1. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Chapter 9, Part 2 Drug Classifications

2. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Part 2 Topics Anatomy and Physiology Related to Pharmacology Common Prehospital Medications Common Patient Scenarios Common Patient Medications

3. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Nervous System

4. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ

5. Central Nervous System Medications Analgesics and antagonists Anesthetics Anti-anxiety and sedative-hypnotic drugs Antiseizure or anti-epileptic drugs Central nervous system stimulants Psychotherapeutic medications Parkinson’s medications

6. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Autonomic Nervous System Medications (1 of 2) Drugs affecting the parasympathetic system: –Cholinergics –Anticholinergics –Ganglionic blocking agents –Neuromuscular blocking agents –Ganglionic stimulating agents

7. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Autonomic Nervous System Medications (2 of 2) Drugs affecting the sympathetic system: –Adrenergic receptors –Adrenergic agonists –Adrenergic antagonists –Skeletal muscle relaxants

8. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Distribution of Sympathetic Post-Ganglionic Fibers

9. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Sympathetic Division of Autonomic Nervous System

10. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Physiology of an Adrenergic Synapse

11. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ

13. Drugs Used to Affect the Cardiovascular System

14. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Blood Flow through the Heart

15. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Cardiac Conductive System

16. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Action Potential of Cardiac Contractile Tissue

17. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Action Potential of Cardiac Pacing Cells

18. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Reentrant Pathways

19. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Classifications of Cardiovascular Drugs (1 of 2) Antidysrhythmics –Used to treat and prevent abnormal cardiac rhythms Antihypertensives –Used to treat hypertension

20. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Classifications of Cardiovascular Drugs (2 of 2) Hemostatic agents –Used to stop bleeding Antihyperlipidemic agents –Used to treat high cholesterol

21. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Antidysrhythmics

22. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Antihypertensives Diuretics Adrenergic inhibiting agents Angiotensin converting enzyme inhibitors Angiotensin II receptor antagonists Calcium channel blockers Direct vasodilators

23. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Hemostatic Agents Antiplatelets –Drugs that decrease the formation of platelet plugs Anticoagulants –Drugs that disrupt the clotting cascade Thrombolytics –Drugs that act directly on thrombi to break them down

24. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Antihyperlipidemics Drugs used to treat high blood cholesterol Examples –Lovastatin (Mevacor) –Simvastatin (Zocor)

25. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Respiratory System

26. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Anti-Asthmatic Medications

27. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used for Rhinitis and Cough Nasal decongestants Antihistamines Antitussives Expectorants Mucolytic

28. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Gastrointestinal System

29. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Main Indications for GI Drug Therapy Peptic ulcers Constipation Diarrhea and emesis Digestion

30. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Peptic Ulcer Disease (1 of 2) H 2 receptor antagonists –Cimetidine (Tagamet), ranitidine (Zantac), Famotidine (Pepcid), Nizatidine (Axid) Proton pump inhibitors –Omeprazole (Prilosec),Lansoprazole (Prevacid)

31. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Peptic Ulcer Disease (2 of 2) Antacids –Aluminum, magnesium, or sodium compounds Anticholinergics –Pirenzepine (Gastrozepine)

32. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Constipation Categories of laxatives – Bulk-forming (methylcellulose or Citrucel) – Stimulant (phenolphthalein or Ex-Lax) – Osmotic (Milk of Magnesia) – Surfactant (Colace)

33. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Diarrhea Although a nuisance, diarrhea is often a helpful process. Specific or non-specific agents may be used.

34. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Emesis Antiemetics –Medication used to prevent vomiting Serotonin antagonists –Zofran Dopamine antagonists –Compazine, Phenergan, Inapsine, Reglan Cannabinoids –Marinol, Cesamet

35. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Aid Digestion Several drugs are available to aid digestion of carboyhydrates and fats. Two such drugs are pancreatin (Entozyme) and pancrelipase (Viokase).

36. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Eyes

37. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Eyes Ophthalmic drugs are used to treat conditions involving the eyes, primarily glaucoma and trauma. –Medications used to treat glaucoma are all aimed at reducing intraocular pressure (IOP). Examples include timolol (Timoptic) and betaxolol (Betoptic). –Tetracaine (Pontocaine) is a local anesthetic of the ester class.

38. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Ears

39. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Ears Most drugs used to treat conditions involving the ear are aimed at eliminating underlying bacterial or fungal infections or at breaking up impacted ear wax. –Chloramphenicol (Chloromycetin Otic) –Gentamicin sulfate (Garamycin)

40. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Endocrine System

41. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ

42. Drugs Affecting the Pituitary Gland Anterior pituitary drugs –The only conditions treated with these drugs are those associated with abnormal growth such as dwarfism. Posterior pituitary drugs –The two drugs in this category are oxytocin and antidiuretic hormone.

43. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Affecting the Parathyroid and Thyroid Glands Parathyroid glands are primarily responsible for regulating calcium levels. Hypothyroidism leads to decreased levels of calcium and Vitamin D. Treatment is therefore through calcium and Vitamin D supplements.

44. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Affecting the Adrenal Cortex The Adrenal Cortex synthesizes and secretes 3 classes of hormones: –Glucocorticoids –Mineralocorticoids –Androgens Two diseases typify the disorders associated with the adrenal cortex: –Cushing’s disease –Addison’s disease

45. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Affecting the Pancreas Diabetes mellitus is the most important disease involving the pancreas. –Insulin A substance that decreases blood glucose level –Glucagon A substance that increases blood glucose level

46. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ

47. Oral Hypoglycemics Orinase (chlorpropamide) Glucotrol (glipizide) Micronase (glyburide)

48. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Hyperglycemic Agents D 50 W is a sugar solution given intravenously for acute hypoglycemia. Glucagon is indicated for emergency treatment when an IV is unobtainable.

49. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Affecting the Female Reproductive System Estrogens and progestins Oral contraceptives Uterine stimulants and relaxants – Brethine, Yutopar Infertility agents – Clomid, Metrodin

50. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Affecting the Male Reproductive System Testosterone deficiency – Metandren Benign prostatic hypertrophy (BPH) – Proscar

51. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Affecting Sexual Behavior L-dopa (Levodopa) has demonstrated increased libido as a side effect. Vardenafil (Levitra) Tadalafil (Cialis) Sildenafil (Viagra) If you treat a patient with chest pain who has taken Viagra recently, do NOT give nitroglycerin or any other nitrate.

52. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Cancer

53. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Cancer Drugs used to treat cancer are called antineoplastic agents. Examples include: –Fluorouracil (Adrucil) –Mechlorethamine (Mustargen) –Vinblastine (Velban) –Vincristine (Oncovin)

54. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Infectious Diseases and Inflammation

55. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Infectious Diseases and Inflammation (1 of 3) Antibiotics –An antibiotic agent may either kill the offending bacteria or so decrease the bacteria’s growth that the patient’s immune system can effectively fight the infection. Antifungal agents –Fungi are parasitic microorganisms that cannot synthesize their own food.

56. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Infectious Diseases and Inflammation (2 of 3) Antimicrobial and antiparasitic drugs. –Although most diseases treated with these drugs are uncommon in developed countries, they are leading causes of death in third-world countries. Diseases include malaria, leprosy, and helminthiasis.

57. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Infectious Diseases and Inflammation (3 of 3) Tuberculosis, caused by bacteria, is increasing in the United States. NSAIDs (non-steroidal anti- inflammatory drugs)—commonly used as analgesics and antipyretics. Uricosuric drugs—used to treat gout. Serums, vaccines, and other immunizing agents.

58. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Recommended Childhood and Adolescent Immunization Schedule A recommended childhood immunization schedule has been approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians.

59. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Skin

60. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Skin Dermatologic drugs are used to treat skin irritations. They are common over-the-counter medications.

61. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Affect the Diet

62. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Many disease processes affect the production, distribution, and utilization of essential dietary nutrients.

63. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ

64. Drugs Used to Treat Poisoning and Overdoses

65. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Drugs Used to Treat Poisoning and Overdoses The treatment for poisoning and overdose depends greatly on the substance involved. –Syrup of ipecac –Activated charcoal –Mucomyst –Atropine –Pralidoxime

66. Bledsoe et al., Paramedic Care Principles & Practice Volume 1: Introduction © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Part 2 Summary Anatomy and Physiology Related to Pharmacology Common Prehospital Medications Common Patient Scenarios Common Patient Medications