CHAPTER © 2011 The McGraw-Hill Companies, Inc. All rights reserved. 1 Principles of Pharmacology.
43
CHAPTER © 2011 The McGraw-Hill Companies, Inc. All rights reserved. 1 Principles of Pharmacology
Transcript of CHAPTER © 2011 The McGraw-Hill Companies, Inc. All rights reserved. 1 Principles of Pharmacology.
Principles of Pharmacology1
50-*
Introduction
Medication errors can result in injury or death
Medical assistant
Understand role of drugs in ambulatory medical facilities
*
50.1 Describe the five categories of pharmacology.
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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
50.5 Distinguish between over-the-counter and prescription drugs.
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Administration of drugs
Understand pharmacologic principles
50.1 Describe the five categories of pharmacology.
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Pharmacotherapeutics – study of how drugs are used to treat disease
Toxicology – study of poisons or poisonous effects of drugs
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Synthesis of chemical makeup of a drug
Manipulation of genetic information
Foxglove – source of digitoxin
Animal substances used in drugs
Glandular substances
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
What is the role of the medical assistant in pharmacology?
*
50-*
___ Study of what the body does to drugs B. Pharmacognosy
___ Used to prevent, diagnose, or treat disease C. Toxicology
___ Study of what drugs do to the body D. Pharmacotherapeutics
___ Study of how drugs are used to treat disease E. Pharmacodynamics
___ Study of characteristics of natural drug F. Drugs
and their sources
50-*
Pharmacodynamics
Mechanism of action of a drug to produce a therapeutic effect
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Pharmacokinetics
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
Distribution
*
50.1 Describe the five categories of pharmacology.
Distribution also refers to the length of time a drug takes to achieve maximum or peak plasma levels: the time between dosing and availability in the bloodstream.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Affected by age, genetic makeup, and characteristics of drug
Excretion
Manner in which a drug is eliminated from the body
Most via urine
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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!
50-*
Pharmacotherapeutics
Generic and trade names used most often
*
50.2 Differentiate between chemical, generic, and trade names for drugs.
Pharmacotherapeutics: Study of how drugs are used to treat disease.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Must be approved by FDA to be part of labeling
Off-label use
50.1 Describe the five categories of pharmacology.
Never assume that a drug is appropriate for only one use or that it is administered in only one form.
Always consult the doctor or other sources of drug information before answering a patient’s questions.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Be alert to patient complaints after starting a new drug
Efficacy – drug is working as expected
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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
*
50.1 Describe the five categories of pharmacology.
Other reasons for patient complaints that a drug is not working
Patient is not taking the medication according to directions
The generic drug may not work, when the trade-name drug does
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Maintenance – maintain health
Prophylactic – prevent disease
Supportive – for a condition other than the primary disease
Supplemental – avoid a deficiency
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Toxicology
Adverse effects
Drug interactions
Patient education
*
Toxic effects that may not be apparent right away
Adverse effect on a fetus when drug crosses placenta
Adverse effect on infants when drug passes into breast milk
Adverse reactions reported in clinical trials
Adverse effect in immunocompromised patients who are unable to metabolize a drug normally
Adverse effect in pediatric or elderly patients or in patients with hypertension, diabetes mellitus, or other serious chronic conditions
Adverse drug interaction when drug is taken with another drug that is incompatible
Carcinogenic effect in some patients
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Apply Your Knowledge
Mr. Anderson is complaining that the new medication does not seem to be working. What may be the reason for this?
*
50-*
Poisons and poisonous effects of drugs
Excretion of drugs
50-*
Published annually
Epocrates: Software program that can be loaded onto a PDA
More than 3,300 brand and generic drugs
Alternative medications
Infectious disease treatment guide
50-*
AHFS – published by the
50-*
50.5 Distinguish between over-the-counter and prescription drugs.
Nonprescription (OTC) drug: Drug approved by the FDA for use without supervision of a licensed health-care practitioner.
Prescription drug: Drug that can be used only by order of a physician and must be dispensed by a licensed health-care professional.
Pregnancy categories
B No evidence of risk in humans
C Risk cannot be ruled out
D Positive evidence of risk
X Contraindicated in pregnancy
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Strictly regulated by federal laws
Comprehensive Drug Abuse Prevention and Control Act (1970)
Created the DEA
*
50-*
Butabarbital
IV
Diazepam
V
Antidiarrheals
50-*
Controlled substance
Learning Outcome:
50.7 Describe how to register or renew a physician with the Drug Enforcement Administration (DEA) for permission to administer, dispense, and prescribe controlled drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Signature – patient instructions
Other items included on a prescription
Doctor’s name, office address and telephone number, and DEA registration number
Doctor’s signature
Number of times the prescription can be refilled
Indication of whether the pharmacist may substitute a generic version of a trade-name drug at the patient’s request
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
*
50-*
50-*
Follow facility policy
50.6 Compare the five schedules of controlled substances.
50.8 Carry out the procedure for renewing medications using a telephone.
You may not telephone a prescription for a Schedule II drug.
In an emergency, the doctor may telephone a prescription for a Schedule II drug, but amount is limited to the period of emergency, and written prescription must be sent to pharmacist within 72 hours.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Apply Your Knowledge
Which of the following sources of drug information is most like the package insert?
A. AHFS B. PDR C. USP/NF D. Drug Evaluations
ANSWER:
Match
___ Name of the drug and dosage B. Signature
___ Instructions to the pharmacist C. Superscription
___ Patient instructions D. Inscription
50-*
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)
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
This arrests or prevents reaction or disease
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Immunizations
Schedule for immunizations for children up to age 16 years
Pre-exposure immunizations
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Indications
Contraindications
Dosages
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Apply Your Knowledge
ANSWER: Vaccines are administered to a person to produce reduced sensitivity to or increase immunity to an infectious disease.
Why are vaccines given to patients?
*
50-*
OTC drugs
May not produce enough therapeutic benefit
May be dangerous in combination with other substances or drugs
May mask symptoms or aggravate a problem
*
Learning Outcome:
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
Also, many OTC drugs contain more than one active ingredient. Extra ingredients, such as aspirin or caffeine, can cause allergic or other undesirable effects.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Prescription drugs
Learning Outcome:
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
To prevent medication errors, be sure patient understands prescription
How and when to take the medication
Appropriate language
Learning Outcome:
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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!
50-*
End of Chapter 50
It is easy to get a thousand prescriptions but hard to get one single remedy.
~Chinese Proverb
50-*
Introduction
Medication errors can result in injury or death
Medical assistant
Understand role of drugs in ambulatory medical facilities
*
50.1 Describe the five categories of pharmacology.
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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
50.5 Distinguish between over-the-counter and prescription drugs.
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Administration of drugs
Understand pharmacologic principles
50.1 Describe the five categories of pharmacology.
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Pharmacotherapeutics – study of how drugs are used to treat disease
Toxicology – study of poisons or poisonous effects of drugs
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Synthesis of chemical makeup of a drug
Manipulation of genetic information
Foxglove – source of digitoxin
Animal substances used in drugs
Glandular substances
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
What is the role of the medical assistant in pharmacology?
*
50-*
___ Study of what the body does to drugs B. Pharmacognosy
___ Used to prevent, diagnose, or treat disease C. Toxicology
___ Study of what drugs do to the body D. Pharmacotherapeutics
___ Study of how drugs are used to treat disease E. Pharmacodynamics
___ Study of characteristics of natural drug F. Drugs
and their sources
50-*
Pharmacodynamics
Mechanism of action of a drug to produce a therapeutic effect
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Pharmacokinetics
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
Distribution
*
50.1 Describe the five categories of pharmacology.
Distribution also refers to the length of time a drug takes to achieve maximum or peak plasma levels: the time between dosing and availability in the bloodstream.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Affected by age, genetic makeup, and characteristics of drug
Excretion
Manner in which a drug is eliminated from the body
Most via urine
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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!
50-*
Pharmacotherapeutics
Generic and trade names used most often
*
50.2 Differentiate between chemical, generic, and trade names for drugs.
Pharmacotherapeutics: Study of how drugs are used to treat disease.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Must be approved by FDA to be part of labeling
Off-label use
50.1 Describe the five categories of pharmacology.
Never assume that a drug is appropriate for only one use or that it is administered in only one form.
Always consult the doctor or other sources of drug information before answering a patient’s questions.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Be alert to patient complaints after starting a new drug
Efficacy – drug is working as expected
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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
*
50.1 Describe the five categories of pharmacology.
Other reasons for patient complaints that a drug is not working
Patient is not taking the medication according to directions
The generic drug may not work, when the trade-name drug does
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Maintenance – maintain health
Prophylactic – prevent disease
Supportive – for a condition other than the primary disease
Supplemental – avoid a deficiency
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Toxicology
Adverse effects
Drug interactions
Patient education
*
Toxic effects that may not be apparent right away
Adverse effect on a fetus when drug crosses placenta
Adverse effect on infants when drug passes into breast milk
Adverse reactions reported in clinical trials
Adverse effect in immunocompromised patients who are unable to metabolize a drug normally
Adverse effect in pediatric or elderly patients or in patients with hypertension, diabetes mellitus, or other serious chronic conditions
Adverse drug interaction when drug is taken with another drug that is incompatible
Carcinogenic effect in some patients
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Apply Your Knowledge
Mr. Anderson is complaining that the new medication does not seem to be working. What may be the reason for this?
*
50-*
Poisons and poisonous effects of drugs
Excretion of drugs
50-*
Published annually
Epocrates: Software program that can be loaded onto a PDA
More than 3,300 brand and generic drugs
Alternative medications
Infectious disease treatment guide
50-*
AHFS – published by the
50-*
50.5 Distinguish between over-the-counter and prescription drugs.
Nonprescription (OTC) drug: Drug approved by the FDA for use without supervision of a licensed health-care practitioner.
Prescription drug: Drug that can be used only by order of a physician and must be dispensed by a licensed health-care professional.
Pregnancy categories
B No evidence of risk in humans
C Risk cannot be ruled out
D Positive evidence of risk
X Contraindicated in pregnancy
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Strictly regulated by federal laws
Comprehensive Drug Abuse Prevention and Control Act (1970)
Created the DEA
*
50-*
Butabarbital
IV
Diazepam
V
Antidiarrheals
50-*
Controlled substance
Learning Outcome:
50.7 Describe how to register or renew a physician with the Drug Enforcement Administration (DEA) for permission to administer, dispense, and prescribe controlled drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Signature – patient instructions
Other items included on a prescription
Doctor’s name, office address and telephone number, and DEA registration number
Doctor’s signature
Number of times the prescription can be refilled
Indication of whether the pharmacist may substitute a generic version of a trade-name drug at the patient’s request
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
*
50-*
50-*
Follow facility policy
50.6 Compare the five schedules of controlled substances.
50.8 Carry out the procedure for renewing medications using a telephone.
You may not telephone a prescription for a Schedule II drug.
In an emergency, the doctor may telephone a prescription for a Schedule II drug, but amount is limited to the period of emergency, and written prescription must be sent to pharmacist within 72 hours.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Apply Your Knowledge
Which of the following sources of drug information is most like the package insert?
A. AHFS B. PDR C. USP/NF D. Drug Evaluations
ANSWER:
Match
___ Name of the drug and dosage B. Signature
___ Instructions to the pharmacist C. Superscription
___ Patient instructions D. Inscription
50-*
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)
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
This arrests or prevents reaction or disease
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Immunizations
Schedule for immunizations for children up to age 16 years
Pre-exposure immunizations
*
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Indications
Contraindications
Dosages
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Apply Your Knowledge
ANSWER: Vaccines are administered to a person to produce reduced sensitivity to or increase immunity to an infectious disease.
Why are vaccines given to patients?
*
50-*
OTC drugs
May not produce enough therapeutic benefit
May be dangerous in combination with other substances or drugs
May mask symptoms or aggravate a problem
*
Learning Outcome:
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
Also, many OTC drugs contain more than one active ingredient. Extra ingredients, such as aspirin or caffeine, can cause allergic or other undesirable effects.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
Prescription drugs
Learning Outcome:
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
To prevent medication errors, be sure patient understands prescription
How and when to take the medication
Appropriate language
Learning Outcome:
50.10 Organize patient education topics related to the use of nonprescription and prescription drugs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
50-*
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!
50-*
End of Chapter 50
It is easy to get a thousand prescriptions but hard to get one single remedy.
~Chinese Proverb
