Transcript Principles of Pharmacology - McGraw Hill Higher Education

Principles of Pharmacology
PowerPoint® presentation to accompany:
Medical Assisting
Third Edition
Booth, Whicker, Wyman, Pugh, Thompson
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-2
Learning Outcomes
50.1 Describe the five categories of pharmacology.
50.2 Differentiate between chemical, generic, and trade
names for drugs.
50.3 Describe the major drug categories.
50.4 List the main sources of drug information.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-3
Learning Outcomes (cont.)
50.5 Contrast over-the-counter and prescription drugs.
50.6 Compare the five schedules of controlled
substances.
50.7 Describe how to register a physician with the
Drug Enforcement Administration (DEA) for
permission to administer, dispense, and prescribe
controlled drugs.
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50-4
Learning Outcomes (cont.)
50.8 Describe how to telephone a medication refill.
50.9 Describe how vaccines work in the
immune system.
50.10 Identify patient education topics related to the use
of nonprescription and prescription drugs.
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50-5
Introduction

Pharmacology – science or study of drugs

Medication errors can result in injury or death

Medical assistant


Knowledge of the foundations of pharmacology
Understand role of drugs in ambulatory medical
facilities
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50-6
Medical Assistant’s Role
in Pharmacology


Prescription drugs –
physician’s order
required to dispense
and administer
OTC drugs –
purchased by patient
for self-treatment

You should

Be sure the physician is
aware of all medications
the patient is taking

Ask patients about use of
alcohol and recreational
drugs

Provide patient
education
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50-7
Medical Assistant’s Role
in Pharmacology (cont.)

Administration of drugs

Check state regulations
scope of practice

Understand pharmacologic principles

Translate prescriptions

Answer basic patient questions

Adhere to legal requirements

Keep accurate records
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50-8
Drugs and Pharmacology

Drug – chemical compound used to prevent,
diagnose, or treat disease

Pharmacognosy – study of characteristics of
natural drugs and their sources

Pharmacodynamics – study of what drugs do
to the body
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50-9
Drugs and Pharmacology (cont.)

Pharmacokinetics – study of what the body
does to drugs

Pharmacotherapeutics – study of how drugs
are used to treat disease

Toxicology – study of poisons or poisonous
effects of drugs
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50-10
Drugs and Pharmacology (cont.)

Prescribe – physician gives a patient a
prescription to be filled by a pharmacist

Administer – give a drug by injection, mouth,
or other route that introduces it into the body

Dispense – health-care professional
distributes the drug, in a properly labeled
container, to the patient for whom it is
prescribed
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-11
Sources of Drugs

Natural products





Plants
Animals
Minerals
Bacteria and fungi
Foxglove is used
to make digitoxin
Chemical development of natural products


Synthesis of chemical makeup of a drug
Manipulation of genetic information
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50-12
Apply Your Knowledge
1.
What is the role of the medical assistant in
pharmacology?
ANSWER: The medical assistant should be sure the
physician is aware of all medications the patient is
taking, including OTC medications; ask patients about
use of alcohol and recreational drugs; and provide
patient education. If the scope of practice permits, the
medical assistant may also be responsible for
administering some medications.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-13
Apply Your Knowledge
2.
Matching:
ANSWER:
___
C Study of poisons
A. Pharmacokinetics
___
A Study of what the body does to drugs
B. Pharmacognosy
___
F Used to prevent, diagnose, or treat disease
C. Toxicology
___
E Study of what drugs do to the body
D. Pharmacotherapeutics
___
D Study of how drugs are used to treat disease
E. Pharmacodynamics
___
B Study of characteristics of natural drug
and their sources
F. Drugs
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50-14
Pharmacodynamics

Mechanism of action of
a drug to produce a
therapeutic effect

Interaction between
drug and target cells
and body’s response to
the interaction
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50-15
Pharmacokinetics

What the body does to a drug

Absorption



Conversion of a drug into a form the body can use
Allows the drug to enter the blood and tissues
Rate and extent of absorption depend on



Route of administration
Characteristics of the drug
Distribution

Transportation of a drug from site of administration
to site of action
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50-16
Pharmacokinetics (cont.)

Metabolism




Drug molecules are transformed into metabolites
Usually in liver, some in kidneys
Affected by age, genetic makeup, and characteristics
of drug
Excretion


Manner in which a drug is eliminated from the body
Most via urine
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-17
Apply Your Knowledge
What is the difference between pharmacodynamics and
pharmacokinetics?
ANSWER: Pharmacodynamics is the way a drug affects the
body to produce its effect. It is the interaction between the
drug and cells and the body's response to the interaction.
Pharmacokinetics is what the body does to the drug and
includes absorption, distribution, metabolism, and excretion
of the drug.
Very Good!
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50-18
Pharmacotherapeutics


Clinical pharmacology
Drug names





Generic – official name
International nonproprietary name
Chemical name
Trade – brand or proprietary name
Generic and trade names used most often
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50-19
Pharmacotherapeutics (cont.)

Drug categories

Indication and labeling

Action on the body

Indication – reason(s)
for using a drug

General therapeutic
effect

Must be approved by
FDA to be part of
labeling

Off-label use

Body system affected
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50-20
Pharmacotherapeutics (cont.)


Safety

Adverse reaction to drug

Interaction with another medication

Be alert to patient complaints after starting a new drug
Efficacy – drug is working as expected
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50-21
Pharmacotherapeutics (cont.)

If a patient complains a drug is not working






The patient may not understand how the drug
works
Dosage may need to be adjusted
Therapeutic level may not have been reached
Wrong drug may have been prescribed
Some drugs work better for one patient than
another
Some forms of drugs work better
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50-22
Pharmacotherapeutics: Kinds of Therapy


Acute – improve a lifethreatening or serious
condition
Empiric – given before test
results are available

Maintenance – maintain
health

Palliative – reduce severity
of a condition or pain

Prophylactic – prevent
disease

Replacement – provide
chemicals a patient lacks

Supportive – for a
condition other than the
primary disease

Supplemental – avoid a
deficiency
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50-23
Toxicology

Study of poisonous effects of drugs



Adverse effects
Drug interactions
Patient education


Inform physician of any adverse effects
Discuss concerns with physician or pharmacist
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-24
Apply Your Knowledge
1.
Mr. Anderson is complaining that the new medication does
not seem to be working. What may be the reason for this?
ANSWER: Mr. Anderson may not understand how the
drug works. His dosage may need to be adjusted, or the
therapeutic level may not have been reached. The wrong
drug may have been prescribed for him, or this
particular drug may not work for as well for him as for
another patient. He may need the medication in a
different form.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-25
Apply Your Knowledge
2.
Toxicology includes which of these?
ANSWER:
A.
B.
C.
D.
E.
Poisons and poisonous effects of drugs
Excretion of drugs
Adverse effects of drugs
Drug interactions
Metabolism of drugs
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50-26
Sources of Drug Information


Sources must be up-to-date
PDR




Information provided by pharmaceutical
companies
Information closely resembles package insert
Published annually
Drug Evaluations – published
annually by the AMA
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50-27
Sources of Drug Information

USP/NF



Official source of drug standards
Published about every 5 years
AHFS – published by the
American Society of
Hospital Pharmacists
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50-28
The FDA Regulatory Function

New drugs


Safety
Efficacy
Drug manufacturing




OTC drugs

Prescription drugs

Pregnancy categories
Clinical trials



Identity
Strength
Purity
Quality





A
B
C
D
X
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50-29
The FDA Regulatory Function (cont.)

Controlled substances



Drugs categorized as potentially dangerous and
addictive
Strictly regulated by federal laws
Comprehensive Drug Abuse Prevention and
Control Act (1970)



Created the DEA
Strengthened drug enforcement authority
Schedules – based on abuse potential
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50-30
The FDA Regulatory Function (cont.)
Schedule
Abuse Potential
Example
I
High
Heroin
II
III
High
Lower than II
(moderate dependence)
Morphine
Butabarbital
IV
Lower than III
(limited dependence)
Diazepam
V
Lower than IV
(very limited dependence)
Antidiarrheals
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50-31
The FDA Regulatory Function (cont.)

Comprehensive Drug Abuse Prevention and Control
Act (1970)





Controlled substance
labeling
Doctor registration
Ordering controlled
substances
Drug security
Record keeping



Dispensing records
Inventory records
Disposal of drugs
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50-32
The FDA Regulatory Function (cont.)

Writing prescriptions – parts of a prescription

Superscription


Subscription –
directions to the
pharmacist

Signature – patient
instructions
Patient information


Inscription


Name of the drug
Amount of drug per dose
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50-33
The FDA Regulatory Function (cont.)
Prescription for a
Single Medication
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The FDA Regulatory Function (cont.)
Prescription for
Multiple Medications
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50-35
The FDA Regulatory Function (cont.)

Writing prescriptions

Keep prescription
blanks secure

Telephone prescriptions

Only at request of the
physician

Follow facility policy

Document carefully
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-36
Apply Your Knowledge
1.
Which of the following sources of drug information is most like
the package insert? ANSWER:
A. AHFS
2.
Match
B. PDR
C. USP/NF
D. Drug Evaluations
Correct!
ANSWER:
C Contains the patient information
___
A. Subscription
___
D Name of the drug and dosage
B. Signature
___
A Instructions to the pharmacist
C. Superscription
___
B Patient instructions
D. Inscription
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50-37
Vaccines

Special preparations made from
microorganisms

Administered to produce reduced
sensitivity to or increased
immunity to an infectious disease

Body creates antibodies in
response to an antigen (vaccine)
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50-38
Vaccines: Antibody Formation
1. Antigen enters body
2. White cells produce antibodies
3. Antibodies combine with antigens
to neutralize them
4. This arrests or prevents reaction or disease
5. Vaccines stimulate antibody formation and reduce
symptoms if patient is exposed to disease
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50-39
Vaccines: Immunizations

Schedule for immunizations for
children up to age 16 years

Pre-exposure immunizations

Post-exposure immunizations –
antiserum or antitoxin that
contains antibodies
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-40
Vaccines: Immunizations (cont.)

Medical assistant should be familiar with






Indications
Contraindications
Dosages
Administration routes
Potential adverse effects
Methods of storing and
handling
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-41
Apply Your Knowledge
Why are vaccines given to patients?
ANSWER: Vaccines are administered to a person to
produce reduced sensitivity to or increase immunity
to an infectious disease.
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-42
Patient Instruction
on Medications

Medical assistant role is important

OTC drugs




Should not be used to avoid medical care
May not produce enough therapeutic benefit
May be dangerous in combination with other
substances or drugs
May mask symptoms or aggravate a problem
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-43
Patient Instruction
on Medications (cont.)

Prescription drugs

Inform patient about special
considerations and drug
safety precautions

Encourage patient to



Maintain a complete list
of medications
Report adverse reactions
Patient compliance
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50-44
Patient Instruction
on Medications (cont.)

To prevent medication errors, be sure patient
understands prescription




How and when to take the medication
Appropriate language
Demonstrate if necessary
Review warnings about
the medication
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-45
Apply Your Knowledge
Mrs. Del Rosario tells you she does not take any medication
when you are taking her history. When you question her further,
she says she takes an OTC pain medication occasionally and
routinely take several herbal supplements. What should you tell
her?
ANSWER: You should tell her it is important to report all
medications, including OTC drugs and herbal and other
supplements, to the physician and that they may be
dangerous in combination with other substances or drugs
or may mask symptoms or aggravate a problem.
Nice Job!
© 2009 The McGraw-Hill Companies, Inc. All rights reserved
50-46
In Summary

Pharmacology – study
of drugs

Medical assistant

Instruct patients about


Drug classifications
based on action



Immunizations provide
immunity to specific
diseases
Specific drugs
Required safety
precautions
Promote patient
compliance
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50-47
End of Chapter
It is easy to get a
thousand prescriptions
but hard to get one
single remedy.
~Chinese Proverb
© 2009 The McGraw-Hill Companies, Inc. All rights reserved