Fundamentals of Pharmacology Dr J Domenech Pearsons Comprehensive

Fundamentals of Pharmacology Dr. J. Domenech Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Drug Names • Generic • Brand • Chemical Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Generic Name • • • Drug’s “official” or nonproprietary name Single identifying name Typically noted in lowercase letters Considered drug’s legal name Required by Food and Drug Administration (FDA) to meet requirements of brand name drugs • Include acetaminophen, ibuprofen, and tetracycline • Typically priced lower than drugs with brand names Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Brand Name • • • Name given a drug by a manufacturer Typically noted in uppercase letters Also called the proprietary name Often a drug’s most familiar name Advil and Motrin are brand names for the generic drug ibuprofen Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Chemical Name • Chemical formula typically used by manufacturers and pharmacists Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Federal Agencies • Food and Drug Administration (FDA) – Responsible for testing, approving, labeling, and enforcing laws for drug sales and distribution • Drug Enforcement Administration (DEA) – Responsible for enforcing drug control Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Federal Legislation • The Federal Food, Drug, and Cosmetic Act of 1938 – Ensures the safety of food, drugs, and cosmetics sold within U. S. borders • The Controlled Substance Act of 1970 – Regulates the manufacture and distribution of drugs that can cause dependencies Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Drug Resources • Physicians’ Desk Reference (PDR) • The Hospital Formulary • The United States Pharmacopeia. National Formulary • Web MD • Medline Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Drug Classifications • Prescription drug • Nonprescription drug • Controlled substance Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Schedule for Controlled Substances • Schedule I – Highest potential for addiction and abuse • Schedule II – High potential for addiction and abuse • Schedule III – Moderate to low potential for addiction and abuse • Schedule IV – Lower potential than Schedule III drugs • Schedule V – Low potential for addition and abuse Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Controlled Substances • Must always be kept locked • Must be labeled according to CSA specifications • All narcotics should be tracked on narcotic log Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Common Controlled Substances • • • Anabolic steroids Butabarbital Chloral hydrate Cocaine Codeine Diazepam Heroin LSD Marijuana Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Common Controlled Substances (cont’d) • • • Morphine Opium Phenobarbital Secobarbital Tylenol with codeine Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Commonly Stocked Injectable Drugs • • • Amitriptyline HCL Brompheniramine maleate Chlorpromazine HCL Diazepam Dimenhydrinate Diphenhydramine Diphtheria, tetanus toxid Fuorsemide Gentamicin sulfate Heparin sodium Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Commonly Stocked Injectable Drugs (cont’d) • • • Hydromorphione (HCL Lidocaine HCL 1%, 2% Prochlorperazine Promethazine HCL Sodium chloride with benzyl alcohol 0. 9% Tetanus and diptheria toxoids Tetanus antitoxin Tuberculin protein derivative Water for injection Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

The Medication Log Book • Contains a complete list of all on-site medications, including sample products • Contains the name of each medication, quantity on hand, and expiration date • Contains a section for patient’s name; quantity, date, and time of distribution; and medical assistant’s initials Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Form DEA 224 • Used by physicians to register with the DEA • Allows physicians to prescribe, dispense, or administer controlled substances • Renewal is required every 3 years Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Drug Abuse and Dependency • Drug abuse – Improper or incorrect drug use • Drug dependency – Reliance or use of medication for psychological support Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Steps to Take When Drug Abuse Is Suspected • Step 1: Notify the physician • Step 2: Check local pharmacies to see if the patient is obtaining medications from multiple pharmacies • Step 3: Inform patients who are frequently calling for refills that another refill will require an office visit • Step 4: Ensure that items in the office are kept in a secure place Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Commonly Abused Drugs • • • Sedatives Antianxiety agents Antidepressants Pain medications Illegal drugs Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Routes of Drug Administration • Oral • Sublingual • Parenteral Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Methods for Parenteral Drug Administration • • • Intradermal Subcutaneous (SC) Intramuscular (IM) Intravenous (IV) Intrathecal Intracavity Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Nonparenteral Methods for Drug Administration • • Rectal Oral Inhalation Topical Vaginal Eyedrops Eardrops Sublingual or buccal tablets Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Before Medication Administration • • • Identify the patient Check and recheck the medication order Check the correct dose Ensure the correct route Note the medication’s expiration date Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Medication Side Effects • • Anaphylactic shock Drug tolerance Habituation Allergic reaction Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Factors Affecting Patients’ Medication Reactions • • • Age Weight Method of administration Allergies Intolerance and tolerance Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Medications to Avoid during Pregnancy • • • Tetracyclines Chloramphenicol Sulfonamides Oral anticoagulants Iodine-containing drugs Antineoplastics Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Main Parts of a Prescription a). -SUPERSCRIPTION = Patient's name and address, the date and the symbol "Rx" (Latin for Recipe, meaning to take). b). -INSCRIPTION = Names and quantities of the ingredients. c). -SUBSCRIPTION = Includes directions for compounding. Most medications are prepared ready for dispensing or administration d). -SIGNATURE = Directions for the patient. It is usually preceded by the symbol "S" or "Sig" (Latin for Signa, meaning "mark"). This is where the physician indicates what instructions are to be placed on the label. Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Guidelines for Administering Medication Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Abbreviations Used in Pharmacology • Many physicians avoid abbreviations in prescription writing and chart documentation • The pharmacy assistant must: – Ensure that any abbreviations are appropriate, correct, and clear – Always use approved abbreviations Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Summary • • Drug names, resources, and classifications Commonly stocked drugs in a medical office The medication log Drug abuse and dependency Routes of administration Parts of a prescription Guidelines for administering medications Abbreviations used in pharmacology Pearson’s Comprehensive Medical Assisting Beaman / Fleming-Mc. Phillips © 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458