PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

1. Chapter 50 Principles of Pharmacology PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

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 List the main sources of drug information.

3. Learning Outcomes (cont.) 50.5 Contrast over-the-counter and prescription drugs. 50.6 Compare the five schedules of controlled substances. 50.7 Describe how to register a physician with the Drug Enforcement Administration (DEA) for permission to administer, dispense, and prescribe controlled drugs.

4. Learning Outcomes (cont.) 50.8 Describe how to telephone a medication refill. 50.9 Describe how vaccines work in the immune system. 50.10 Identify patient education topics related to the use of nonprescription and prescription drugs.

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

6. 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 Medical Assistant’s Role in Pharmacology

7. Medical Assistant’s Role in Pharmacology(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

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 do to the body

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

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

11. Foxglove is used to make digitoxin Sources of Drugs • Natural products • Plants • Animals • Minerals • Bacteria and fungi • Chemical development of natural products • Synthesis of chemical makeup of a drug • Manipulation of genetic information

12. 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. Impressive!

13. Apply Your Knowledge • Matching: • ___ Study of poisons A. Pharmacokinetics • ___ 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 ANSWER: C A F E D B Impressive!

14. Pharmacodynamics • Mechanism of action of a drug to produce a therapeutic effect • Interaction between drug and target cells and body’s response to the interaction

15. What the body does to a drug 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 Characteristics of the drug Distribution Transportation of a drug from site of administration to site of action Pharmacokinetics

16. Metabolism Drug molecules are transformed into metabolites Usually in liver, some in kidneys Affected by age, genetic makeup, and characteristics of drug Excretion Manner in which a drug is eliminated from the body Most via urine Pharmacokinetics (cont.)

17. Apply Your Knowledge 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!

18. Pharmacotherapeutics • Clinical pharmacology • Drug names • Generic – official name • International nonproprietary name • Chemical name • Trade – brand or proprietary name • Generic and trade names used most often

19. 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 Pharmacotherapeutics (cont.)

20. 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 Pharmacotherapeutics (cont.)

21. Pharmacotherapeutics (cont.) • If a patient complains a drug is not working • The patient may not understand how the drug 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

22. Acute – improve a life-threatening or serious condition Empiric – given before test results are available Maintenance – maintain health Palliative – reduce severity of a condition or pain Prophylactic – prevent disease Replacement – provide chemicals a patient lacks Supportive – for a condition other than the primary disease Supplemental – avoid a deficiency Pharmacotherapeutics: Kinds of Therapy

23. 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

24. Apply Your Knowledge • Mr. Anderson is complaining that the new medication does not seem to be working. What may be the reason for this? • ANSWER: Mr. Anderson may not understand how the drug works. His dosage may need to be adjusted, or the therapeutic level may not have been reached. The wrong drug may have been prescribed for him, or this particular drug may not work for as well for him as for another patient. He may need the medication in a different form. Correct !

25. Apply Your Knowledge • Toxicology includes which of these? • Poisons and poisonous effects of drugs • Excretion of drugs • Adverse effects of drugs • Drug interactions • Metabolism of drugs ANSWER: Correct !

26. Sources of Drug Information • Sources must be up-to-date • PDR • Information provided by pharmaceutical companies • Information closely resembles package insert • Published annually • Drug Evaluations – published annually by the AMA

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

28. New drugs Clinical trials Safety Efficacy Drug manufacturing Identity Strength Purity Quality OTC drugs Prescription drugs Pregnancy categories A B C D X The FDA Regulatory Function

29. The FDA Regulatory Function (cont.) • Controlled substances • Drugs categorized as potentially dangerous and addictive • Strictly regulated by federal laws • Comprehensive Drug Abuse Prevention and Control Act (1970) • Created the DEA • Strengthened drug enforcement authority • Schedules – based on abuse potential

30. The FDA Regulatory Function (cont.)

31. 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 The FDA Regulatory Function (cont.)

32. Writing prescriptions – parts of a prescription Superscription Patient information Inscription Name of the drug Amount of drug per dose Subscription – directions to the pharmacist Signature – patient instructions The FDA Regulatory Function (cont.)

33. The FDA Regulatory Function (cont.) Prescription for a Single Medication

34. The FDA Regulatory Function (cont.) Prescription for Multiple Medications

35. Writing prescriptions Keep prescription blanks secure Telephone prescriptions Only at request of the physician Follow facility policy Document carefully The FDA Regulatory Function (cont.)

36. Apply Your Knowledge • Which of the following sources of drug information is most like the package insert? • AHFS B. PDR C. USP/NFD. Drug Evaluations ANSWER: Correct! • Match • ___ Contains the patient information A. Subscription • ___ Name of the drug and dosage B. Signature • ___ Instructions to the pharmacist C. Superscription • ___ Patient instructions D. Inscription ANSWER: C D A B

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)

38. Vaccines: 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

39. Vaccines: Immunizations • Schedule for immunizations for children up to age 16 years • Pre-exposure immunizations • Post-exposure immunizations – antiserum or antitoxin that contains antibodies

40. Vaccines: Immunizations (cont.) • Medical assistant should be familiar with • Indications • Contraindications • Dosages • Administration routes • Potential adverse effects • Methods of storing and handling

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. Very Good!

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

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

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

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!

46. Pharmacology – study of drugs Drug classifications based on action Immunizations provide immunity to specific diseases Medical assistant Instruct patients about Specific drugs Required safety precautions Promote patient compliance In Summary

47. End of Chapter End of Chapter 50 It is easy to get a thousand prescriptions but hard to get one single remedy.  ~Chinese Proverb