OBJECTIVES:
Upon completion of this lesson, you will be able to overview:
- Define Pharmacology.
- List Six Rights of Medication Administration.
- Describe medical listings.
- List 05 routes of drug administration.
- List & Describe 08 classifications of emergency drugs.
1. Pharmacology
Definition: Pharmacology is the study of drugs and their effects on the body.
EMTs must have a comprehensive understanding of all medications they might administer.
- EMTs have to make quick decisions about:
- When to administer medications
- What medications to administer
- When administering certain medications would be harmful to the patient
- Pharmacology is constantly changing.
- Stay up to date on the latest pharmacological information.
- State and regional EMS systems have the right to include medications and indications.
- Always follow local protocols.
2. The 6 Rights of Medication Administration
- Right Patient: Ensure the medication is being administered to the correct individual.
- Right Medication: Verify the medication name and dosage match the prescription or order.
- Right Dose: Confirm the correct amount of medication to be administered.
- Right Time: Administer the medication at the correct time as prescribed.
- Right Route: Use the appropriate route of administration (e.g., oral, intravenous).
- Right Documentation: Record the administration accurately in medical records.
3. Medication Listings
3.1 Name of medication
3.1.1 Brand name
3.1.2 Trade name
Drugs are named according to
3.2 Indications
3.3 Contraindications
3.4 Adverse reaction/side effects
3.5 Dosage and administration
3.6 Special considerations
4. Routes of Administration
- Intravenous
- Intramuscular
- Oral
- Subcutaneous
- Inhalation
5. Classification of Emergency Drugs
5.1 Anti-platelet aggregation
5.2 Anti-emetic
5.3 Analgesics
5.4 Bronchodilators
5.5 Anti Angina
5.6 Corticosteroids
5.7 Anti-allergic
5.8 Intravenous fluids
5.9 Topical Drugs
5.1 Anti-platelet aggregation
Salicylic acid (Aspirin)
5.1.1 Indications
- New onset chest pain suggestive of acute myocardial infarction
5.1.2 Contraindications
- Relatively contraindicated in patients with active ulcer disease or asthma
- Pregnancy safety: ⠀
5.1.3 Adverse reactions
- Bronchospasm, anaphylaxis, wheezing
- Hypersensitivity, prolonged bleeding
5.1.4 Route of Administration
- Oral
Not recommended in Pediatric patients
5.2 Anti-emetic
Dimenhydrinate (Gravinate)
5.2.1 Indications
- Vertigo, Nausea, Vomiting, Motion Sickness
5.2.2 Contraindications
- Allergy or sensitivity to Dimenhydrinate or other antihistamines
5.2.3 Adverse reactions
- Drowsiness, Headache, Blurred vision, Tinnitus, Dry mouth, Palpitations, Vertigo, Hypotension, Pain at injection site
5.2.4 Route of Administration
- Intramuscular / Intravenous
- Oral
5.3 Analgesics / Anti-Pyretic
Dicloran (Diclofenac Sodium)
5.3.1 Indications
- Muscular Skeletal Pain, Renal Colic.
5.3.2 Contraindications
- Don’t administer to asthmatic patients.
- Hypersensitivity.
- Observe and report signs of bleeding (e.g., bleeding gums, bloody or black stools, cloudy or bloody urine).
- Monitor BP for hypertension and blood sugar for hyperglycemia.
5.3.3 Adverse reactions
- Epigastric Pain, Headache, Peptic Ulcer, Abnormalities of Liver / Kidney Function, Pain at the site of injection.
5.3.4 Route of administration
- Oral
- Intramuscular
Note: Never use intravenous.
Paracetamol (Acetaminophen)
5.3.5 Indications
- Paracetamol is used to treat many conditions such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers.
5.3.6 Contraindications
- Hypersensitivity to Acetaminophen.
- Alcohol increases the risk of liver damage when taken with or in an overdose of paracetamol.
- The hazards of paracetamol overdose are greater in chronic heavy drinkers and in people with alcoholic liver disease.
5.3.7 Adverse reactions
- It has similar side effects to aspirin. Most common are rashes, ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea, heartburn.
5.3.8 Route of Administration
- Intramuscular / Intravenous
- Oral
5.4 Bronchodilators
Salbutamol (Proventil, Ventoline)
5.4.1 Indications
- Treatment of Bronchospasm in patients with COPD/asthma
5.4.2 Contraindications
- Hypersensitivity
- Pregnancy safety
- May precipitate angina pectoris and dysrhythmias
5.4.3 Adverse reactions
- Often dose-related and include tachycardia, headache, fatigue, light-headedness, irritability, restlessness
5.4.4 Route of administration
- Inhalation
5.5 Vasodilator
Glyceryl Trinitrate (Angised)
5.5.1 Indications
- Angina Pectoris
5.5.2 Contraindications
- Low blood pressure
- Blood flow problems in the brain
5.5.3 Adverse reactions
- Headache, nausea, vomiting, hypotension, tastelessness
5.5.4 Route of administration
- Sublingual
5.6 Corticosteroids
Hydrocortisone (Solo Cortief)
5.6.1 Indications
- Shock due to acute adrenocortical insufficiency, anaphylaxis, asthma, and COPD
5.6.2 Contraindications
- Systemic fungal infections, premature infants
- May be used in status asthmaticus as a second-line drug
5.6.3 Adverse reactions
- Headache, vertigo, pulmonary tuberculosis
5.6.4 Route of administration
- Oral
- Intravenous
5.7 Anti-Allergic / Anti-Histamine
Chlorpheniramine Maleate
5.7.1 Indications
- Allergic condition like Hypersensitivity reaction i.e., Anaphylactic Shock, Urticaria, Eczema with Pruritus, Hay Fever
- Reddening and Swelling of skin
5.7.2 Contraindications
- Hypersensitivity to chlorpheniramine maleate
5.7.3 Adverse reactions
- Dryness of Mouth, Urine Retention, Palpitation, Dizziness
5.7.4 Considerations
- Skin: color, lesions, texture
- CNS: orientation reflexes
- CVS: BP
5.7.5 Route of administration
- Oral
- Intravenous
5.8 Intravenous Fluids
Dextrose in Water (DW)
Dextrose is a form of glucose (sugar). It provides nutrients in the form of dextrose as well as free water.
5.8.1 Indications
- To replace lost fluids & carbohydrates in non-diabetic patients (5% DW)
- To treat low blood sugar (hypoglycemia) or insulin shock (25% DW)
- Neonatal resuscitation (10% DW)
- Used as a diluent (liquid) for preparing injectable medication in an IV bag
5.8.2 Contraindications
- Diabetes Mellitus
- Hypersensitivity to DW
- Check & stop transfusion in case of burning, pain, or swelling around the IV needle when dextrose 5% in water is administered
- Avoid fluid overload
5.8.3 Adverse reactions
- Rare in therapeutic dosages
5.8.4 Types
- 5% DW
- 10% DW
- 25% DW
Lactated Ringer’s (Hartmann’s Solution)
5.8.5 Indications
- Hypovolemic shock; keep open IV
5.8.6 Contraindications
- Should not be used in patients with congestive heart failure or renal failure
5.8.7 Adverse reactions
- Rare in therapeutic dosages
0.9% Sodium Chloride (Normal Saline)
5.8.8 Indications
- Hypotension, Heat-related problems (heat exhaustion, heat stroke)
5.8.9 Contraindications
- Should not be used in patients with congestive heart failure or hypertensive patients
5.8.10 Adverse reactions
- Rare in therapeutic dosages
5.9 Topical Drugs
Povi Iodine Solution
- Povidone-iodine is a broad-spectrum antiseptic for topical application in the treatment and prevention of infection in wounds.
- May be used in first aid for minor cuts, abrasions, and blisters.
Polyfax (Polymyxin B, bacitracin)
- It is a topical antibacterial agent.
- It is indicated for the treatment of infected wounds, burns, skin grafts, and ulcers.
- It kills bacterial cells by binding to their cell membrane.
6. Dosage of Emergency Drugs
| Sr.# | Name of Drug | Adult Dose | Pediatric Dose |
| 1 | Salicylic Acid (Aspirin) | 75 to 325 mg once daily | Not recommended in infants |
| 2 | Dimenhydrinate (Gravinate) | 50 to 100 mg orally, IM or IV, every 4 to 6 hours, to a maximum of 400 mg in 24 hours | Not recommended in infants |
| 3 | Dicloran (Diclofenac Sodium) | I.V = 75 mg / 3 ml to 150 mg per day Oral = 50 mg, three times a day | Not recommended |
| 3.1 | Paracetamol (Acetaminophen) | 500 mg three times in a day | 1.25 mg to 2.5 mg up to 4 times a day (For children 5 to 12 years) |
| 4 | Salbutamol (Proventil, Ventoline) | 2.5 mg to 5.0 mg up to 4 times per day | 1.25 mg to 2.5 mg up to 4 times a day (For children 5 to 12 years) |
| 5 | Glyceryl Trinitrate (Angised) | 0.3 to 0.6 mg sublingual after every 5 minutes as needed, up to three doses in 15 minutes | Not recommended |
| 6 | Hydrocortisone (Solo Cortief) | Oral, IM, or IV 15 to 240 mg/day (For anti-inflammatory) | Oral: 2.5 to 10 mg/kg/day divided every 6 to 8 hours. IM or IV: 1 to 5 mg/kg/day divided every 12 to 24 hours |
| 7 | Chlorpheniramine Maleate | Anaphylaxis: 10 to 20 mg IV as a single dose | Not recommended in infants |
Post-Test – Emergency Drugs
- Define Pharmacology?
Pharmacology is the scientific study of drugs, their composition, uses, and effects on the body. It involves understanding how medications interact with biological systems to diagnose, treat, or prevent diseases. Pharmacology enables healthcare professionals to make informed decisions on medication use for patient care.
- List Six Rights of medication administration.
- Right Patient: Confirm the identity of the patient before administering medication.
- Right Medication: Ensure the correct medication is given as per the prescription.
- Right Dose: Verify and administer the accurate dosage.
- Right Time: Administer the medication at the correct time as prescribed.
- Right Route: Use the appropriate route of administration (e.g., oral, intravenous, intramuscular).
- Right Documentation: Record the details of medication administration accurately in the patient’s medical records.
- List 05 routes of drug administration.
- Oral: Medication is taken through the mouth and swallowed.
- Intravenous (IV): Medication is injected directly into a vein.
- Intramuscular (IM): Medication is injected into a muscle.
- Subcutaneous (SC): Medication is injected under the skin.
- Inhalation: Medication is inhaled through the nose or mouth into the lungs
Emma Lee, an expert in fire safety with years of firefighting and Rescuer experience, writes to educate on arescuer.com, sharing life-saving tips and insights.