Pharmacology

1. Pharmacology Medical Careers Eden Area ROP

2. What is Pharmacology? • Pharmacology is the study of drugs and their actions, uses, properties and origins. • Drug: Any substance that causes a change to the body’s function and/or structure.

3. Drug Sources • Plant: • Leaves of Eucalyptus makes cold remedies • Tobacco • Animal: • Sheep thyroid is a source of thyroxin, used in hypertension. • Cod liver is used as a source of vitamin A and D. • Mineral • Iron is used in treatment of iron deficiency anemia. • Iodine is antiseptic. Iodine supplements are also used. • Synthetic • When the nucleus of the drug from natural source as well as its chemical structure is altered, we call it synthetic. • Most of the drugs used nowadays (such as antianxiety drugs, anti convulsants) are synthetic forms.

4. Drug Names • Chemical Name: The chemical name gives a precisedescription of chemical composition of the drug • Used most by manufacturers and pharmacists • EX: Chemical name for Vicodin: 4,5α-epoxy-3-methoxy-17-methylmorphinan-6-one tartrate (1:1) hydrate (2:5) • Generic Name: assigned by manufacturer who developed the drug (official name) • Often shortened derivative of chemical name • EX: generic name for Vicodin: hydrocodone and acetaminophen • Brand Name (Trade name): name under which pharmaceutical manufacturer markets the drug and is owned by manufacturer • A drug may be marketed by more than one company • Generic drug may have several brand names • EX: Brand names for Vicodin: Liquicet, Lorcet, Lortab, Maxidone, Norco, Vicodin, etc.

5. MA must be familiar with generic and brand name of each drug prescribed or administered in the office

6. Drug Routes • Oral: taken by mouth • Sublingual: placed under tongue and dissolves • Buccal: placed inside cheek and dissolves • Topical: ointment, cream applied to skin and absorbed • Inhalation: inhaled into lungs • Vaginal: inserted vaginally and absorbs into the vaginal walls • Rectally: inserted rectally and absorbed into the walls of the rectum • Parenteral: injected • ID: intradermal-injected into the dermis (2nd layer of skin) • SC: subcutaneous-injected into the subcutaneous layer (3rd layer of skin) • IM: intramuscular-into the muscle • IV: intravenous- into a vein (MA’s cannot perform; only RN or above)

7. Routes of Administration Route depends on: • Type of drug • Dosage form • Intended action • Rapidity of response desired

8. How Medications Are Given • Prescribe: a written order is given to the patient to take to the pharmacy and have filled • Administer: The drug is given to the patient while in the medical office (example: giving a patient an injection) • Dispense: A drug is handed to the patient to be taken at a later time (example: samples given to patient)

9. Controlled Substance Act • The Controlled Substances Act (CSA) was enacted into law by the Congress of the United States as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. The CSA is the federal U.S. drug policy under which the manufacture, importation, possession, use and distribution of certain substances is regulated. • The legislation created five Schedules (classifications), with varying qualifications for a substance to be included in each. • Two federal agencies, the Drug Enforcement Administration and the Food and Drug Administration, determine which substances are added to or removed from the various schedules. • Classification decisions are required to be made on criteria including potential for abuse and currently accepted medical use in treatment in the United States.

10. Controlled Substance Act • Schedule I: drugs with no currently accepted medical use and a high potential for abuse. Schedule I drugs are the most dangerous drugs of all the drug schedules with potentially severe psychological or physical dependence. Some examples of Schedule I drugs are: • heroin, lysergic acid diethylamide (LSD), marijuana, 3,4-methylenedioxymethamphetamine (ecstasy), meth, and peyote • Schedule II: drugs with a high potential for abuse, less abuse potential than Schedule I drugs, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs are: • cocaine, methamphetamine, methadone, hydromorphone, Demerol, oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin • Schedule III: drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples of Schedule III drugs are: • Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone • Schedule IV: drugs with a low potential for abuse and low risk of dependence. Some examples of Schedule IV drugs are: • Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien • Schedule V: drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. Schedule V drugs are generally used for antidiarrheal, antitussive, and analgesic purposes. Some examples of Schedule V drugs are: • cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica

11. What is a Prescription? A written order from a provider for the compounding, dispensing and administration of a particular drug for a particular patient.

12. Parts of a Prescription • Physician's name, address, telephone number, and fax number • Preprinted on form • Provides info if pharmacist has a question and needs to contact office • Date • Pharmacist cannot fill prescription without date • Prescription expires after a certain length of time after being issued • Usually 1 year except for controlled drugs

13. Parts of a Prescription Cont.. • Patient's name and address • Used for insurance billing and to properly dispense medications • Patient's age • Important in dispensing medications: • Pharmacist double-checks physician's order • Makes sure proper dose is being dispensed based on age

14. Parts of a Prescription Cont.. • Superscription • Rx symbol: Latin for recipe and means "take" • Inscription • Name, form (tabs, caps, etc.) and strength (ex: 50 mg) of drug • Example: Amoxil 250 mg • Subscription • Directions to pharmacist • Generally used to designate number of doses to be dispensed • To prevent prescription from being altered: • Use both numbers and letters to indicate quantity • Example: #30 (thirty)

15. Parts of a Prescription Cont.. • Signatura (sig) • Latin for write or label • Indicates information to be included on medication label • Directions for taking medication at home • Name of medication • EX: take 1 poqd • Refill • Number of times medication can be refilled • Physician's signature • Prescription cannot be filled without physician's signature • DEA number • Must appear on prescription for a controlled drug

16. Parts of a Prescription

17. PDR: Physicians’ Desk Reference • A Physicians Desk Reference, or PDR, is used to identify the thousands of prescription drugs and the effect of the drugs by physicians across the world. PDRs' assist anyone who is interested in knowing what a certain medication is or does.

18. PDR: Physicians’ Desk Reference cont.. • Section 1: Manufacturer’s index • Section 2: brand and generic name index • Section 3: product category index • Section 4: Product identification guide (pictures of each drug) • Section 5: Product information • Section 6: diagnostic product information

19. Always follow seven "rights" of preparing and administering medication • Right drug • Right dose • Right time • Right patient • Right route • Right technique • Right documentation

20. Checking the Label • ALWAYS check the medication label 3 times before administering a medication: • When removing drug from the cabinet • Before preparing medication • After preparing medication but before putting medication away

21. Abbreviations • q8h • po • stat • q • prn • qd • bid • tid • pc • ac • qid