home medication: implications for EMS

[LucidResq]

I have an assignment for my EMT class; I was given a list of some common medications and I am to find the indications and any implications or concerns relevant to EMS.

Finding the uses was a breeze, and I found some information about how the particular drugs may affect the treatment or assessment of a patient, but I feel like there's probably more out there that I didn't catch. I have enough information to complete the assignment, but I'm not just concerned about the grade here. I just couldn't find any information in my book or on the web about these drugs that is intended for EMS providers.

Again, I'm not asking you to do my homework. The homework is done. I want to dig deeper.

So, if you could give me any information or direct me to a website that provides information, that'd be lovely. Here's the list of drugs and their implications in EMS that I know of:

Hydrocodone - abuse, overdose, use with other depressants
Atenolol- sudden withdrawal can cause/worsen cardiac problems
Lasix- dehydration
Paxil- psych, MAOIs, withdrawal syndrome
Prednisone- addisonian crisis
Amitriptyline- psych, MAOIs
Warfarin- hemorrhage, necrosis
Diazepam- abuse, OD, chance of respiratory and/or cardiac arrest in elderly
Lanoxin- ECG changes, interaction with epinephrine
Dilantin- ???

Thanks for any help!

 

[BossyCow]

One of the big EMS links to meds the pt. takes at home is an indicator of an existing condition... on a call it goes something like this...
"Ma'am, do you have any medical conditions we should be concerned about?"
"No... I don't"
"Have you ever had chest pain like this before?"
"No.. not really"

"Hmm.. what do you take this for?" pointing at name on med list (2pgs.. typed, single spaced)
Oh.. that's for my heart..
How long have you been taking that?
Since my heart attack in 85..
And this?
For my ulcer..
This?
oh.. pancreatic enzymes.. for my pancreatitis...That one's for my thyroid, and I take that one for cholesterol, the steroid is one they gave me after my knee replacement and that one is for blood pressure and I've been taking that one since I had that shunt put in in '97

Okay.. so about that previous medical history.. anything???
Nope.. healthy as a horse.

understanding what some of the more common elderly meds are gives you clues about the patient. A common trait in the elderly is they deal with aches and pains on a daily basis, so they can downplay certain medical conditions as something normal.

You can google any of those meds, or check in one of the little EMS flip field guides to find out what they are for.

 

[skyemt]

you know what Bossy,

i have run into that soooo many times...

they consider it a problem they had in the "past", but is not a problem now, because their meds are controlling it...

it is almost an issue of wording and semantics...

rather than putting it in the present, i often will ask if they've EVER had heart problems, and then they will say straight out, yes, in 85, but it's not a problem now because i take my meds...

they just don't really understand where we're coming from sometimes...

 

[Ridryder911]

I have an assignment for my EMT class; I was given a list of some common medications and I am to find the indications and any implications or concerns relevant to EMS.

Finding the uses was a breeze, and I found some information about how the particular drugs may affect the treatment or assessment of a patient, but I feel like there's probably more out there that I didn't catch. I have enough information to complete the assignment, but I'm not just concerned about the grade here. I just couldn't find any information in my book or on the web about these drugs that is intended for EMS providers.

Again, I'm not asking you to do my homework. The homework is done. I want to dig deeper.

So, if you could give me any information or direct me to a website that provides information, that'd be lovely. Here's the list of drugs and their implications in EMS that I know of:

Hydrocodone - abuse, overdose, use with other depressants PAIN MGMT, RESPIRATORY DEPRESSION, CONSTIPATION,
Atenolol- sudden withdrawal can cause/worsen cardiac problems
Lasix- dehydration, ELECTROLTE IMBALANCES, DEHYDRATION, DEAFNESS, LOWERS BLOOD PRESSURE,
Paxil- psych, MAOIs, withdrawal syndrome, LOWERS BLOOD PRESSURE
Prednisone- addisonian crisis, COPD, ASTHMA, CANCER TREATMENT, RASHES-(POISON IVY), DRUG REACTION, INSECT STINGS, BRONCHITIS, ORTHOPEDIC INJURIES
Amitriptyline- psych, MAOIs, DEPRESSION, RESPIRATORY FAILURE, GI DEPRESSSION,
Warfarin- hemorrhage, necrosis, CEREBRAL BLEED, ANEMIA, NOT COMPATABLE W/CORDORONE
Diazepam- abuse, OD, chance of respiratory and/or cardiac arrest in elderly, ANXIETY USE, USE FOR SEIZURES, USE FOR MENNIERS DISEASE (VERTIGO),
Lanoxin- ECG changes, interaction with epinephrine, ALWAYS TAKE APICAL HEART BEAT FOR ONE MINUTE BEFORE ADMINSTRATION, CAN CAUSE BRADYCARDIA-AYSTOLE, VISUAL CHANGES, LOC CHANGES
Dilantin- ??? USE FOR ARRYTHMIAS, USE FOR SEIZURE CONTROL,

Thanks for any help!

You did NOT searchvery well. There are TONS of information out there.
http://www.ssgfx.com/CP2020/medtech/procedures/protocols.htm

R/r 911

 

[LazarusHeart]

If you really want to go indepth, you can view the PIs (Package Inserts) for each of the pharmaceuticals listed by going to the company's home page. For example, Paxil belongs to GSK. There's alot of info you DON'T need in the PI for our level, but it's good to know the general side effect profiles of the more common ones to get a clearer picture of how the pt is presenting (is it pharmacological or physiological?).

 

[Outbac1]

As others have said having an understanding of what various drugs do can be a great help on scene. Any side effect or drug interaction can have implications for EMS. Try this site (if you haven't already). It seems to have a fair bit of info on drugs. http://www.rxlist.com/drugs/alpha_a.htm

I've pretty much given up on asking IF they take meds. It is more of "What medications DO you take and where are they?". I like to see them to see how old the script is and maybe I can tell how compliant they are with them. I take them to the ER if I can (often times a bag full), so the Dr. can check them for dangerous interactions. Some people get meds prescribed by different Drs. who don't know what else they are on. And that interaction may be their problem and why you are there.

Many meds have many names and learning them or what type of med they are is a work in progress. Seven years and still going.

Best of luck on your course.

 

[Jon]

www.epocrates.com

I've been using it for years... it is great for when you are scratching your head about a med... how to spell it, what the side effects are, what it is used for, "Is my patient having an allergic reaction to the med", etc.