Pharmacology and Medication Administration
Pharmacology items test safe administration: right patient, drug, dose, route, time, and documentation, plus indication and contraindication.
Core rules
- Check allergies, current medications, and contraindications before every dose. Confirm concentration and expiry.
- Use the five rights plus the right reason and right documentation.
- Common prehospital drugs: aspirin 300 mg chewed for ACS; nitroglycerin sublingual for ischemic chest pain if SBP >90; epinephrine 1 mg IV every 3–5 min in arrest and 0.3–0.5 mg IM for anaphylaxis; albuterol nebulized for bronchospasm; naloxone for opioid overdose; dextrose for hypoglycemia.
- Reassess vital signs and the intended effect after administration. Document time, dose, route, and response.
- Controlled substances require secure storage, accurate counts, and complete records.
Worked example
A patient with chest pain has SBP 88 mmHg. You withhold nitroglycerin because hypotension is a contraindication, give aspirin if not allergic, obtain a 12-lead, and transport. You document the reason for withholding the drug.
Traps
Failing to check allergies; giving nitroglycerin in hypotension or recent PDE5 inhibitor use; using the wrong epinephrine concentration; and not reassessing after medication.