Exam 6

What does pharmacology mean?

The science of drugs.

What is a drug(medication)?

Chemical substance used to prevent, treat, diagnose disease.

What is Pharmacodynamics?

Process by which medication works on the body.

What is Pharmacokinetics?

Process of what the body does to the drug.

What does ADME stand for?

Absorption Distribution Metabolism Elimination

What does agonist mean?

Causes stimulation of receptor

What does antagonist mean?

Binds to receptor and blocks other actions

What does does mean?

Amount of medication given

What variables effect dosages?

Weight, desired action, age

What is action of medications?

Effect on body following administration

What is indications in medicine?

Acceptable medical uses

What is contraindications of medicine?

Conditions in which drugs should not be given.

What is absorption?

The process by which medications travel through body tissues.

What is a side effect?

Any action of a drug other than the desired one

What is adsorption?

To bind or stick to a surface

What are indications of medicine?

Therapeutic. use for a particular medication

What is action of medications?

Effect that a drug is expected to have

What are capsules?

Gelatin shells filled with powdered or liquid medication

What are topical medications?

Lotions, creams, ointments

Nitroglycerin relieves the squeezing or crushing pain associated with angina by?

Dilating the arteries to increase the oxygen supply to the heart muscle.

What is the brand name that a manufacturer gives to a medication called?

Trade name

What is the fastest way to deliver a chemical substance?

Intravenous Route

What is a solution?

Liquid mixture of substances.

What routes may solutions be given?

Orally, intramuscularly, rectally

The form the manufacturer chooses for a medication ensures what?

The proper route of the medication, the timing of the medication's release into the bodystream, the medication's effects on target organs or body systems.

What does epinephrine act as a specific antidote to?

Histamine.

Epinephrine is given to patients with anaphylatic shock because of its

bronchodilation and vasoconstriction

What are the Characteristics of epinephrine?

Dilating passages in the lungs, constricting blood vessels, and increasing the heart rate and blood pressure.

An acute bacterial infection of the flap over the larynx is _____.

Epiglottis

What is the preferred method of giving oxygen to patients who have sufficient tidal volume and can provide up to 90% inspired oxygen prehospital?

Nasal Cannula

Nitroglycerin relieves pain because its purpose is to increase blood flow by relieving the spasms or causing the arteries to ______.

dilate

What symbolizes the atrial depolarization on an ECG?

P-wave

What symbolizes the ventricular depolarization on an ECG?

QRS-complex

What symbolizes the ventricular repolarization on an ECG?

T-wave

What is the node in the atrium?

Sinoatrial Node

What is the gate keeper node?

Atriaventricular Node

How does nitroglycerin affect the body?

It decreases blood pressure, it relaxes veins throughout the body, it often causes a mild headache after administration.

What are medications that EMTs can give?

Albuterol, Oral Glucose, Nitroglycerin, Activated Charcoal, Epinephrine, Aspirin, Oxygen

How do you administer oral glucose?

Place between a patient's cheek and gum

What is the government publication listing all drugs in the United States?

United States Pharmocopoeia

Is oxygen a flammable substance?

no

Can glucose be administered to an unconscious patient in order to save his or her life?

no

Is epinephrine a hormone produced by the body to aid in digestion?

no

Does nitroglycerin lower blood pressure?

yes

Are sublingual medications rapidly absorbed into the digestive tract?

no

Should vital signs be taken before and after a medication is given?

yes

What are contraindications for Nitroglycerin?

Low Blood Pressure < 100
Erectile Disfunction pills

What is a simple sugar that is readily available by the bloodstream?

glucose

What is the main hormone that controls the body's fight-or-flight response?

Epinephrine

How is nitroglycerin usually taken?

Sublingually

List the seven routes of medication administration

1.Intravenous
2.Intramuscular
3.Transcutaneous
4. Oral
5.Intraosseous
6.Inhalation
7.Sublingual
8.Subcutaneous
9.Per rectum

Describe the general steps of administering medication.

1.Obtain an order from medical control
2.Verify the proper patient, medication, and prescription
3.Verify the form, dose and route
4.Check the expiration date and condition of medication
5.Reassess vital signs, especially heart rate and blood pressure, at

Describe the action of activated charcoal and the steps of administration that are specific to this medication.

Many drugs adsorb (Stick to) activated charcoal, preventing the drugs from being absorbed by the body. It needs to be shaken because it is a suspension and should be given in a covered container with a straw.

List three characteristics of epinephrine.

1.Secreted naturally by the adrenal glands
2.Dilates lung passages
3.Constricts blood vessels
4.Increase heart rate and blood pressure

How is an epinephrine auto-injector activated?

By pressing it into the skin

List four side effects of nitroglycerin.

1.Headache
2.Burning under the tongue
3.Hypotension
4.Nausea

Explain why metered-dose inhalers are often used with a spacer.

To aim the spray properly and ensure inhalation of all medication.

What is a blood clot in the pulmonary artery?

Pulmonary Embolism

What is respiration?

The exchanged of oxygen and carbon dioxide.

What is Pulmonary Edema?

Fluid build-up within the alveoli and lung tissue.

What is Epiglottitis?

Bacterial infection that can produce severe swelling.

What is Emphysema?

Diseas of the lungs in which the alveoli lose elasticity due to chronic stretching.

What is Pleural Effusion?

Fluid outside of the lung.

What is Tuberculosis?

A disease that can lay dormant in the lungs for decades, then reactivate.

What is Dyspnea?

Difficulty breathing.

What is Pneumonia?

An infection of the lung that damages lung tissue.

What is Hypoxia?

Condition in which the body's cells and tissues do not have enough oxygen.

What is Bronchitis?

An acute or chronic inflammation of the major lung passageways.

What is Hyperventilation?

Overbreathing to the point that the level of carbon dioxide in the blood falls below normal.

What is Allergen?

A substance that causes an allergic reaction.

What is Embolus?

A blood clot or other substance in the circulatory system that travels to a blood vessel where it causes blockage.

What is Asthma?

Acute spasm of the bronchioles, associated with excessive mucus production and swelling of the mucous lining.

What is Pneumothroax?

Accumulation of air in the pleural space

Where does the oxygen-carbon dioxide exchange take place?

Alveoli

The letter "S" in the pnuemonic PASTE, stands for what?

Sputum (color) / Speech.

The letter "P" in the pnuemonic PASTE, stands for what?

Provoking factors.

The letter "A" in the pnuemonic PASTE, stands for what?

Associated pain.

The letter "T" in the pnuemonic PASTE, stands for what?

Time of onset / Temperatue.

The letter "E" in the pnuemonic PASTE, stands for what?

Exacerbation.

What is PASTE pneumonic useds for?

For respiratory emergencies, PASTE can be used in lieu of OPQRST for the focused history portion of patient assessments.

What happens if the carbon dioxide levels drop too low?

The person automatically breathes slower and less deeply.

What if the level of carbon dioxide in the arterial blood rises above normal?

The patient breathes rapidly and deeply.

Inflammation and swelling of the phrynx, larynx and trachea that results in a "seal bark" is typically caused by waht?

Croup

When does the rate of breathing typically increase?

Carbon dioxide levels increase

What is a sign of hypoxia to the brain?

Altered mental Status

What causes an obstruction to the exchange of gases between the alveoli and the capillaries?

Pneumonia

Pulmonary edema can develop quickly after a major _____.

Heart attack

Pulmonary edema may also be produced by _____.

Inhaling toxic chemical fumes

What is the loss of elastic material aroudn the air spaces as a result of chronic stretching of the alveoli?

Emphysema

What is a genetic disorder that affects the lungs and digestive system?

Cystic Fibrosis

What does a patient with COPD usually present with?

a green or yellow productive cough

A pneumothorax is a partial or complete accumulation of air in where?

pleural space

Asthma produces a characteristic ______ as patients attempt to exhale through partially obstructed air passages.

wheezing

What does an allergic response to certain food or some other allergen produce?

an acute asthma attack

What are the treatments for anaphylaxis and acute asthma attacks?

Epinephrine, high flow oxygen, and antihistamines.

What is a collection of fluid outside the lungs uni or bilaterrally of the chest?

Pleural Effusion

What should you consider in patients who were eating just before becoming short of breath?

Upper Airway Obstruction

What is defined as overbreathing to the point that the level of arterial carbon dioxide falls below normal?

Hyperventiliation.

What is an indication of inadequate breathing?

Accesory muscle use, Cyanosis, and Unequal chest expansion

What is an indication of adequate breathing?

a regular pattern of inspiration and expiration

Contraindications to helping a patient self-administer a metered-dose inhaler are?

Failure to obtain permission from medical control, noticing that the patient has already taken the maximum dose of the medication, and noticing that the medication has expired.

Contraindications for continuous positive airway pressure are?

Hypotension

Pulse oximeters meausre the percentage of hemoglobin saturated with what?

Oxygen

True or False. Chronic bronchitis is characterized by spasm and narrowing of the bronchioles due to exposure to allergens.

False

True or False. With pneumothorax, the lung collapses because the negative vacuum pressure in the pleural space is lost.

True

True or False. Anaphylactic reactions occur only in patients with a previous history of asthma or allergies.

False

True or False. Decreased breath sounds in asthma occur because fluid in the pleural space has moved the lung away from the chest wall.

False

True or False. Patients with carbon monoxided poisoning initally complain of headache, fatigue and nausea

True

True or False. Pulmonary edema is commonly associated with congestive heart failure.

True

True or False. The distinction between hyperventilation and hyperventilation syndrome is straightforward and should guide the EMT's treatment choice.

False

True or False. COPD most often results from cigarette smoking.

True

True or False. Asthma and COPD are characterized by long inspiratory times.

False

True or False. MRSA is a bacterium that most commonly infects people with weak immune system.

True

True or False. When assessing a patient, the general impression will help you decide whether the patient's condition is stable or unstable.

True

True or False. Skin color, capillary refill, level of consciousness, and respiratory pattern are key in evaluating the respiratory patient.

True

True or False. Oxygen is typically withheld from COPD patients regardless of their breathing status.

False

True or False. Side effects of inhalers used for acute shortness of breath include increased pulse rate, nervousness, and muscle tremors.

True

True or False. Patients who are hyperventilating should be treated by having them breathe into a paper bag.

False

True or False. Epiglottitis is more predominant in adult population.

False

True or False. An RSV infection can cause respiratory illness such as bronchiolitis and pneumonia.

True

True or False. When assisting a patient with a small-volume nebulizer, the oxygen flowmeter should be set to 10 L/min.

False

True or False. Snoring sounds are indicative of a partial upper airway obstruction.

True

True or False. Signs and symptoms of pulmonary emboli include dyspnea, hemoptysis, and tachycardia.

True

____ is an odorless, highly poisonous gas that results from incomplete oxidation of carbon in combustion.

carbon monoxide

The level of ______ _______ sensed by the brain stem stimulates respiration.

carbon dioxide

The level of _____ in the blood is a secondary stimulus for respiration.

oxygen

_____ passes from the blood through capillaries to tissue cells.

Oxygen

Carbon dioxide and oxygen are exchanged in the ______.

alveoli

If you suspect a patient has tuberculosis, you should wear gloves, eye protection, and a(n) ______ _______.

HEPA respirator

Abnormal breathing is indicated by a rate slower than _____ breaths/min or father than ________ breaths/min.

12; 20

High-pitched sounds heard on inspiration as air tries to pass through an obstructions in the upper airway is commonly referred to as ______.

stridor

______ are the sounds of air trying to pass through fluid in the alveoli.

Rales or crackles

When asking questions about the present illness during the history and secondary assessment, use the mnemonics _____ and _____ to guide you in your general questioning.

SAMPLE; OPQRST

One sign of foreign body aspiration in a child may be an abnormality in the _____.

voice

A patient with a seizure lasting longer than 30 minutes is said to be experiencing ______ ________.

status epilepticus

_______ is an airbone bacterial infection that is highly contagious and results in coughing attacks lasting longer than a minute.

Pertussis (whooping cough)

______ are lower pitched sounds caused by secretions or mucus in the larger airways.

Rhonchi

A patient with a barrel chest and a "puffing" style of breathing most likely has ____.

emphysema

List five characteristics of normal breathing.

1. Normal rate
2. Regular pattern of inhalation and exhalation
3. Clear and equal lung sounds on bilateral chest sides
4. Regular and equal chest rise and falll
5. Adequate depth

List six conditions where wheezing can be found.

1. Asthma
2. Chronic obstructive pulmonary disease
3. Congestive heart failure/pulmonary edema
4. Pneumonia
5. Bronchitis
6. Anaphylaxis

Under what conditions should you not assist a patient with a metered-dose inhaler?

1. Patient is unable to coordinate administration and inhalation
2. Inhaler is not prescribed for patient
3. You did not obtain permission from medical control or local protocol
4. Patient has already met maxiumum prescribed dose before your arrival.
5. M

Describe chronic bronchitis.

An ongoing irriation of the respiratory tract; excess mucus production obstructs small airways and alveoli. Protective mechanisms are impared. Repeated episodes of irriation and pneumonia can cause scarring and alveolar damage, leading to COPD.

List complications associated with tracheostomy tube.

Obstruction with secretions, mucus, foreign bodies, and/or airway swelling
Bleeding
Leaking
Dislodgement
Infection

Explain carbon dioxide retention.

A condition characterized by a chronically high blood level of carbon dioxide in which the respiratory center no longer responds to high blood levels of carbon dioxide. In these patients, low blood oxygen causes the respiratory center to respon and stimul

When ventilating a patient, how would you determine whether your ventilations are adequate?

1. Is the air going in?
2. Does the chest expand with each breath?
3. Does the chest fall after each breath?
4. Is the rate adequate for the age of your patient?

What is atria?

Upper chambers of heart.

What are coronary arteries?

Blood vessels that supply blood to the myocardium

What is the atrioventricular node?

Electrical impulses slow here to allow blood to move from the atria to the ventricles.

What is the myocardium?

Heart muscle.

What is the sinus node?

Electrical impulses begin here.

What is the Venae Cavae?

Carry oxygen-poor blood back to the heart

What are the Ventricles?

Lower chambers of heart

What is the aorta?

Body's main artery

What is Atherosclerosis?

Calcium and cholesterol buildup inside blood vessels

What is arrhythmia?

Abnormal heart rhythm.

What is Ischemia?

Lack of oxygen

What is infarction?

Tissue death

What is tachycardia?

Rapid heart rhythm, greater than 100 beats/min

What is asystole?

Abnormal heart rhythm

What is Bradycardia?

Unusually slow heart rhythm, less than 60 beats/min

What is Thromboembolism?

Blood clot floating through blood vessels until it reaches a narrow area and blocks blood flow.

What is an acute myocardial infarction?

Complete blockage of coronary artery

What is cardiac arrest?

Pulseless, apneic

What is angina pectoris?

Exertional chest pain, relieved by nitroglycerin

What is Cardiogenic shock?

Heart lacks pumping power, low blood pressure

What are signs of Congestive Heart Failure?

Swollen ankles, rales

What are signs of Hypertensive emergency?

Severe headache, bounding pulses, ringing in ears

What is a dissecting aneurysm?

Sudden tearing, seperation of lining, potential for great blood loss

What allows a cardiac muscle cell to contract spontaneously without a stimulus from a nerve source?

Automaticity

Where does the aorta receive its blood supply from?

Left ventricle

Where does blood enter the right atrium from the body?

Vena Cava

What are the only vein(s) in the body that carry oxygenated blood?

Pulmonary veins

Normal electrical impulses originate in the sinus node, just above the ______.

atria

Does dilation of the coronary arteries increas or decrease blood flow?

increase

What are the tiny blood vessels that are approximately one cell thick?

Capillaries

What carries oxygen to the body's tissues and then remove carbon dioxide?

Red blood cells.

What is the maximum pressure extered by the left ventricle as it contracts?

Systolic blood pressure

What can atherosclerosis lead to in the coronary artery?

Occlusion