Legal Aspects and Scope
This federal agency oversees the approval, safety, and labeling of prescription and over-the-counter medications in the United States.
Food and Drug Administration (FDA)
Before administering medication, the athletic trainer checks the correct patient, medication, dose, route, and time. These are collectively called this.
the five rights of medication administration
This pharmacokinetic term describes movement of a drug from its administration site into systemic circulation.
absorption
This term describes what a drug does to the body, including its mechanisms of action and effects.
pharmacodynamics
A medication swallowed as a tablet or capsule uses this enteral route.
oral route
This legal authorization, commonly issued under a licensed prescriber's authority, may permit specified medications to be administered under predefined conditions.
a standing order
A patient says they are allergic to a prescribed medication. Before administration, the athletic trainer should take this action.
withhold administration, verify and document the allergy, and consult the prescribing clinician
This organ is the primary site of metabolism for most drugs.
the liver
A medication binds to a receptor and activates it, producing a biological response. It is called this.
an agonist
This common nonopioid analgesic reduces pain and fever but has minimal peripheral anti-inflammatory activity.
acetaminophen
An athletic trainer receives a request to administer a prescription medication. These two sources primarily determine whether the AT is legally authorized to perform the act.
the applicable state practice law/regulations and the authorized clinician's order or protocol, within the AT's permitted scope
An athlete reports receiving a dose of medication from another clinician 30 minutes ago. This is the key information the AT must verify before another dose.
the medication identity, strength/dose, route, administration time, and prescribed dosing interval
A medication has a half-life of 4 hours. If 80 mg is present initially, approximately this amount remains after 8 hours, assuming first-order elimination.
20 mg
A medication occupies a receptor without activating it and prevents an agonist from producing its usual effect.
an antagonist
A provider orders 600 mg of an oral medication. Each tablet contains 200 mg. This is the number of tablets required.
3 tablets
A coach asks an AT to provide an athlete another player's prescription medication. Identify the legal and professional problem and appropriate action.
unauthorized distribution or administration of a prescription drug. The AT should refuse, assess the athlete, and arrange appropriate evaluation and treatment.
Two medications have similar packaging and names. Identify two system-level safeguards to reduce selection errors in an athletic training facility.
separating or clearly labeling look-alike/sound-alike medications and using independent label/barcode verification.
A drug taken orally has a much lower systemic bioavailability than the same dose administered intravenously. Name the two major processes that may explain this difference.
incomplete gastrointestinal absorption and first-pass metabolism
Two medications produce the same maximum therapeutic response, but drug A reaches 50% of its maximum response at a lower concentration. Identify the pharmacodynamic property in which drug A differs.
greater potency (a lower EC50), not necessarily greater efficacy
An athlete has localized pain and requests a topical local anesthetic. Explain the primary mechanism by which lidocaine reduces sensation.
reversible blockade of voltage-gated sodium channels, preventing propagation of action potentials in sensory nerves
During an away-game emergency, an AT considers administering a medication under a home institution's standing order. Identify three legal or safety considerations before proceeding.
The AT's authority in the state where care is provided, the order's validity and applicability at that location, and the medication's indication/contraindications. Also accept patient-specific verification and emergency protocols.
After a medication is given, an athlete develops wheezing, facial swelling, and hypotension. Identify the likely emergency and the immediate priorities.
anaphylaxis. Activate EMS/emergency response, administer IM epinephrine promptly if authorized and available, and support airway, breathing, and circulation.
A medication is highly protein-bound, and an athlete begins another medication that may displace it. Explain the potential effect on the free-drug concentration and why the clinical outcome is not always predictable.
A possible transient rise in unbound drug concentration. The sustained effect also depends on distribution, clearance, and other interactions, so displacement alone does not necessarily cause toxicity.
A drug has a narrow therapeutic index. Explain what that means clinically and identify two implications for patient care.
A small separation between effective and toxic exposures. It calls for careful dosing, monitoring, and attention to interactions, organ function, and adherence.
An athlete with impaired swallowing needs an analgesic, and a teammate suggests crushing an extended-release tablet. Explain why this is unsafe and identify the appropriate next step.
The risk of dose dumping and toxicity due to destruction of the extended-release mechanism. Do not crush it; consult the prescriber or pharmacist for an appropriate alternative formulation or route.