Transcript pharmacology - Brands Delmar

CHAPTER 22
Pharmacology
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
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Pharmacology Overview
• Pharmacodynamics
– Study of how drugs interact in the human
body
• Pharmacist
– One who is licensed to prepare and dispense
drugs
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Pharmacology Overview
• Pharmacy
– Drug store
• Toxicology
– Study of poisons, their detection, their
effects
– Establishing antidotes and methods of
treatment for conditions they produce
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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)
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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)
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Controlled
Substances or Schedule Drugs
• 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
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Controlled
Substances or Schedule Drugs
• 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
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Controlled
Substances or Schedule Drugs
• 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
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Controlled
Substances or Schedule Drugs
• 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 sixmonth period – prescription expires in six
months
• Examples: Librium, valium, darvon, equanil
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Controlled
Substances or Schedule Drugs
• 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
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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
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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
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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
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Drug References
• Hospital formulary
– Lists all drugs commonly stocked in the
hospital pharmacy
– Provides information about the characteristics
of drugs and their clinical use
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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
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Drug References
• Medical economics company references
– Physicians’ Desk Reference for
Nonprescription Drugs
– Physicians’ Reference for Ophthalmology
– Drug Interactions and Side Effects Index
– Indications Index
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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
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Drug Sources
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Drug Names
• Chemical name
– Describes chemical structure of the drug
– Formula that indicates composition of the
drug
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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
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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 ®
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Drug Actions – Drug Interactions
• 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
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Drug Actions – Drug Interactions
• 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
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Drug Actions – Drug Interactions
• 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
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Drug Actions – Drug Interactions
• 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
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Drug Actions – Drug Interactions
• 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
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Drug Actions – Drug Interactions
• 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
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Drug Actions – Drug Interactions
• 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
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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
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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 badtasting medications or irritating medications
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Routes of Administration
• 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
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Routes of Administration
• 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
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Routes of Administration
• 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
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Routes of Administration
• 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
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Routes of Administration
• 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
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Routes of Administration
• 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
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Routes of Administration
• 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
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Routes of Administration
• 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
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Routes of Administration
• 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
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Routes of Administration
• 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
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Routes of Administration
• Subcutaneous
– Medication is injected into subcutaneous
layer, or fatty tissue of skin
– Used for administering insulin, hormones, and
local anesthetics
• Needle Angle: 45-degree
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Parenteral
Routes of Administration
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DRUG CLASSIFICATIONS
Pharmacology
Analgesic
• Pronounced
– (an-al-JEE-sik)
• General definition
– Relieves pain
• Example: acetylsalicylic acid, aspirin, Bayer
Children’s Aspirin
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Anesthetic
• Pronounced
– (an-ess-THET-ik)
• General definition
– Partially or completely numbs or eliminates
sensitivity with or without loss of
consciousness
• Example: lidocaine (Xylocaine)
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Antiarrhythmic
• Pronounced
– (an-tee-ah-RITH-mik)
• General definition
– Corrects cardiac arrhythmias (irregular beats)
• Example: digoxin (Lanoxin)
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Antibiotic
(Anti-infective)
• Pronounced
– (an-tih-BYE-ot-ik)
• General definition
– Stops or controls growth of infection-causing
microorganisms
• Example: phenoxymethyl-penicillin sodium (PenVee-K, Penicillin VK, Veetids, V-Cillin K)
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Anticoagulant
• Pronounced
– (an-ti-koh-AG-yoo-lant)
• General definition
– Prevents clot continuation and formation
• Example: warfarin sodium (Coumadin)
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Anticonvulsant
• Pronounced
– (an-tih-kon-VULL-sant)
• General definition
– Prevents or relieves convulsions (seizures)
• Example: clonazepam (Klonopin)
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Antidepressant
• Pronounced
– (an-tih-dee-PRESS-ant)
• General definition
– Prevents, cures, or alleviates mental
depression
• Example: amitriptyline hydrochloride (Elavil,
Amitril)
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Antidiabetic
• Pronounced
– (an-tih-dye-ah-BET-ik)
• General definition
– Helps control the blood sugar level
• Example: metformin (Glucophage)
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Antidiarrheal
• Pronounced
– (an-tih-dye-ah-REE-ul)
• General definition
– Prevents or treats diarrhea
• Example: loperamide hydrochloride (Imodium)
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Antidiuretic
• Pronounced
– (an-tih-dye-yoo-REH-tic)
• General definition
– Suppresses the formation of urine
• Example: vasopressin (Pitressin)
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Antiemetic
• Pronounced
– (an-tih-ee-MET-ik)
• General definition
– Prevents or relieves nausea and vomiting
• Example: meclizine hydrochloride (Bonine,
Dramamine II, Antivert)
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Antifungal
• Pronounced
– (an-tih-FUNG-gal)
• General definition
– Destroys or inhibits the growth of fungi
• Example: fluconazole (Diflucan)
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Antihistamine
• Pronounced
– (an-tih-HISS-tah-meen)
• General definition
– Opposes action of histamine, released in
allergic reactions
• Example: cetirizine (Zyrtec)
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Antihypertensive
• Pronounced
– (an-tih-high-per-TEN-siv)
• General definition
– Prevents or controls high blood pressure
• Example: nadolol (Corgard)
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Anti-infective
(Antibiotic)
• Pronounced
– (an-tih-in-FEK-tiv)
• General definition
– Stops or controls the growth of infectioncausing microorganisms
• Example: amoxycillin (Amoxil, Polymox)
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Anti-Inflammatory
• Pronounced
– (an-tih-in-FLAM-ah-toh-ree)
• General definition
– Counteracts inflammation in body
• Example: naproxen sodium (Anaprox, Aleve)
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Antineoplastic
• Pronounced
– (an-tih-nee-oh-PLASS-tik)
• General definition
– Prevents development, growth, or
reproduction of cancerous cells
• Example: fluorouracil (Adrucil)
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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)
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Antiulcer Agent
• Pronounced
– (an-tih-ULL-ser agent)
• General definition
– Treats and prevents peptic ulcer and gastric
hypersecretion
• Example: ranitidine hydrochloride (Zantac)
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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)
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Beta Blocker
• Pronounced
– (BAY-tah BLOCK-er)
• General definition
– Treats hypertension, angina, and various
abnormal heart rhythms
• Example: metoprolol tartrate (Lopressor)
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Bronchodilator
• Pronounced
– (brong-koh-DYE-lay-tor)
• General definition
– Expands bronchial tubes by relaxing bronchial
muscles
• Example: theophylline (Bronkodyl)
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Calcium Channel Blocker
• Pronounced
– (KAL-see-um CHAN-ell BLOCK-er)
• General definition
– Treats hypertension, angina, and various
abnormal heart rhythms
• Example: amlodipine (Norvasc)
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Diuretic
• Pronounced
– (dye-yoor-RET-ik)
• General definition
– Increases urine secretion
• Example: furosemide (Lasix)
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Hormone
• Pronounced
– (HOR-mohn)
• General definition
– Treats deficiency states where specific
hormone level is abnormally low
• Example: estrogen, conjugated (Premarin)
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Hypnotic
• Pronounced
– (hip-NOT-ik)
• General definition
– Induces sleep or dulls the senses
• Example: pentobarbital (Nembutal)
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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)
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Laxative
• Pronounced
– (LACK-sah-tiv)
• General definition
– Prevents constipation or promotes the
emptying of the bowel contents with ease
• Example: docusate calcium (Surfak)
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Lipid-Lowering Agent
• Pronounced
– (LIP-id lowering agent)
• General definition
– Reduces blood lipid (fat) levels
• Example: atorvastatin (Lipitor)
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Sedative
• Pronounced
– (SED-ah-tiv)
• General definition
– Exerts a soothing or tranquilizing effect on the
body
• Example: phenobarbital (Nembutal)
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Skeletal Muscle Relaxant
• Pronounced
– (SKELL-eh-tal muscle rih-LAK-sant)
• General definition
– Relieves muscle tension
• Example: carisoprodol (Soma)
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Vitamin
• Pronounced
– (VIGH-tah-min)
• General definition
– Prevents and treats vitamin deficiencies and
used as dietary supplement
• Example: ascorbic acid (vitamin C)
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Common Charting Abbreviations
• 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
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