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Clinical. Pharmacology Basics. What is Pharmacology?. Pharmacology: The study and description of drugs, their composition, actions, and effects. Definitions. Pharmacy : A licensed business involved in dispensing drugs. Dispensing : - PowerPoint PPT Presentation
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Pharmacy:A licensed business involved in dispensing drugs.
Dispensing:Compounding, packaging, labeling, and selling and/or delivering a drug in response to a prescription written by a qualified health provider
PharmacokineticsDeals with the effects drugs have on people, including absorption, metabolism, distribution, and excretion
ToxicologyConcerned with the adverse effects of drugs and chemicals used for therapeutic purposes
Clinical PharmacologyStudy of how drugs work, how they interact with other drugs, and their therapeutic effects on diseases and disease processes
Drug:A chemical substance that affects the processes of the mind or body
Any chemical compound used in the diagnosis, treatment, or prevention of disease or other abnormal condition.
Plants◦ From leaves, seeds, sap, stems, fruit, roots
Ex Willow tree extract used in aspirin
Animal Sources◦ Usually a source of hormones
Ex insulin from pigs, estrogen from horses
Minerals◦ Supplements and chemicals
Ex iron, milk of magnesia, lithium carbonate
Semi-synthetic◦ Drug from a natural source is combined with a
synthetically produced compound to alter the effect Ex heroin is semi-synthetic variant of morphine
Synthetic◦ Drug completely formulated in the laboratory
Ex insulin, ibuprofen, diazepam (Valium)
A single drug can have up to four names◦ Chemical
Represents the exact formula Ex N-(4-hydroxyphenyl) acetanamide is Tylenol
◦ Generic Official, nonproprietary name given by international
body to ensure no two products have the same name Always spelled in lowercase
Ex acetaminophen (Tylenol), tetracycline
Trade Name◦ Patented name chosen by a company for sales
purposes Patented compounds are protected for 20 years Patented trade names are protected forever
Other companies can produce a drug after the patent on the compound runs out, but they cannot use the patented trade name
Pharmacists can replace a prescribed Brand name drug with the equivalent generic as long as the doctor has not indicated “no substitutions” Ex Advil (ibuprofen), Tylenol (acetaminophen)
Botanical Name◦ Refers to the natural substance that a drug is
made of Digitalis purpurea is the plant from which digitalis is
derived
Two methods:◦ Prescription
Drugs defined by the federal government to be dangerous, powerful, or habit forming are only available by physician’s order
Correspond to NAPRA Schedule I Pharmacist must have prescription from physician
before it is filled
◦ Over-the-Counter (OTC) Drugs that are considered safe to take without
specific advice of a physician
3 categories Pharmacy Only: Restricted Access (Schedule II) Pharmacy Only: Under Supervision (Schedule III) Sold Anywhere: No Restrictions (Unscheduled)
Classification of Drugs by Use◦ Therapeutic
Taken to relieve symptoms
◦ Diagnostic Used to perform diagnostic tests
◦ Curative Overcome a disease, infection, or other condition
◦ Replacement Taken to replace a hormone or other normally present
substance that the human body can no longer produce
◦ Prophylactic Prevent a condition or to decrease the severity of a
condition
Classification by Scope of Action◦ Local
Drug is stored and produces an effect only at the site of application Ex steroid creams to treat a rash
◦ Systemic Drug circulates through the bloodstream to produce a
general effect Ex most orally ingested drugs
◦ Cumulative Drug accumulates in the body faster than it can be
metabolized or excreted and exerts a greater effect than the initial dose.
Can be harmful or beneficial Ex some antibiotics
Classification by Action or Function
◦ Analgesic◦ Anesthetic (Local, Regional, General)◦ Antacid◦ Anxiolytic◦ Antibiotic (bactericidal, bacteriostatic)◦ Anticoagulant◦ Anticonvulsant
◦ Anti-depressant◦ Antihyperglycemic◦ Antidiarrheal◦ Anti-emetic◦ Antifungal◦ Antihistamine◦ Antihypertensive◦ Anti-inflammatory (NSAID)
◦ Antipyretic◦ Antitussive◦ Bronchodilator◦ Cathartic◦ Contraceptive◦ Decongestant◦ Diuretic◦ Emetic
Classification by route of transmission◦ Some drugs must be administered in a very
specific form for them to act. Others come in different forms that can be used for different circumstances. Ex Antibiotics can be given orally for normal
treatment, but can also be injected intravenously for more rapid action
Topical / Transdermal◦ Applied to a body surface or mucous membrane◦ May be local or systemic
Ex steroid cream to locally treat dermatitis, patch to deliver hormones, heart medication, motion sickness, etc
◦ Ointment: emulsion of semisolid consistency having a petroleum or paraffin base
◦ Lotion: active ingredients contained in a water base
◦ Liniment: active ingredients contained in a liquid base, usually more oil than lotions
Inhalation◦ Drugs administered into the airway to be
absorbed through the mucous membranes of the respiratory system
◦ Puffers or Metered Dose Inhalers (MDI’s) dispense a powder or nebulized liquid
Otic ◦ Placed directly in the ear – usually drops◦ Often antibiotics used to treat ear infection
Ophthalmic◦ Drops or ointments placed directly in the eye ◦ Used to treat localized eye conditions
Nasal ◦ Drugs sprayed or inhaled through the nostrils◦ Sprays are often used for localized effect
Ex Otrivin◦ Mostly decongestants, but also pain medication
Sublingual or Buccal◦ Drugs placed under the tongue or between the
cheek and the gum◦ Usually absorbed through mucous membranes –
no swallowing◦ Quick acting◦ Used for nitroglycerine, Ativan (tranquilizer)
Vaginal◦ Suppositories or creams to treat local infections◦ Creams or foams used in contraception
Rectal◦ Suppositories that dissolve at normal body
temperature◦ Effect can be local or systemic
Ex suppository for hemorrhoids, nausea
◦ Enemas used for diagnostic purposes
Oral◦ Most common route of delivery
◦ Comes in many forms Pills: pressed, round, solid medication (AKA Tablet) Enteric-coated: covered to prevent medication from
dissolving until later in the GI tract (intestines) Sustained Release: additives slow the action of the
drug to ensure sustained action
Oral con’t Caplets: Oval-shaped solid medication, may be
easier to swallow Capsules: drug in powder or liquid form encased in a
hard or soft shell (usually gelatin) – masks taste of drug, can be extended release
Liquid: easy to ingest Suspension: small particles of medicine suspended in a
liquid base Emulsion: droplets of oil and water mixed together Elixir: contains alcohol, sugar water and sometimes
flavouring Syrup: Similar to elixir, but no alcohol and thicker
Parenteral◦ Administration by injection◦ Fastest, most accurate effect◦ Several ways to inject
Subcutaneous (SC) Intradermal Intramuscular (IM) Z-track Intravenous (IV)
Therapeutic Action◦ The effect considered desirable
Side Effect◦ Two kinds:
Those that are expected to occur and are usually minor Those that are detrimental to the health of the patient
(may be fatal) AKA Adverse Effects
Allergies◦ Different from side effects
Serious reaction such as chest pain, skin rash, anaphylaxis that is life threatening
Must also be aware of food allergies when prescribing medication
Body Weight◦ Drug effects are often not about
amount, but about proportion◦ Larger people need larger doses
Age◦ The elderly and young children
process drugs differently due to differences in metabolism and excretion mechanism
Time of Day◦ Food intake, normal body rhythms,
level of activity all affect drug action◦ Some drugs need to be taken on a
strict schedule◦ Some drugs should always be given
at same time of day, some on a full stomach, some on an empty stomach
◦ Certain foods should be avoided with certain drugs
Gender◦ Men and women’s bodies process differently
due to differences in muscle mass and hormone levels
◦ Pregnancy is also a significant issue
Other medication◦ Physicians and pharmacists check for drug –
drug interactions◦ Herbal medicines can also effect a drug’s action
Includes:◦ Vitamins and Minerals◦ Herbal remedies◦ Homeopathic medicines (HM) and Traditional
medicines◦ Probiotics
Natural Health Products Regulations (2004)◦ To be sold, products must have a Product License
NPN – natural product number DIN-HM – homeopathic medicine number
◦ Manufacturers must have a Site License
Should be treated as drugs◦ Many have therapeutic effects◦ Many also have side, unpredictable and/or
adverse effects◦ Can interact with other, prescribed medications
Encourage patients to bring/list natural health products when they tell the physician about other medications they are taking