Chapter 35 Basic Pharmacology

Uses of Medications Therapeutic Diagnostic Curative Replacement Preventive or prophylactic

Research and Development Up to 15 years for drug to make it to market Understand process of change from health to illness from level of cellular components (targets) Design chemical compounds and biopharmaceuticals

Research and Development 2003: Human Genome Project completed Pharmacogenomics Study of response of body to various chemical compounds based on individual’s genetic inheritance

Drug Names Chemical name Generic name Trade or brand name

History and Sources of Drugs Drugs from roots, herbs, bark, plant life earliest known pharmaceuticals Drugs derived from animals and minerals Produced in laboratories using chemical, biochemical, biotechnologic processes

History and Sources of Drugs Plant sources Animal sources Mineral sources Herbal supplements Synthetic drugs Genetically engineered pharmaceuticals

Drug Regulations and Legal Classifications of Drugs Must comply with federal and state laws Laws govern: Manufacture Sale Possession Administration Dispensing Prescribing of drugs

Drug Regulations and Legal Classifications of Drugs Federal Food, Drug, and Cosmetic Act Protects public by ensuring purity, strength, and composition of foods, drugs, and cosmetics Prohibits movement in interstate commerce of altered and misbranded food, drugs, devices, and cosmetics Enforced by Food and Drug Administration (FDA)

Drug Regulations and Legal Classifications of Drugs Controlled Substances Act of 1970 Regulates drugs with potential for abuse or addiction Controls manufacture, importation, compounding, selling, dealing in, giving away of drugs that have potential for abuse Controlled substances

Drug Regulations and Legal Classifications of Drugs Controlled Substances Act of 1970 Drug Enforcement Agency (DEA) Provider registration Controlled Substances Schedules I–V

Drug Regulations and Legal Classifications of Drugs Controlled Substances Act of 1970 Storage of controlled substances Separation from other drugs Well-constructed metal box or compartment with double lock Separate record book Counted, verified, recorded at end of workday

Drug Regulations and Legal Classifications of Drugs Controlled Substances Act of 1970 Controlled Substance Disposal Policy (per DEA) Medical assistant role and responsibilities Monitor provider’s DEA registration renewal date Maintain legally designated records and inventories of drugs Provide security for all drugs, in particular controlled substances

Drug Regulations and Legal Classifications of Drugs Controlled Substances Act of 1970 Medical assistant role and responsibilities Provide security for prescription pads Properly destroy expired drugs and document Know and understand federal and state laws that regulate drugs, including controlled substances and samples

Drug Regulations and Legal Classifications of Drugs Prescription drugs Also called legend drugs E-prescribing Nonprescription drugs Over-the-counter (OTC) drugs Readily accessible to public Do not require prescription (See Patient Education box)

Drug Regulations and Legal Classifications of Drugs Proper disposal of drugs Expired drugs removed from shelf and destroyed Expired drugs could be harmful Pharmacists have medications incinerated DEA sponsors annual National Take-Back Initiative (See Procedure 35-1: Proper Disposal of Drugs)

Drug Regulations and Legal Classifications of Drugs Administer, prescribe, dispense Prescribe: licensed practitioner gives written order to be taken to pharmacist to be filled Dispense: provide medication as ordered by provider to patient Administer: give to patient by mouth or injection or other method

Drug References and Standards U.S. Pharmacopeia/National Formulary List drugs for which standards have been established Compendium of Drug Therapy Desk Reference for Nonprescription Drugs Physician’s Desk Reference (PDR) Each medication described using manufacturer’s package insert

Drug References and Standards How to use the PDR Brand name and generic name index, section 2 Classification or category, section 3 Product identification guide, section 4 Product information and alphabetical arrangement by manufacturers, section 5

Drug References and Standards Other reference sources Refer to another drug reference book Research medications online; make sure source reliable Ask pharmacist about drug Refer to packet insert that comes in drug package

Classification of Drugs Drugs used to treat or prevent disease Drugs that have principal action on body Drugs that act on specific body systems or organs Drug preparation (See Table 35-1: Common Classifications of Drugs and Their Actions)

Principal Actions of Drugs Act directly on one or more tissues of body Act on microorganisms Replace body chemicals Local action Remote action Systemic action Synergistic action

Principal Actions of Drugs Factors that affect drug action Absorption Distribution Biotransformation Elimination

Principal Actions of Drugs Undesirable actions of drugs Side effect Drug interaction Adverse reactions

Drug Routes Route of administration determined by: Action of medication on body Physical and emotional state of patient Characteristics of drug

Drug Routes Oral Parenteral Direct application to skin Sublingual Buccal Rectal Vaginal Inhalation Instillation

Forms of Drugs Liquids, solids, and semisolids Tablets and capsules >> [FIGURE 35-6A and FIGURE 35-6B and FIGURE 35-6C and FIGURE 35-6D]

Forms of Drugs Other drug delivery systems Transdermal system Inhalation medications Eye-curing lens Implantable devices

Storage and Handling of Medications Goal: store in original containers in separate room in locked cabinet Darkness Refrigeration Glass containers Consult drug label for storage Organization of storage area

Storage and Handling of Medications Please refer to the video library on the Instructor Resources CD to view video “Medical Assistant’s Role in Drug Orders.”

Emergency Medications and Supplies Tray, box, cabinet, crash cart Emergency drugs Emergency supplies and equipment (See Table 35-2: Examples of Common Emergency Drugs)

Emergency Medications and Supplies Bioterrorism Use of biologic weapons (pathogenic microorganisms) Most diseases treated with pharmaceutical agents (antibiotics and antitoxoids) Dangerous disease threats: anthrax, botulism, pneumonic/bubonic plague, smallpox, tularemia

Drug Abuse Recognizing symptoms of drug abuse Drug abuse programs Examples of drug types commonly abused Effects of drug abuse Prevention programs (See Table 35-3: Drugs of Abuse—Uses and Effects)