CHAPTER 50 Principles of Pharmacology © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 Identify the main sources of drug information © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-3 Learning Outcomes (cont.) 50.5 Distinguish between over-the-counter and prescription drugs 50.6 Compare the five schedules of controlled substances 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 Com panies, Inc A ll rights reserv e d 50-4 Learning Outcomes (cont.) 50.8 Carry out the procedure for renewing medications using a telephone 50.9 Describe how vaccines work in the immune system 50.10 Organize patient education topics related to the use of nonprescription and prescription drugs © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d Medical Assistant’s Role in Pharmacology 50-7 (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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 to the body © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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) © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-38 Antibody Formation Antigen enters body White cells produce antibodies Antibodies combine with antigens to neutralize them This arrests or prevents reaction or disease Vaccines stimulate antibody formation and reduce symptoms if patient is exposed to disease © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-39 Immunizations • Schedule for immunizations for children up to age 16 years • Pre-exposure immunizations • Post-exposure immunizations – antiserum or antitoxin that contains antibodies © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-40 Immunizations (cont.) • Medical assistant should be familiar with – Indications – Contraindications – Dosages – Administration routes – Potential adverse effects – Methods of storing and handling © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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! © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-46 In Summary 50.1 The five categories of pharmacology include pharmacognosy, pharmacokinetics, pharmacodynamics, pharmacotherapeutics, and toxicology 50.2 The chemical name of a drug is based upon the chemical makeup of the medication The generic name is the drug’s official name, and the trade name is the name given a medication by the manufacturer A medical assistant should be familiar with both the generic and trade names © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-47 In Summary (cont.) 50.3 Drug categories are sometimes named based upon their action; for example, anticonvulsants are used to treat convulsions (seizures) The major drug categories and their actions are outlined in Table 502 50.4 The main book sources for drug information are the Physicians’ Desk Reference (PDR), Drug Evaluations, United States Pharmacopeia/National Formulary, and the American Hospital Formulary Service You may also access medication information from package inserts, at the web site www.rxlist.com, or at other reliable Internet sites © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-48 In Summary (cont.) 50.5 Nonprescription or over-the-counter drugs can be obtained without a physician’s order For prescription drugs, patients must have a physician’s order 50.6 For drugs that have been classified as controlled substances because they are potentially dangerous and addictive, extensive regulations apply There are five schedules (I to V) of controlled substances, with schedule I being the most addictive © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-49 In Summary (cont.) 50.7 All physicians must be registered with the Drug Enforcement Administration and follow the legal requirements of the Controlled Substances Act of 1970 to administer, dispense, and prescribe controlled drugs The medical assistant must follow these legal requirements when registering the physician 50.8 Receiving and telephoning medication refills is frequently done by the medical assistant for all medications except schedule II and III drugs © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-50 In Summary (cont.) 50.9 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 50.10 Patients should be educated about why, when, and how they should take medications This includes instruction to ensure patient compliance regarding nonprescription and prescription drugs, herbal remedies, and supplements Patients should also be instructed about the dangers of medication combinations, the importance of reporting an adverse effect, and maintaining a complete medication list © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50-51 End of Chapter 50 It is easy to get a thousand prescriptions but hard to get one single remedy. ~Chinese Proverb © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d [...]... 50- 28 The FDA Regulatory Function • New drugs – Clinical trials • Safety • Efficacy • Drug manufacturing – – – – Identity Strength Purity Quality • OTC drugs • Prescription drugs • Pregnancy categories – – – – – A B C D X © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 29 Controlled Substances • Drugs categorized as potentially dangerous and addictive • Strictly regulated by federal... 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! © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 18 Pharmacotherapeutics • Clinical pharmacology • Drug names – Generic – official name – International nonproprietary name – Chemical name – Trade – brand... d 50- 31 Controlled Substances (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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 32 Writing Prescriptions • Parts of a prescription – Superscription.. .50- 11 Sources of Drugs • Natural products – Plants – Animals – Minerals – Bacteria and fungi Foxglove – source of digitoxin • Chemical development of natural products – Synthesis of chemical makeup of a drug – Manipulation of genetic information © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 12 Apply Your Knowledge 1 What is the role of the medical assistant in... brand or proprietary name • Generic and trade names used most often © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 19 Pharmacotherapeutics (cont.) • Drug categories – Action on the body – General therapeutic effect – Body system affected • Indication and labeling – Indication – reason(s) for using a drug – Must be approved by FDA to be part of labeling – Off-label use © 2011 The McGraw... Replacement – provide chemicals a patient lacks • Maintenance – maintain health • Supportive – for a condition other than the primary disease • Palliative – reduce severity of a condition or pain • Supplemental – avoid a deficiency © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 23 Toxicology • Study of poisonous effects of drugs – Adverse effects – Drug interactions • Patient education –. .. reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 21 Pharmacotherapeutics (cont.) • If a patient complains a drug is not working – The patient may not understand how the... 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 22 Kinds of Drug Therapy • Acute – improve a lifethreatening or serious condition • Prophylactic – prevent disease • Empiric –. .. package insert – Published annually • Drug Evaluations – published annually by the AMA © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 28 The FDA... 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 © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 50- 16 Pharmacokinetics (cont.) – Metabolism • • • Drug molecules are transformed into