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Pharmacology. CHAPTER 22. 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. Pharmacology Overview.

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Pharmacology

Pharmacology

CHAPTER 22


Pharmacology overview
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


Pharmacology overview1
Pharmacology Overview

  • Pharmacodynamics

    • Study of how drugs interact in the human body

  • Pharmacist

    • One who is licensed to prepare and dispense drugs


Pharmacology overview2
Pharmacology Overview

  • Pharmacy

    • Drug store

  • Toxicology

    • Study of poisons, their detection, their effects

    • Establishing antidotes and methods of treatment for conditions they produce


Drug laws
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)


Drug laws1
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)


Controlled substances or schedule drugs
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


Controlled substances or schedule drugs1
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


Controlled substances or schedule drugs2
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


Controlled substances or schedule drugs3
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 six-month period – prescription expires in six months

      • Examples: Librium, valium, darvon, equanil


Controlled substances or schedule drugs4
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


Drug standards
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


Drug standards1
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


Drug references
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


Drug references1
Drug References

  • Hospital formulary

    • Lists all drugs commonly stocked in the hospital pharmacy

    • Provides information about the characteristics of drugs and their clinical use


Drug references2
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


Drug references3
Drug References

  • Medical economics company references

    • Physicians’ Desk Reference for Nonprescription Drugs

    • Physicians’ Reference for Ophthalmology

    • Drug Interactions and Side Effects Index

    • Indications Index


Drug references4
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



Drug names
Drug Names

  • Chemical name

    • Describes chemical structure of the drug

    • Formula that indicates composition of the drug


Drug names1
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


Drug names2
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 ®


Drug actions drug interactions
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


Drug actions drug interactions1
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


Drug actions drug interactions2
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


Drug actions drug interactions3
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


Drug actions drug interactions4
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


Drug actions drug interactions5
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


Drug actions drug interactions6
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


Routes of administration
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


Routes of administration1
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 bad-tasting medications or irritating medications


Routes of administration2
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


Routes of administration3
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


Routes of administration4
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


Routes of administration5
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


Routes of administration6
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


Routes of administration7
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


Routes of administration8
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


Routes of administration9
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


Routes of administration10
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


Routes of administration11
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


Routes of administration12
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


Parenteral routes of administration
Parenteral Routes of Administration


Drug classifications

DRUG CLASSIFICATIONS

Pharmacology


Analgesic
Analgesic

  • Pronounced

    • (an-al-JEE-sik)

  • General definition

    • Relieves pain

      • Example: acetylsalicylic acid, aspirin, Bayer Children’s Aspirin


Anesthetic
Anesthetic

  • Pronounced

    • (an-ess-THET-ik)

  • General definition

    • Partially or completely numbs or eliminates sensitivity with or without loss of consciousness

      • Example: lidocaine (Xylocaine)


Antiarrhythmic
Antiarrhythmic

  • Pronounced

    • (an-tee-ah-RITH-mik)

  • General definition

    • Corrects cardiac arrhythmias (irregular beats)

      • Example: digoxin (Lanoxin)


Antibiotic anti infective
Antibiotic(Anti-infective)

  • Pronounced

    • (an-tih-BYE-ot-ik)

  • General definition

    • Stops or controls growth of infection-causing microorganisms

      • Example: phenoxymethyl-penicillin sodium (Pen-Vee-K, Penicillin VK, Veetids, V-Cillin K)


Anticoagulant
Anticoagulant

  • Pronounced

    • (an-ti-koh-AG-yoo-lant)

  • General definition

    • Prevents clot continuation and formation

      • Example: warfarin sodium (Coumadin)


Anticonvulsant
Anticonvulsant

  • Pronounced

    • (an-tih-kon-VULL-sant)

  • General definition

    • Prevents or relieves convulsions (seizures)

      • Example: clonazepam (Klonopin)


Antidepressant
Antidepressant

  • Pronounced

    • (an-tih-dee-PRESS-ant)

  • General definition

    • Prevents, cures, or alleviates mental depression

      • Example: amitriptyline hydrochloride (Elavil, Amitril)


Antidiabetic
Antidiabetic

  • Pronounced

    • (an-tih-dye-ah-BET-ik)

  • General definition

    • Helps control the blood sugar level

      • Example: metformin (Glucophage)


Antidiarrheal
Antidiarrheal

  • Pronounced

    • (an-tih-dye-ah-REE-ul)

  • General definition

    • Prevents or treats diarrhea

      • Example: loperamide hydrochloride (Imodium)


Antidiuretic
Antidiuretic

  • Pronounced

    • (an-tih-dye-yoo-REH-tic)

  • General definition

    • Suppresses the formation of urine

      • Example: vasopressin (Pitressin)


Antiemetic
Antiemetic

  • Pronounced

    • (an-tih-ee-MET-ik)

  • General definition

    • Prevents or relieves nausea and vomiting

      • Example: meclizine hydrochloride (Bonine, Dramamine II, Antivert)


Antifungal
Antifungal

  • Pronounced

    • (an-tih-FUNG-gal)

  • General definition

    • Destroys or inhibits the growth of fungi

      • Example: fluconazole (Diflucan)


Antihistamine
Antihistamine

  • Pronounced

    • (an-tih-HISS-tah-meen)

  • General definition

    • Opposes action of histamine, released in allergic reactions

      • Example: cetirizine (Zyrtec)


Antihypertensive
Antihypertensive

  • Pronounced

    • (an-tih-high-per-TEN-siv)

  • General definition

    • Prevents or controls high blood pressure

      • Example: nadolol (Corgard)


Anti infective antibiotic
Anti-infective(Antibiotic)

  • Pronounced

    • (an-tih-in-FEK-tiv)

  • General definition

    • Stops or controls the growth of infection-causing microorganisms

      • Example: amoxycillin (Amoxil, Polymox)


Anti inflammatory
Anti-Inflammatory

  • Pronounced

    • (an-tih-in-FLAM-ah-toh-ree)

  • General definition

    • Counteracts inflammation in body

      • Example: naproxen sodium (Anaprox, Aleve)


Antineoplastic
Antineoplastic

  • Pronounced

    • (an-tih-nee-oh-PLASS-tik)

  • General definition

    • Prevents development, growth, or reproduction of cancerous cells

      • Example: fluorouracil (Adrucil)


Antitussive
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)


Antiulcer agent
Antiulcer Agent

  • Pronounced

    • (an-tih-ULL-ser agent)

  • General definition

    • Treats and prevents peptic ulcer and gastric hypersecretion

      • Example: ranitidine hydrochloride (Zantac)


Antiviral agent
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)


Beta blocker
Beta Blocker

  • Pronounced

    • (BAY-tah BLOCK-er)

  • General definition

    • Treats hypertension, angina, and various abnormal heart rhythms

      • Example: metoprolol tartrate (Lopressor)


Bronchodilator
Bronchodilator

  • Pronounced

    • (brong-koh-DYE-lay-tor)

  • General definition

    • Expands bronchial tubes by relaxing bronchial muscles

      • Example: theophylline (Bronkodyl)


Calcium channel blocker
Calcium Channel Blocker

  • Pronounced

    • (KAL-see-um CHAN-ell BLOCK-er)

  • General definition

    • Treats hypertension, angina, and various abnormal heart rhythms

      • Example: amlodipine (Norvasc)


Diuretic
Diuretic

  • Pronounced

    • (dye-yoor-RET-ik)

  • General definition

    • Increases urine secretion

      • Example: furosemide (Lasix)


Hormone
Hormone

  • Pronounced

    • (HOR-mohn)

  • General definition

    • Treats deficiency states where specific hormone level is abnormally low

      • Example: estrogen, conjugated (Premarin)


Hypnotic
Hypnotic

  • Pronounced

    • (hip-NOT-ik)

  • General definition

    • Induces sleep or dulls the senses

      • Example: pentobarbital (Nembutal)


Immunosuppressant
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)


Laxative
Laxative

  • Pronounced

    • (LACK-sah-tiv)

  • General definition

    • Prevents constipation or promotes the emptying of the bowel contents with ease

      • Example: docusate calcium (Surfak)


Lipid lowering agent
Lipid-Lowering Agent

  • Pronounced

    • (LIP-id lowering agent)

  • General definition

    • Reduces blood lipid (fat) levels

      • Example: atorvastatin (Lipitor)


Sedative
Sedative

  • Pronounced

    • (SED-ah-tiv)

  • General definition

    • Exerts a soothing or tranquilizing effect on the body

      • Example: phenobarbital (Nembutal)


Skeletal muscle relaxant
Skeletal Muscle Relaxant

  • Pronounced

    • (SKELL-eh-tal muscle rih-LAK-sant)

  • General definition

    • Relieves muscle tension

      • Example: carisoprodol (Soma)


Vitamin
Vitamin

  • Pronounced

    • (VIGH-tah-min)

  • General definition

    • Prevents and treats vitamin deficiencies and used as dietary supplement

      • Example: ascorbic acid (vitamin C)


Common charting abbreviations
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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