Transcript GENERAL PRINCIPLES OF PHARMACOLOGY

GENERAL
PRINCIPLES OF
PHARMACOLOGY
Part 2 Topics
 Anatomy & Physiology Related to
Pharmacology
 Common Prehospital Medications
 Common Patient Scenarios
 Common Patient Medications
Drugs Used to Affect
the Nervous System
Central Nervous System
Medications
 Analgesics & Antagonists
 Anesthetics
 Anti-anxiety & Sedative-Hypnotic Drugs
 Antiseizure or Anti-epileptic Drugs
 Central Nervous System Stimulants
 Psychotherapeutic Medications
 Parkinson’s Medications
Autonomic Nervous System
Medications (1 of 2)
 Drugs Affecting the
Parasympathetic System:
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Cholinergics
Anticholinergics
Ganglionic Blocking Agents
Neuromuscular Blocking Agents
Ganglionic Stimulating Agents
Autonomic Nervous System
Medications (2 of 2)
 Drugs Affecting the Sympathetic
System:
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Adrenergic Receptors
Adrenergic Agonists
Adrenergic Antagonists
Skeletal Muscle Relaxants
Distribution of Sympathetic
Post-Ganglionic Fibers
Sympathetic Division of
Autonomic Nervous System
Physiology of an Adrenergic
Synapse
Drugs Used to Affect the
Cardiovascular System
Blood Flow Through the Heart
Cardiac Conductive System
Action Potential of Cardiac
Contractile Tissue
Action Potential of Cardiac
Pacing Cells
Reentrant Pathways
Classifications of Cardiovascular
Drugs (1 of 2)
 Antidysrhythmics:
 Used to treat and prevent abnormal
cardiac rhythms.
 Antihypertensives:
 Drugs used to treat hypertension.
Classifications of Cardiovascular
Drugs (2 of 2)
 Hemostatic Agents:
 Drugs used to stop bleeding.
 Antihyperlipidemic Agents:
 Drugs used to treat high cholesterol.
Antidysrhythmics
Antihypertensives
 Diuretics
 Adrenergic inhibiting agents
 Angiotensin converting enzyme
inhibitors
 Angiotensin II receptor antagonists
 Calcium channel blockers
 Direct vasodilators
Hemostatic Agents
 Antiplatelets:
 Drugs that decrease the formation of
platelet plugs.
 Anticoagulants:
 Drugs that disrupt the clotting cascade.
 Thrombolytics:
 Drugs that act directly on thrombi to break
them down.
Antihyperlipidemics
 Drugs used to treat high blood
cholesterol.
 Examples:
 Lovastatin (mevacor).
 Simvastatin (zocor).
Drugs Used to Affect the
Respiratory System
Antiasthmatic Medications
Drugs Used for Rhinitis and Cough
 Nasal Decongestants
 Antihistamines
 Antitussives
 Expectorants
 Mucolytic
Drugs Used to Affect the
Gastrointestinal System
Main Indications for GI Drug
Therapy
 Peptic Ulcers
 Constipation
 Diarrhea and Emesis
 Digestion
Drugs Used to Treat Peptic Ulcer
Disease (1 of 2)
 H2 Receptor Antagonists:
 Cimetidine (Tagamet), ranitidine
(Zantac), famotidine (Pepcid),
nizatidine (Axid).
 Proton Pump Inhibitors:
 Omeprazole (Prilosec),
lansoprazole (Prevacid).
Drugs Used to Treat Peptic Ulcer
Disease (2 of 2)
 Antacids:
 Aluminum, magnesium, or sodium
compounds.
 Anticholinergics:
 Pirenzepine (Gastrozepine).
Drugs Used to Treat Constipation
 Categories of Laxatives:
 Bulk–forming
(methylcellulose or Citrucel).
 Stimulant (phenolphthalein or
Ex-Lax).
 Osmotic (Milk of Magnesia).
 Surfactant (Colace).
Drugs Used to Treat Diarrhea
 Although a nuisance, diarrhea is
often a helpful process.
 Specific or non-specific agents
may be used.
Drugs Used to Treat Emesis
 Antiemetics:
 Medication used to prevent vomiting.
 Serotonin Antagonists:
 Zofran.
 Dopamine Antagonists:
 Compazine, Phenergan, Inapsine, Reglan.
 Cannabinoids:
 Marinol, Cesamet.
Drugs Used to Aid Digestion
 Several drugs are available to
aid digestion of carboyhydrates
and fats.
 Two such drugs are pancreatin
(Entozyme) and pancrelipase
(Viokase).
Drugs Used to Affect the
Eyes
Drugs Used to Affect the Eyes
 Opthalmic drugs are used to treat
conditions involving the eyes,
primarily glaucoma and trauma.
 Medications used to treat glaucoma
are all aimed at reducing intraocular
pressure (IOP). Examples include
timolol (Timoptic) and betaxolol
(Betoptic).
 Tetracaine (Pontocaine) is a local
anesthetic of the ester class.
Drugs Used to Affect the
Ears
Drugs Used to Affect the Ears
 Most drugs used to treat conditions
involving the ear are aimed at
eliminating underlying bacterial or
fungal infections or at breaking up
impacted ear wax.
 Chlorampenicol (Chloromycetin otic).
 Gentamicin sulfate (Garamycin).
Drugs Used to Affect the
Endocrine System
Drugs Affecting the Pituitary Gland
 Anterior Pituitary Drugs—The only
conditions treated with these drugs
are those associated with abnormal
growth such as dwarfism.
 Posterior Pituitary Drugs—The two
drugs in this category are oxytocin
and antidiuretic hormone.
Drugs Affecting the Parathyroid and
Thyroid Glands
 Parathyroid glands are primarily
responsible for regulating calcium
levels.
 Hypothyroidism leads to decreased
levels of calcium and Vitamin D.
 Treatment is therefore through
calcium and Vitamin D supplements.
Drugs Affecting the Adrenal
Cortex
 The Adrenal Cortex synthesizes and
secretes 3 classes of hormones:
glucocorticoids, mineralocorticoids,
and androgens.
 Two diseases typify the disorders
associated with the Adrenal Cortex:
Cushing’s disease and Addison’s
disease.
Drugs Affecting the Pancreas
 Diabetes mellitus is the most important
disease involving the pancreas.
 Insulin—a substance that decreases
blood glucose level.
 Glucagon—a substance that increases
blood glucose level.
Oral Hypoglycemics
 Orinase
(chlorpropamide)
 Glucotrol (glipizide)
 Micronase (glyburide)
Hyperglycemic Agents
 D50W is a sugar solution given
intravenously for acute
hypoglycemia.
 Glucagon is indicated for
emergency treatment when an
IV is unobtainable.
Drugs Affecting the Female
Reproductive System
 Estrogens and Progestins
 Oral contraceptives
 Uterine stimulants and relaxants:
 Brethine, Yutopar.
 Infertility agents:
 Clomid, Metrodin.
Drugs Affecting the Male
Reproductive System
 Testosterone deficiency:
 Metandren.
 Benign Prostatic Hypertrophy
(BPH):
 Proscare.
Drugs Affecting Sexual Behavior
 L-dopa (Levodopa) has demonstrated
increased libido as a side effect.
 Sildenafil (Viagra) was approved in
1998 for patients suffering erectile
dysfunction.
 NOTE: If you treat a patient with chest pain
who has taken Viagra recently, do NOT
give nitroglycerin or any other nitrate.
Drugs Used to Treat
Cancer
Drugs Used to Treat Cancer
 Drugs used to treat cancer are
called antineoplastic agents.
 Examples include:
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fluorouracil (Adrucil)
mechlorethamine (Mustargen)
vinblastine (Velban)
vincristine (Oncovin)
Drugs Used to Treat
Infectious Diseases and
Inflammation
Drugs Used to Treat Infectious
Diseases and Inflammation (1 of 3)
 Antibiotics.
 An antibiotic agent may
either kill the offending bacteria or
so decrease the bacteria’s growth
that the patient’s immune system
can effectively fight the infection.
 Antifungal Agents.
 Fungi are parasitic microorganisms that
cannot synthesize their own food.
Drugs Used to Treat Infectious
Diseases and Inflammation (2 of 3)
 Antimicrobial and Antiparasitic Drugs.
 Although most diseases treated with
these drugs are uncommon in
developed countries, they are leading causes of
death in third-world countries.
 They include malaria, leprosy, and
helminthiasis.
Drugs Used to Treat Infectious
Diseases and Inflammation (3 of 3)
 Tuberculosis, caused by bacteria, is
increasing in the United States.
 NSAIDs (non-steroidal antiinflammatory drugs)—Commonly
used as analgesics and antipyretics.
 Uricosuric drugs—Used to treat gout.
 Serums, vaccines, and other
immunizing agents.
Drugs Used to Affect the
Skin
Drugs Used to Affect the Skin
 Dermatologic drugs are used to
treat skin irritations.
 They are common over-thecounter medications.
Drugs Used to Affect the
Diet
Many disease processes affect the
production, distribution, and utilization
of essential dietary nutrients.
Drugs Used to Treat
Poisoning and Overdoses
Drugs Used to Treat Poisoning
and Overdoses
 The treatment for poisoning and
overdose depends greatly on
the substance involved.
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Syrup of Ipecac
Activated Charcoal
Mucomyst
Atropine
Pralidoxime
Part 2 Summary
 Anatomy and Physiology
Related to Pharmacology
 Common Prehospital
Medications
 Common Patient Scenarios
 Common Patient Medications