Transcript The Profession of Medical Assisting

CHAPTER
51
Principles of
Pharmacology
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51-2
Learning Outcomes
51.1 Identify the medical assistant’s role in
pharmacology.
51.2 Recognize the five categories of
pharmacology and their importance to
medication administration.
51.3 Differentiate the major drug categories,
drugs names, and their actions.
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51-3
Learning Outcomes
51.4 Classify over-the-counter (OTC),
prescription, and herbal drugs.
51.5 Use credible sources to obtain drug
information.
51.6 Carry out the procedure for registering or
renewing a physician with the Drug
Enforcement Administration (DEA) for
permission to administer, dispense, and
prescribe controlled drugs.
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51-4
Learning Outcomes
51.7 Identify the parts of a prescription, including
commonly used abbreviations and symbols.
51.8 Discuss nonpharmacological treatments for
pain.
51.9 Describe how vaccines work in the immune
system.
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51-5
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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Medical Assistant’s Role in
Pharmacology
51-6
• Prescription drugs vs. OTC drugs
• The medical assistant 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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Medical Assistant’s Role in
Pharmacology (cont.)
51-7
• To administer 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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51-8
Apply Your Knowledge
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.
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51-9
Pharmacology
• Drug – chemical compound used to
prevent, diagnose, or treat disease
• Pharmacology – study of drugs
• Pharmachologist – specialist in
pharmacology
• Pharmacognosy
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51-10
Pharmacology
• Pharmacodynamics
• Pharmacokinetics
• Pharmacotherapeutics
• Toxicology
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51-11
Pharmacology (cont.)
• A physician prescribes a drug
• Administer a drug by any route that
introduces it into the patient body
• A healthcare professional
dispenses a drug
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51-12
Sources of Drugs (Pharmacognosy)
• Natural products
– Plants
– Animals
– Minerals
– Bacteria and fungi
• Chemical development
Foxglove – source of
digitoxin
– Synthesis of chemical makeup of a drug
– Manipulation of genetic information
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51-13
Pharmacodynamics
• Mechanism of action of a drug to produce
a therapeutic effect
• Drugs are categorized based on
mechanism of action
• Interaction between drug and their target
cells and the body’s response to the
interaction
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51-14
Pharmacokinetics
•
What the body does to a drug
– Absorption ~ conversion of a drug into a form
the body can use
– Distribution ~ transportation of a drug from
site of administration to site of action
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51-15
Pharmacokinetics (cont.)
– Metabolism
•
•
Drug molecules are transformed into
metabolites
Affected by age, genetic makeup, and
characteristics of drug
– Excretion
•
•
Manner in which a drug is eliminated from
the body
Most via urine
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51-16
Pharmacotherapeutics
• Indication and labeling
– Indication
• Reason for using a drug
• Must be approved by FDA to be part of labeling
– Labeling ~ includes drug form
– Off-label prescribing
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51-17
Pharmacotherapeutics (cont.)
• Safety
– Determined by adverse effects of a drug
– Be alert to patient complaints after starting a
new drug
• Efficacy – drug is working as expected
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51-18
Pharmacotherapeutics (cont.)
• Kinds of therapy
– Acute
– Prophylactic
– Empiric
– Replacement
– Maintenance
– Supportive
– Palliative
– Supplemental
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51-19
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
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51-20
Apply Your Knowledge
Matching:
ANSWER:
C Study of poisons
___
___
A Study of what the body does to
drugs
___
F Used to prevent, diagnose, or
treat disease
E Study of what drugs do to the
___
body
___
D Study of how drugs are used to
treat disease
B Study of characteristics of
___
natural drug and their sources
A. Pharmacokinetics
B. Pharmacognosy
C. Toxicology
D. Pharmacotherapeutics
E. Pharmacodynamics
F. Drugs
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51-21
Drug Names and Categories
• Drug names
– Generic
– International nonproprietary name
– Chemical name
– Trade
• Generic and trade names used most often
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51-22
Drug Names and Categories (cont.)
• Prescribed by either generic or trade name
• Categorized by
– Action on the body
– General therapeutic effect
– Body system affected
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51-23
Apply Your Knowledge
What is the difference between the trade name
and generic name of a drug?
ANSWER:
Trade name – the brand or proprietary name chosen
by the manufacturer.
The generic name – the drug’s official name selected
by the U.S. Adopted Names (USAN) Council. It is
nonpropiretary.
Very Good!
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51-24
FDA Regulation and Drugs
• New drug approval
– Animal trials ~ toxicity
– Clinical trials ~ ratio of benefit to risk
• Regulation of drug manufacturing
– Drugs shipped between states
– Use exact formula approved
– Quality of ingredients
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51-25
FDA Regulation and Drugs (cont.)
• OTC drugs – nonprescription
• Prescription drugs
• Pregnancy categories
– Available information on risk to fetus
– Most drugs are Category C
• Complementary and alternative therapies
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51-26
Apply Your Knowledge
What drugs are regulated by the FDA?
ANSWER: All drugs are regulated by the FDA in some
manner. This includes prescription, OTC and CAM
therapies.
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51-27
Sources of Drug Information
• Sources must be up-to-date and credible
• PDR
– Information provided by pharmaceutical
companies
– Information closely
resembles package
insert
– PDR Internet site
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51-28
Sources of Drug Information (cont.)
• USP/NF
– Official source of drug standards
– Published about every 5 years
• AHFS® – published by the American
Society of Hospital Pharmacists
• Epocrates®
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51-29
Sources of Drug Information (cont.)
• Package insert
– Describes the drug
– Purpose and effects
– Indications and contraindications
– Warning, precautions and adverse reactions
– Drug abuse and dependence
– Overdosage, dosage and administration
– How drug is supplied
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51-30
Sources of Drug Information (cont.)
• Drug
labels
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51-31
Apply Your Knowledge
Which of the following sources of drug information
is most like the package insert?
ANSWER:
A. AHFS
B. PDR
C. USP/NF
D. Drug Evaluations
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51-32
Controlled Substances
• Potentially dangerous and addictive
• Comprehensive Drug Abuse Prevention
and Control Act (1970)
– Created the DEA
– Strengthened drug enforcement authority
– Schedules ~ based on abuse potential
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51-33
Controlled Substances (cont.)
Schedule
Abuse Potential
Example
I
High
II
High
Heroin; GHB; LSD
Opioids (narcotics):
Morphine;
Barbiturates
III
Lower than II
(moderate
dependence)
Anabolic steroids;
Vicodin®
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51-34
Controlled Substances (cont.)
Schedule
Abuse Potential
Example
IV
Lower than III
(limited dependence)
V
Lower than IV
(very limited
dependence)
Xanax®,
Diazepam
Antitussives
and
antidiarrheals
with opioids
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51-35
Controlled Substances (cont.)
• Labeling – identification
• Doctor registration and drug ordering
– Register with DEA
– Comply with CSA
• Drug security
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51-36
Controlled Substances (cont.)
• Record keeping
– Dispensing records
• Schedule II drugs – separate from patient record
• Schedule III through V – with patient record
– Inventory records ~ every two years
– Disposing of drugs ~ follow DEA regulations
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51-37
Apply Your Knowledge
What does the Controlled Substances Act
regulate?
ANSWER:
Controlled substance labeling
Drug ordering
Record keeping
Inventory records
Doctor registration
Drug security
Dispensing records
Disposing of drugs
Nice Job!
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51-38
Prescriptions
• Prescriber
information
• Patient information
BWW
Medical Associated, PC
305 Main Street, Port Snead YZ 12346-9876
Tel: 555-654-3210, Fax: 555-987-6543
Web: BWW Associates.com
Pt: Valerie Ramirez
198 Elm St.
Sherman, TX 77521
DOB: 08/04/19XX
Paul F. Buckwalter, MD
Lic: J87877 DEA AJ3434343
11/27/XX
Allegra 180 mg
disp: 30 thirty
sig: i po q am
Refill: 6
• Medication
Paul F. Buckwalter, MD
***Electronic Signature Verified***
• Subscription
Paul F Buckwalter. MD
A generically equivalent drug product may be dispensed unless the
practitioner hand writes the words ‘BRAND NECESSARY’ or ‘ BRAND
MEDICALLY NECESSARY’ on the prescription face
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
51-39
Prescriptions
• Signa
BWW
Medical Associated, PC
305 Main Street, Port Snead YZ 12346-9876
Tel: 555-654-3210, Fax: 555-987-6543
Web: BWW Associates.com
Pt: Valerie Ramirez
198 Elm St.
Sherman, TX 77521
DOB: 08/04/19XX
• Signature
• DEA number
Paul F. Buckwalter, MD
Lic: J87877 DEA AJ3434343
11/27/XX
Allegra 180 mg
disp: 30 thirty
sig: i po q am
Refill: 6
Paul F. Buckwalter, MD
***Electronic Signature Verified***
Paul F Buckwalter. MD
A generically equivalent drug product may be dispensed unless the
practitioner hand writes the words ‘BRAND NECESSARY’ or ‘ BRAND
MEDICALLY NECESSARY’ on the prescription face
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
51-40
Prescriptions (cont.)
• Managing prescriptions
– Prescription blanks
– E-prescribing
• Telephone prescriptions
– New or renewals may be called to pharmacy
– Only the physician may call for Schedule II
drugs
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51-41
Apply Your Knowledge
Match
ANSWER:
___
C Before meals
A. Subscription
A Instructions to the
___
pharmacist
B. Signa
B Patient instructions
___
G apl
E drop
D. Dispense as written
E. gtt
D DAW
F MDI
C. ac
F. Metered dose inhaler
Correct!
G. Applicatorful
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51-42
Nonpharmacologic Pain Management
• Chiropractors
• Meditation
• Massage therapy
• Hypnotism
• Acupuncture
• Yoga
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51-43
Nonpharmacologic Pain Management
• Glucosamine
chondroitin
• CAM
– Less expensive
• Magnetic therapy
– Fewer side effects
• Biofeedback
– More accessible
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51-44
Apply Your Knowledge
Why do patient’s consider complementary and
alternative medicine?
ANSWER: It is generally less expensive, has fewer
side effects and more accessible than traditional
medical treatments
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51-45
Vaccines
• Preparations
– Produce reduced
sensitivity
– Increase immunity
• Immunity – formation
of antibodies
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51-46
Antibody Formation
• Response to an antigen
• Lymphocytes produce antibodies to
neutralize antigen
– Antibodies are antigen specific
– Prevents the reaction or disease
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51-47
Immunizations
• Immunization schedules
– Children
– Adults
• Post-exposure immunizations
– Antiserum
– Antitoxin
• Be familiar with vaccines used in your
workplace
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51-48
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.
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51-49
In Summary
51.1 The role of the medical assistant in pharmacology
includes being attentive to ensure the physician is
aware of all medications, both prescription and OTC,
that a patient is taking; asking each patient about
alcohol and recreational drug use (both past and
present), as well as herbal remedies; assisting in
managing and renewing medication prescriptions; and
educating the patient, using guidelines provided by
the licensed practitioner, about the purpose of a drug
and how to take the drug for maximum effectiveness
and minimum adverse effects.
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51-50
In Summary (cont.)
51.2 The five categories of pharmacology include:
pharmacognosy, pharmacokinetics,
pharmacodynamics, pharmacotherapeutics, and
toxicology. It is important to understand each of these
in order to carry out the medical assistant’s role in
pharmacology.
51.3 Drug categories are sometimes named based on their
action. The major drug categories and their actions
are outlined in Table 51-1.
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
51-51
In Summary (cont.)
51.4
Nonprescription drugs, including herbal and OTC
drugs, can be obtained without a physician’s order.
For prescription drugs, patients must have a
physician’s written (or oral) order.
51.5 Credible sources for drug information are the
Physicians’ Desk Reference® (PDR), United States
Pharmacopeia-National Formulary, and the
American Hospital Formulary Service (AHFS®).
You may also access medication information from
package inserts, drug labels, and other reliable
Internet sites.
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51-52
In Summary (cont.)
51.6
The medical assistant should assist the physician
with registration, renewal, and ordering of controlled
substances, as outlined in the Controlled Substance
Act of 1970 and Procedure 51-1.
51.7
A prescription must be complete to be filled.
The medical assistant must be able to interpret a
prescription in order to manage new and refilled
medications.
Procedure 51-2 and Table 51-4 will assist the
medical assistant in performing these tasks.
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51-53
In Summary (cont.)
51.8
Multiple nonpharmacologic methods are used to
treat pain, including CAM therapies such as
massage, yoga, biofeedback, chiropractic,
acupuncture, magnetic therapy, hypnotism, and
glucosamine chondroitin.
51.9 Immunizations usually contain killed or weakened
organisms. When given, they stimulate the body to
build up a resistance to the organism. They are used
to provide immunity against specific diseases.
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51-54
End of Chapter 51
It is easy to get a
thousand prescriptions
but hard to get one
single remedy.
~Chinese Proverb
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.