Paramedic CH 10 Drug Classes
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- Primarily Treat acute bronchospasm associated with asthma and COPD.
- Beta-2 receport sites cause muscle relaxation and bronchodilation when activated by beta-2 chemicals.
- EPI and NOREPI are natural occuring beta-2
- Beta-agonist can be selective effecting only beta-2 or nonselective effecting beta-1 and 2
Examples of Beta-Agonist Medications?
- Albuterol (Ventolin, Proventil) is a selective beta-2 agonist
- Levalbuterol is similar to albuterol but doesn't have the reported effects on the beta-1
Mucokinetic and Bronchodilator Medications
- May use Ipratropium Bromide (Atrovent) when treating with bronchospasm or reactive airway disease.
- Antagonizes muscarinic recepotrs, causing dilation and decreased mucous in upper and lower airways.
- reduce airway inflammation and improve oxygenation and ventilation.
- Immunsuppressant and can alter a vast array of endocrine functions.
Types of corticosteroids
Methylprednisolone (Solu-Medrol), Dexamethasone (Decadron), prednisone
- Improve or correct abnormalities in a patients cardiac rhythm.
- Many that can improve rhythm can also cause dysrhythmias and have large adverse effects.
Class I Antidysrhythmic Medications
- Slow the movement of Sodium through channels in cardial cells.
- Procainamide (Pronestyl) Class IA suppress activity of ectopic foci and slow QRS and QT intervals.
- Lidocaine Class IB Blocks sodium channels in the Purkinje Fibers and ventricle, resolving various ventricular dysrhythmias and suppress ectopic foci
Class II Antidysrhythmic Medication Beta-Adrenergic blocking agent
- 2nd major class off antidysrhythmic.
- Competitively inhibit catecholamine (epi and norepi) activation of beta receptor sites.
- Metoprolol (Lopressor) is a beta blocking agent used to reduce HR during myocardial ischemia and certain atrial tachycardias. Decrease HR
Class III Antidysrhythmic Medications
- Increase duration of Phase 1, 2, and 3 of the cardiac cycle.
- extends cellular action potential, prolong refractory periods, treat atrial or ventricular tachycardias.
- Amiodarone (Cordarone)
Class IV Antidysrhythmic Medications/Calcium Channel Blockers
- Have a variety of potential uses. IE lower BP control HR. May inhibit uterine contractions during preterm labor, management of migraines, and cardiomyopathy.
- Verapamil (Calan) and Diltiazem (Cardizem) are two calcium channel blockers control HR w/ atrial fibrilation or atrial flutter.
Class V Unnamed class Antidysrhythmic
- Adenosine is the only one.
- Used to treat paroxysmal supraventricular tachycardia
Alpha-Adrenergic Receptor Antagonist
Alpha blockers! prevent endogenous catecholamines from reaching alpha receptors. Lower BP (Diastolic) and decrease systemic vascular resistance.
Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors)
- alter function of the renin-angiotensin system in the body. This system causes vasoconstriction and fluid retention in response to hypotention or hypoperfusion.
- BP reduced and cardiac afterload is decreased w/out much effect on HR
- *CHF patients
- Used for several prehospital purposes.
- Atropine used to treat bradycardia inhibits action of acetylcholine at postganglionic sites.
Catecholamines and Sympathomimetics
- Catecholamines are naturally occuring chemicals in the body that stimulate receptor sites in the sympathetic nervous system. Epi, Norepi, and dopamine.
- Sympathomimetics- not found naturally in body. These chemicals mimic natural occuring catecholamines. Amphetamines, albuterol, phenylephrine, and cocaine have sympathomimetic properties.
Direct Vasodilator Medications
- Management of uncontrolled hypertension, CHF, MI, cardiac ischemia, and cardiogenic shock.
- Act on arteries, veins, or both, vascular muscle relax and dilation.
- Nitro and Sodium nitroprusside (Nipride)
- Correct volume overload, manage CHF, imporove respirations experiencing pulmonary edema.
- Impair the function of clotting or coagulation chemials in the bloodstream.
- Dissolve blood clots
- Heparin and Enoxaparin (Lovenox) enhance antithrombin III to inhibit blood coagulation.
- reduce platelet aggregation, prevent new thrombus formation or extension of existing thrombus.
- Asprin, Clopidogrel (Plavix), Ticlopidine (Ticlid)
- dissolve blood clots in arteries and veins. Treat Acute MI in prehospital setting and strokes.
- Serious ability to cause hemorrhaging.
- Stimulate opiod receptors in the body to relieve or prevent pain associated with an injury, medical condition, or medically related proceedure.
- Morphine Sulfate, Fentanyl
Opiate Antagonist Medication
Naloxone opiod receptor antagonist used to reverse effects of excessive opiod chemicals in the body
Phenytoin and Fosphenytoin
- Phenytoin (Dilantin) and Fosphenytoin (Cerebyx) to prevent seizure activity.
- May see them in head injury, intracranial hemorrhage.
Histamine-2 Receptor Antagonist
- H2 blocker decrease acid secretion in the stomach.
- Ranitidine (Zantac) Cimetidine (Tagamet) and Famotidine (Pepcid)
- Used for several reasons. Prevent nausea and vomiting in patients.
- Promethazine (Phenegran), Metoclopramide (Reglan)
5-HT3 receptors are present in the brain and GI tract
- Sandostatin may see it during interfacility transports.
- hormone that inhibits serotonin release, casing decreade secretion of insulin, glucagon, growth hormone.
- *Esophageal varices
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