DwayneEMTP Posted March 1, 2007 Posted March 1, 2007 Hey all, Starting pharmacology in medic school and need to answer when and why certain drug constitutions/routes would be chosen. One of them is an oil-based emulsion given IM...And I can't find any reason to use this prehospital!! It seems like it might be painful, being more viscus. An that it would absorb more slowly than IV, sublingual, rectal (possibly?) I don't know... What would be the advantages to this route either in or out of hospital? Any ideas would be appreciated... Have a great day all... Dwayne
Just Plain Ruff Posted March 1, 2007 Posted March 1, 2007 dwayne some meds out there require the oil to keep the solution mixed. I'm not sure of the actual drugs that require oil based but I don't believe any of them have a place in pre-hospital EMS. Most of the drugs based on a google search are vitamins and fat solutions. I remember giving one med in the ER that was such a thick emulsion that we had to use the z-track method of administration due to the medication coming out the injection site. Yes they do hurt more goin in and they stay in the tissue longer. ERDOC, Asys or Rid you have anything to add?
DwayneEMTP Posted March 3, 2007 Author Posted March 3, 2007 Thanks for the info Ruff! I guess it didn't pique anyone else's interest... Have a good one! Dwayne
SnowFlight Posted March 3, 2007 Posted March 3, 2007 by oil based emulsion are you thinking lipid based? some drugs need to be emulsified so they can pass through through the phospholipid bi-layer of cells directly, rather than having to go through the liver and get attached to lipids there, then pass into cells. It also usually speeds uptake and clearance (ie: skipping the liver buisiness). prime examples are valium emulsion (Diazemuls), Propofol, etc.. If this is along the track you are looking for, take a search through physiology or drug texts for info re: lipophilic / lipophobic & hydrophilic / hydrophobic. that should clear things up.
SnowFlight Posted March 3, 2007 Posted March 3, 2007 by the way, emulsions used IM = badness. IV use only
DwayneEMTP Posted March 3, 2007 Author Posted March 3, 2007 by oil based emulsion are you thinking lipid based? some drugs need to be emulsified so they can pass through through the phospholipid bi-layer of cells directly, rather than having to go through the liver and get attached to lipids there, then pass into cells. It also usually speeds uptake and clearance (ie: skipping the liver buisiness). prime examples are valium emulsion (Diazemuls), Propofol, etc.. If this is along the track you are looking for, take a search through physiology or drug texts for info re: lipophilic / lipophobic & hydrophilic / hydrophobic. that should clear things up. Thanks so much! That is exactly what I needed. For some reason I just couldn't get this in my head... Welcome to EMTCity!! It's pretty exciting to see your first two posts so clear, to the point and helpful! Thanks again! Dwayne
Doczilla Posted March 3, 2007 Posted March 3, 2007 Haldol Depo is one example of such an emulsion for deep IM injection. These types of injections are for extremely-long acting shots that are intended to work over days or weeks. With haldol, it ensures compliance with medication if the patient has demonstrated that they will stop taking oral meds if given the chance. They are required to show up once a week to get their shot, and if they don't, someone goes looking for them. Actually, haldol is the only injectable oil emulsion that I can think of right now, though I'm sure there are others. And you're right; there's no reason to use these prehospital. 'zilla
ERDoc Posted March 3, 2007 Posted March 3, 2007 Amphotericin B, daunorubicin, doxorubicin also have a lipid based preparation. The are many topical meds that are emulsions. Don't think any of these are relevant to the EMS setting.
tniuqs Posted March 4, 2007 Posted March 4, 2007 ERDOC, Asys or Rid you have anything to add? Ok and squint is chopped liver! snif snif.... Propofol = Mothers Milk! Isn't it time to introduce this into EMS, ie Facilitated Intubation as opposed to RSI, (perhaps with an ephedrine chaser) it certianly simplifies the process. I have some real concerns with the RSI sequence.....it really should be called SSI, "Slow Sequence of Intubation" just pull up Lydo, or Etomidate, Fentanyl, Versed, Succs, and then Pav. or Vec. or Trac......tell me again this is "RAPID" hmmm? cheers PS SnowFlight.....where is your Flag ? Show the colors Man!
tniuqs Posted March 4, 2007 Posted March 4, 2007 PS SnowFlight.....where is your Flag ? Show the colors Man! I thought so.....good god not another Kanukistanian ! Greetings and Salutations.
Recommended Posts