Prehospital Emergency Pharmacology Chapter 5

Intracellular fluids

ICF, fluid located within cells

extracellular fluid

ECF, fluid outside the cells

interstitial fluid

liquid found between the cells of the body that provides much of the liquid environment of the body

intracellular fluid percentage

45% of total body weight

extracellular fluid percentage

15% of total body weight, interstitial fluid - 10.5, intravascular fluid - 4.5.

total body water

60% of total body weight

electrolytes

minerals that carry electrical charges that help maintain the body's fluid balance

nonelectrolytes

substances that form no ions in water and cannot conduct electricity

milliequivalents

(mEq), measurements used to indicate the strength of certain drugs (sodium and potassium are measured in this)

cation

a positively charged ion

major cation examples

sodium (Na+), calcium (Ca2+), potassium (K+), and magnesium (Mg2+)

cation concentration in extracellular fluid

sodium and calcium

cation concentration in intracellular fluid

potassium and magnesium

sodium (Na+)

helps regulate the bodies water, nerve impulse transmission, and transfer of calcium into the cell. examples of sodium combinations: chloride (Cl-) or bicarbonate (HCO3-)

regulation of sodium occurs in the

kidneys

aldosterone

increases renal absorption of sodium

hypernatremia

high sodium concentration

calcium (Ca2+)

used in the structure of bone and teeth. it also functions as an enzyme for blood clotting and is required for hormone secretion, membrane stability, and permeability, and muscle contraction.
example of calcium combination: phosphate (HPO-4)

blood levels of calcium are closely related by

parathyroid hormone (PTH), vitamin D, and calcitonin (from thyroid gland)

potassium (K+)

used for the transmission and conduction of nerve impulses, maintenance of normal cardiac rhythms, and skeletal smooth muscle contraction. Also required for glycogen deposits in the liver and skeletal muscle.

magnesium (Mg2+)

40 to 60 percent of magnesium is stored in muscle and bone. it activates enzyme (ATPase) that is essential for normal cell membrane function and is the energy source for the sodium-potassium pump. helps prevent dysrhythmias.

anions

negatively charged ions

examples of anion

chlorine (Cl-), bicarbonate (HCO3-), phosphate (HPO4-)

semipermeable

membranes that allow some substances through but not others

diffusion

process by which molecules tend to move from an area where they are more concentrated to an area where they are less concentrated

facilitated diffusion

the transport of substances through a cell membrane along a concentration gradient with the aid of carrier proteins

active transport

energy-requiring process that moves material across a cell membrane against a concentration difference

plasma

colorless watery fluid of blood and lymph containing no cells and in which erythrocytes and leukocytes and platelets are suspended

erythrocytes

red blood cells

hemoglobin

an important iron containing protein within erythrocytes

hematocrit

a measurement of the percentage of packed red blood cells in a given volume of blood

leukocytes

White blood cells

thrombocytes

platelets

transfusion reaction

reaction of the body to a transfusion of blood that is not compatible with its own blood

type A

the blood group whose red cells carry the A antigen

type B

the blood group whose red cells carry the B antigen

type AB

the blood group whose red cells carry both the A and B antigens

type O

the blood group whose red cells carry neither the A nor B antigens

type A blood types

b antibodies, type A or O receive, type A and AB can donate

type B blood types

A antibodies, type B or O receive, type B and AB can donate

type AB blood types

no antibodies, type AB, A, B, O receive, type A, B, AB can donate

type O blood types

A and B antibodies, type O receive, type A, B, AB, O can donate

colloid

a mixture in which the particles are dispersed throughout but are not heavy enough to settle out

colloid osmotic pressure

Pressure that tends to keep fluid in the intravascular compartment.

plasma protein fraction (plasmanate)

plasmanate is a protein containing colloid.

salt poor albumin

salt poor albumin contains only human albumin.

dextran

is not a protein but a large sugar molecule with osmotic properties similar to those of albumin.

hetastarch (hespan)

is a sugar molecule with osmotic properties similar to those of protein. does not have the same side effects as dextran

polygeline (haemaccel)

is a gelatinous colloid with osmotic properties similar to albumin. it is free of side effects and is temp stable with a relative shelf life.

albumin

most abundant plasma protein, 60% of the total protein, made by the liver, plays an important role in osmotic balance, contributes to the viscosity of blood, transportation of lipids/hormones/calcium..., and helps to maintain pH

Rh

any of several hormones produced in the hypothalamus and carried by a vein to the anterior pituitary gland where they stimulate the release of anterior pituitary hormones

isotonic solution

a solution whose solute concentration is equal to the solute concentration inside a cell

hypertonic solution

a solution in which the concentration of solutes is greater than that of the cell that resides in the solution

hypotonic solution

a solution in which the concentration of solutes is less than that of the cell that resides in the solution

HBOC's

isolated hemoglobin based oxygen carriers-
-resemble blood
-modified to prevent rapid breakdown in the body (can damage kidney)
- work like ordinary RBC's (smaller so can fit in more places)
-lasts only 1 day, bind to nitric oxide and raise BP, abdominal

Lactated ringers

-Isotonic
-expands ECF
-treats HYPOTENSION or BLOOD LOSS
-used for fluid resuscitation with ACIDOSIS or fluid loss from PANCREAS, SMALL BOWEL, saliva or diarrhea

normal saline

Salt and water solution at the physiologic concentration, 0.9%. Also called 0.9%

5% dextrose in water

A carbohydrate solution that uses glucose (sugar) as the solute dissolved in sterile water. Five percent dextrose in water is packed as an isotonic solution but becomes hypotonic once in the body because the glucose (solute) dissolved in sterile water is

Drug cards

see pages 96-111