Transcript Introduction to Basic Pharmacology and Selected Therapies

Introduction to Basic
Pharmacology and Selected
Therapies
Chapter 16
Pgs 218-230
Overview
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Basic principles of drugs
Administration and distribution of drugs
Drugs and receptors
Prescription and medication orders
Other common traditional forms of therapy
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Physiotherapy
Occupational therapy
Speech/language pathologist
Nutritionist/dietitian
Complementary or alternative therapies
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Osteopathy
Chiropractic
Homeopathy
Aromatherapy
Asian concepts of disease and healing
• acupuncture
Basic Principles
• Pharmacology
• Sources of drugs
– Natural
– Synthesized
Drug
• Substances that alters biologic activity
• Prescribed for many reasons:
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To promote healing
To cure disease
To control or slow progress of disease
To prevent disease
To decrease risk of complications
To increase comfort level
As replacement therapy
To decrease excessive activity in body
Drug Effects
• Exerts therapeutic action by stimulating or
inhibiting cell function
• Block effects of biochemicals in tissue
• Have physical/mechanical action
• Classified by primary pharmacologic
action and effect
• Indications vs. contraindications
• Side effects vs. adverse effects
Specific Forms of Adverse Effects
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Hypersensitivity
Idiosyncratic reactions
Iatrogenic reactions
Teratogenic
Interactions
– Synergism
– Antagonism
– Potentiation
Administration and Distribution of
Drugs
• 1st consideration is dosage
– Amt required to produce specific desired effect in an
adult
– “loading dose”
– Should not increase prescribed dose (Duh!)
• Freq important in maintaining approp blood
levels
– Dosing schedule based on:
• Absorption
• Transport in blood
• ½ life of drug
Factors affecting blood levels
Factors Affecting Blood Levels of
Drug
• Also dependent on individual’s:
– Circulation
– Age
– Weight
– Ability to metabolize and excrete drug
• What organs have that responsibility?
– Genetic factors
– State of health/illness
Administration and Distribution of
Drugs
• Drug enters body  blood  target site 
exerts effect  metabolized & secreted
• Routes for administration
– Orally
– Parenterally
– Inhalation
– Topical
– Rectal
Drug Circulation
• Often bound to plasma proteins
• Some of drug may follow different pathway
• Enters target tissue/organ  ISF  exerts
effect
• Blood brain barrier
Drug Absorption, Distribution, &
Excretion
Drugs and Receptors
• Many in body
• Respond to natural substances
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Enzymes
Hormones
NT
Electrolyte
• Many meds at receptor sites in cells or on cell
membrane
– Stimulate receptor (agonist)
– Block receptor (antagonist)
Drug Receptor Sites
Prescription and Medication Orders
• Prescription is a legal signed document
– Must include:
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Pt’s name, address, age
Prescriber’s name, address, identification
Date
Name of drug, amount, dosage, route, directions, # refills
• Has chemical name, generic name, trademark
name
• FDA regulates
• OTC
• Official schedules
Clinical Research
• Preliminary studies
• Trials
• Research
– Experimental group
– Control group (placebo)
Physiotherapist
• Assess physical function and words to
restore any deficit and prevent further
dysfunction
• Pts with acute neurologic,
musculoskeletal, cardiopulmonary
disorders
• Rehabilitation and long-term care
Occupational Therapy
• Provide a functional assessment of pt.
capabilities related to normal activities of
daily living (ADL)
• Goal is to assist in max. func. & indep.
Speech/Language Pathologist
• Specialist in assessment and treatment of
those with communication and swallowing
problems
• Infants  elderly
Nutritionist/Dietitian
• Advise to individuals and groups
– On nutritional demands
– Food management best suited to diagnosis
• Consulted regarding extreme diets,
anorexia
Alternative Therapies
• Considered to be on outside range of
traditional Western medication
• Many have roots in Asia
– Emphasis on preserving healthy lifestyle
– Holistic approach
• Increase in usage
• Varying degrees of training, professional
regulation
Osteopathy
• Medical Drs.
• Use traditional treatments and procedures
– Also promote body’s natural healing
processes
Chiropractic
• I love them!!!!
• Based on concept that one’s health status
depends on state of N.S.
Homeopathy
• Goal is to stimulate the immune system
and natural healing power in the body
Aromatherapy
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Essential oils extracted from plants
Rubbed on skin, inhaled
Chamomile  calming, sleep-inducing
Lavender  soothe headache, calming
Eucalyptus  stress reliever
Rosemary  relieves muscle and joint
pain
Asian Concepts of Disease &
Healing
• Based on balance (or imbalance) of life
energy
– Called qi
• Disease caused by excess/deficit of qi
• Qi derived from three sources
– Inherited or ancestral factors
– Food ingested
– Air breathed in
Asian Concepts
• Imbalance between yin and yang
– Caused by changes in
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Diet
Stress
Metabolism
Activity
Environment
Asian Concepts
• Meridians
– Specific channels in body
• Qi flows along them
• May be located far from organ from which it is
named
• All bilateral except:
– Midline anterior (conception vessel)
– Midline posterior (governor’s vessel)
Asian Concepts
• Acupoints
– To access qi and it’s flow
– Each has specific action or property
• Moving qi or blood, decrease pain, heating,
cooling, drying, calming, emotions
• Disharmony may involve many acupoints
and meridians
Acupuncture
• Chinese therapy (3000 years old)
• Involves inserting very fine needles into merdian
acupoints
– Classically 365 acupoints
• Only 150 used today
• Each point has specific therapeutic action
• Treatment
– 5-15 needles
– Connected to low-level electrical current
– Period of 30-45 min