 drug involved in emergency room visits
• How is it used?
• Take measures to prevent spread of bloodborne
  pathogens
• To treat call EMS, be aware for seizures and
  cardiac arrest, limit stimuli, protect yourself
  from psychotic behavior

13
PCP
Cocaine
14
Stopping cold turkey

• Withdrawal syndrome
• Occurs after cutback in amount of alcohol
• Four stages
• _at_ 8 hours nausea, insomnia, sweating, tremors
• _at_8-72 hours add vomiting and hallucinations
• _at_48 hours seizures
• Go into the DTs
• Signs symptoms can mimic psychiatric disorders

• Delirium tremens
• Life threatening condition
• 15 mortality rate
• Occurs 1 to 14 days from last drink
• Can last up to a month
• Signs symptoms same as withdrawal, but add
  frightening hallucinations
• Seizures occur in withdrawal (not DTs)
• 1/3 of those with seizures in withdrawal progress
  to the DTs

15
Care for an overdose

• Mules or body packers
• General goals
• Be prepared for cardiac arrest
• Dont panic stay calm
• Have victim sit or lie down
• Establish/maintain airway
• Place on side
• Monitor vital signs
• Prevent shock
• Reduce stimuli
• Reduce paranoia
• Locate and transport any evidence to the hospital

16
Talk down technique

• Used to treat effects of hallucinogens
• Anxiety, panic states, disorientation, lack of
  reality
• Dont use with a PCP user!
• Make them feel welcome
• Reassure them that the trip wont last forever
• Identify yourself clearly
• Help them verbalize whats happening
• Repeat and confirm what they say
• Get them HELP