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Pharmacology 1

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  • 1. Pharmacology CHAPTER 22
  • 2. 2 Pharmacology Overview • Pharmacology – Field of medicine that specializes in the study of drugs, their sources, appearance, chemistry, actions, and uses • Drug – Any substance that when taken into the body, may modify one or more of its functions
  • 3. 3 • Pharmacodynamics – Study of how drugs interact in the human body • Pharmacist – One who is licensed to prepare and dispense drugs Pharmacology Overview
  • 4. 4 • Pharmacy – Drug store • Toxicology – Study of poisons, their detection, their effects – Establishing antidotes and methods of treatment for conditions they produce Pharmacology Overview
  • 5. 5 Drug Laws • Food, Drug, and Cosmetic Act (FDCA) – 1938 – Regulates quality, purity, potency, effectiveness, safety, labeling, and packaging of food, drug, and cosmetic products – Enforced by the Food and Drug Administration (FDA)
  • 6. 6 Drug Laws • Controlled substance act – Regulates manufacture, distribution, and dispensing and administration of controlled substances • Drugs that have the potential of being abused and of causing physical or psychological dependence – Enforced by the Drug Enforcement Administration (DEA)
  • 7. 7 • Schedule I Drugs – Not considered to be legitimate for medical use in the United States – Used for research only and cannot be prescribed – High risk for abuse • Examples: LSD, heroin, marijuana Controlled Substances or Schedule Drugs
  • 8. 8 • Schedule II Drugs – Accepted medical use but have a high potential for abuse or addiction – Must be ordered by written prescription – Cannot be refilled without a new, written prescription • Examples: morphine, cocaine, codeine, demerol, dilaudid Controlled Substances or Schedule Drugs
  • 9. 9 • Schedule III Drugs – Moderate potential for abuse or addiction, low potential for physical dependence – May be ordered by written prescription or by telephone order – Prescription expires in six months – may not be refilled more than five times in six-month period • Examples: Tylenol with codeine, butisol, hycodan Controlled Substances or Schedule Drugs
  • 10. 10 • Schedule IV Drugs – Less potential for abuse or addiction than those of Schedule III, with limited physical dependence – May be ordered by written prescription or by telephone order – May be refilled up to five times in a six- month period – prescription expires in six months • Examples: Librium, valium, darvon, equanil Controlled Substances or Schedule Drugs
  • 11. 11 • Schedule V Drugs – Have a small potential for abuse or addiction – May be ordered by written prescription or by telephone order – No limit on prescription refills – Some of these drugs may not need prescription • Examples: Robitussin-AC, donnagel-PG, lomotil Controlled Substances or Schedule Drugs
  • 12. 12 Drug Standards • Rules established to control strength, quality, and purity of medications prepared by various manufacturers –Require all preparations called by the same drug name to be of a uniform strength, quality, and purity
  • 13. 13 Drug Standards • United States Pharmacopeia/National Formulary (USP/NF) – Contains formulas and information that provide standards for preparation and dispensation of drugs • Recognized by U.S. government as the official listing of standardized drugs in the United States • FDCA specifies a drug is official when it is listed in USP/NF
  • 14. 14 Drug References • Available for health professionals responsible for safe administration of medications – Provide the following information: • Composition, action, indications for use, contraindications for use, precautions, side effects, adverse reactions, route of administration, dosage range, and what forms are available
  • 15. 15 Drug References • Hospital formulary – Lists all drugs commonly stocked in the hospital pharmacy – Provides information about the characteristics of drugs and their clinical use
  • 16. 16 Drug References • Physicians’ Desk Reference – Published yearly by Medical Economics Company – Manufacturers pay to list information about their products in the PDR – Same information that appears on Package Inserts (as required by the FDA) • Generic name, indications, contraindications, adverse effects, dosage, and route of administration
  • 17. 17 Drug References • Medical economics company references – Physicians’ Desk Reference for Nonprescription Drugs – Physicians’ Reference for Ophthalmology – Drug Interactions and Side Effects Index – Indications Index
  • 18. 18 Drug References • Drug facts and comparisons – Loose-leaf binder reference that provides information on drugs according to their therapeutic classification • Same basic facts as other drug references – Particularly helpful in comparing the various drugs within each category to other products • In reference to effectiveness, content, and cost
  • 19. 19 Drug Sources
  • 20. 20 Drug Names • Chemical name – Describes chemical structure of the drug – Formula that indicates composition of the drug
  • 21. 21 Drug Names • Generic name – Name that was established when drug was first manufactured • Written in lowercase letters – Official name of a drug – Each drug has only one generic name – Original manufacturer is only company that can use generic name for the first 17 years
  • 22. 22 Drug Names • Brand name – Name under which the drug is sold by a specific manufacturer • Spelling always begins with a capital letter – Also known as the Trade Name – Name is owned by the drug company and no other company may use that name • Each brand name carries a registered trademark symbol ®
  • 23. 23 • Drug actions – How drugs produce changes within the body • Drug effect – Changes that take place in the body as a result of drug action • Slowing down or speeding up processes • Destroying certain cells or parts of cells • Replacing substances that the body lacks or fails to produce Drug Actions – Drug Interactions
  • 24. 24 • Desired effect – Effect of drug in the body that was intended • Side effect – Additional effect on the body by the drug that was not part of the goal for that medication • Not usually severe enough to warrant discontinuing the medication Drug Actions – Drug Interactions
  • 25. 25 • Adverse reaction – One in which the body reacts to a drug in an unexpected way that may endanger a patient’s health and safety • Contraindication – Any special symptom or circumstance that indicates that the use of a particular drug or procedure is dangerous, not advised, or has not been proven safe for administration Drug Actions – Drug Interactions
  • 26. 26 • Local effect – Response to a medication that is confined to a specific part of the body • Systemic effect – Generalized or widespread response to a drug by the body because it is absorbed into the bloodstream Drug Actions – Drug Interactions
  • 27. 27 • Cumulation – Occurs when a drug is not completely excreted from the body before another dose is given – Drug starts to accumulate in the body tissues when repeated doses are given • Toxic effects may occur Drug Actions – Drug Interactions
  • 28. 28 • Idiosyncracy – An unusual, inappropriate response to a drug or to the usual effective dose of a drug – Anaphylactic Shock = severe idiosyncratic reaction • Acute respiratory distress, hypotension, edema, tachycardia, cool pale skin, cyanosis, and possible convulsions shortly after administration of the medication Drug Actions – Drug Interactions
  • 29. 29 • Potentiation – Occurs when two drugs administered together produce a more powerful response than the sum of their individual effects • Tolerance – Resistance to effect of a drug • A characteristic of drug addiction Drug Actions – Drug Interactions
  • 30. 30 Routes of Administration • Oral – Given by mouth and swallowed – Advantage • Easiest and safest method • Most economical method – Disadvantage • Slow method of absorption • Possibility of being destroyed by gastric juices
  • 31. 31 Routes of Administration • Sublingual – Placed under the tongue – dissolves in saliva – Advantage • More rapid absorption rate than oral • Higher concentration of medication reaches bloodstream – Disadvantage • Not convenient route of administration for bad- tasting medications or irritating medications
  • 32. 32 • Buccal – Placed in mouth next to cheek (tablet form) – Advantage • More rapid absorption rate than oral • Higher concentration of medication reaches bloodstream – Disadvantage • Possibility of swallowing the pill Routes of Administration
  • 33. 33 • Inhalation – Medication is sprayed or inhaled into nose, throat, and lungs – Advantage • Good absorption due to large surface contact area • Provides rapid treatment – Disadvantage • Sometimes difficult to regulate dose • Not suitable method for medications that irritate mucous membrane lining Routes of Administration
  • 34. 34 • Rectal – Medication inserted into rectum and is slowly absorbed into mucous membrane lining of rectum (suppository) – Advantage • One method of choice when patient is nauseated or cannot take medications orally – Disadvantage • Absorption is slow and irregular Routes of Administration
  • 35. 35 • Vaginal – Medication is inserted into the vagina in the form of a suppository, cream, foam, or tablet – Advantage • Easiest method for treating the specific area – Disadvantage • Medications sometimes stain underwear • No other disadvantages Routes of Administration
  • 36. 36 • Topical – Medication is applied directly to the skin or mucous membrane for a local effect to area – Advantage • Easy method, convenient – Disadvantage • Slow absorption through skin Routes of Administration
  • 37. 37 • Transdermal – Method of applying a pre-measured amount of medicine to unbroken skin through an adhesive-backed disk – Advantage • Good method for administering medications slowly into bloodstream over a period of time – Disadvantage • Units can be dangerous if they come in contact with skin of children or pets Routes of Administration
  • 38. 38 • Parenteral – Administered by injecting medication into body using a needle and syringe – Must be in liquid form – Administered by one of following methods • Intradermal • Intramuscular • Intravenous • Subcutaneous Routes of Administration
  • 39. 39 • Intradermal – Small amount of medication is injected just beneath epidermis – Used for allergy testing, tuberculin skin testing, and some vaccinations • Needle Angle: 10 to 15-degree Routes of Administration
  • 40. 40 • Intramuscular – Medication is injected directly into muscle – Used for administering antibiotics, medications that might be irritating to layers of the skin, and medications that require dosages larger than amount allowed for subcutaneous injections • Needle Angle: 90-degree Routes of Administration
  • 41. 41 • Intravenous – Medication is injected directly into the vein, entering the bloodstream immediately – Used when medication is needed quickly – Used for infusing medication over a period of time, by adding the medication to a bag of intravenous fluids • Needle Angle: 25-degree Routes of Administration
  • 42. 42 • Subcutaneous – Medication is injected into subcutaneous layer, or fatty tissue of skin – Used for administering insulin, hormones, and local anesthetics • Needle Angle: 45-degree Routes of Administration
  • 43. 43 Parenteral Routes of Administration
  • 44. DRUG CLASSIFICATIONS Pharmacology
  • 45. 45 Analgesic • Pronounced –(an-al-JEE-sik) • General definition – Relieves pain • Example: acetylsalicylic acid, aspirin, Bayer Children’s Aspirin
  • 46. 46 Anesthetic • Pronounced – (an-ess-THET-ik) • General definition – Partially or completely numbs or eliminates sensitivity with or without loss of consciousness • Example: lidocaine (Xylocaine)
  • 47. 47 Antiarrhythmic • Pronounced – (an-tee-ah-RITH-mik) • General definition – Corrects cardiac arrhythmias (irregular beats) • Example: digoxin (Lanoxin)
  • 48. 48 Antibiotic (Anti-infective) • Pronounced – (an-tih-BYE-ot-ik) • General definition – Stops or controls growth of infection-causing microorganisms • Example: phenoxymethyl-penicillin sodium (Pen- Vee-K, Penicillin VK, Veetids, V-Cillin K)
  • 49. 49 Anticoagulant • Pronounced – (an-ti-koh-AG-yoo-lant) • General definition – Prevents clot continuation and formation • Example: warfarin sodium (Coumadin)
  • 50. 50 Anticonvulsant • Pronounced – (an-tih-kon-VULL-sant) • General definition – Prevents or relieves convulsions (seizures) • Example: clonazepam (Klonopin)
  • 51. 51 Antidepressant • Pronounced – (an-tih-dee-PRESS-ant) • General definition – Prevents, cures, or alleviates mental depression • Example: amitriptyline hydrochloride (Elavil, Amitril)
  • 52. 52 Antidiabetic • Pronounced – (an-tih-dye-ah-BET-ik) • General definition – Helps control the blood sugar level • Example: metformin (Glucophage)
  • 53. 53 Antidiarrheal • Pronounced – (an-tih-dye-ah-REE-ul) • General definition – Prevents or treats diarrhea • Example: loperamide hydrochloride (Imodium)
  • 54. 54 Antidiuretic • Pronounced – (an-tih-dye-yoo-REH-tic) • General definition – Suppresses the formation of urine • Example: vasopressin (Pitressin)
  • 55. 55 Antiemetic • Pronounced – (an-tih-ee-MET-ik) • General definition – Prevents or relieves nausea and vomiting • Example: meclizine hydrochloride (Bonine, Dramamine II, Antivert)
  • 56. 56 Antifungal • Pronounced – (an-tih-FUNG-gal) • General definition – Destroys or inhibits the growth of fungi • Example: fluconazole (Diflucan)
  • 57. 57 Antihistamine • Pronounced – (an-tih-HISS-tah-meen) • General definition – Opposes action of histamine, released in allergic reactions • Example: cetirizine (Zyrtec)
  • 58. 58 Antihypertensive • Pronounced – (an-tih-high-per-TEN-siv) • General definition – Prevents or controls high blood pressure • Example: nadolol (Corgard)
  • 59. 59 Anti-infective (Antibiotic) • Pronounced – (an-tih-in-FEK-tiv) • General definition – Stops or controls the growth of infection- causing microorganisms • Example: amoxycillin (Amoxil, Polymox)
  • 60. 60 Anti-Inflammatory • Pronounced – (an-tih-in-FLAM-ah-toh-ree) • General definition – Counteracts inflammation in body • Example: naproxen sodium (Anaprox, Aleve)
  • 61. 61 Antineoplastic • Pronounced – (an-tih-nee-oh-PLASS-tik) • General definition – Prevents development, growth, or reproduction of cancerous cells • Example: fluorouracil (Adrucil)
  • 62. 62 Antitussive • Pronounced – (an-tih-TUSS-iv) • General definition – Relieves cough due to various causes • Example: dextromethorphan hydrobromide (Benylin DM, Robitussin Pediatric, Vick’s Formula 44)
  • 63. 63 Antiulcer Agent • Pronounced – (an-tih-ULL-ser agent) • General definition – Treats and prevents peptic ulcer and gastric hypersecretion • Example: ranitidine hydrochloride (Zantac)
  • 64. 64 Antiviral Agent • Pronounced – (an-tih-VYE-ral agent) • General definition – Treats various viral conditions such as serious herpes virus infections, chickenpox, and influenza A • Example: acyclovir (Zovirax)
  • 65. 65 Beta Blocker • Pronounced – (BAY-tah BLOCK-er) • General definition – Treats hypertension, angina, and various abnormal heart rhythms • Example: metoprolol tartrate (Lopressor)
  • 66. 66 Bronchodilator • Pronounced – (brong-koh-DYE-lay-tor) • General definition – Expands bronchial tubes by relaxing bronchial muscles • Example: theophylline (Bronkodyl)
  • 67. 67 Calcium Channel Blocker • Pronounced – (KAL-see-um CHAN-ell BLOCK-er) • General definition – Treats hypertension, angina, and various abnormal heart rhythms • Example: amlodipine (Norvasc)
  • 68. 68 Diuretic • Pronounced – (dye-yoor-RET-ik) • General definition – Increases urine secretion • Example: furosemide (Lasix)
  • 69. 69 Hormone • Pronounced – (HOR-mohn) • General definition – Treats deficiency states where specific hormone level is abnormally low • Example: estrogen, conjugated (Premarin)
  • 70. 70 Hypnotic • Pronounced – (hip-NOT-ik) • General definition – Induces sleep or dulls the senses • Example: pentobarbital (Nembutal)
  • 71. 71 Immunosuppressant • Pronounced – (im-yoo-noh-suh-PRESS-ant) • General definition – Suppresses the body’s natural immune response to an antigen, as in treatment for transplant patients • Example: cyclosporine (Sandimmune)
  • 72. 72 Laxative • Pronounced – (LACK-sah-tiv) • General definition – Prevents constipation or promotes the emptying of the bowel contents with ease • Example: docusate calcium (Surfak)
  • 73. 73 Lipid-Lowering Agent • Pronounced – (LIP-id lowering agent) • General definition – Reduces blood lipid (fat) levels • Example: atorvastatin (Lipitor)
  • 74. 74 Sedative • Pronounced – (SED-ah-tiv) • General definition – Exerts a soothing or tranquilizing effect on the body • Example: phenobarbital (Nembutal)
  • 75. 75 Skeletal Muscle Relaxant • Pronounced – (SKELL-eh-tal muscle rih-LAK-sant) • General definition – Relieves muscle tension • Example: carisoprodol (Soma)
  • 76. 76 Vitamin • Pronounced – (VIGH-tah-min) • General definition – Prevents and treats vitamin deficiencies and used as dietary supplement • Example: ascorbic acid (vitamin C)
  • 77. 77 • Guidelines – Medical abbreviations are a form of shorthand • Serve as a universal language for medical professionals • Provide specific information and/or orders in an abbreviated format – Health professional should use standard abbreviations accepted by their place of employment • When abbreviations have more than one meaning Common Charting Abbreviations

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