11/15/ Pharmacology

11/15/ Today’s topics…. What is pharmacology? Drug nomenclature & classification Pharmcokinetics Pharmcodynamics Effects of medications Sources of drug information Antiinflammatories & analgesics Adrenal steroids

11/15/ What is pharmacology? The science of drugs Why does the athletic trainer need a working knowledge of pharmacology?

11/15/ Nomenclature & Classification Chemical, generic or trade name Over-the-counter (OTC) Prescription drugs - controlled substances

11/15/ Pharmacokinetics Pharmaco – Kinetics- How drugs are administered Absorbs, distributes, metabolizes, and eliminates

11/15/ How drugs are administered? Enteral – digestive system Nonenteral (parenteral) – other pathway

11/15/ Drug absorption & distribution Definition Diffusion or transport Distributed by circulatory system

11/15/ Metabolism & excretion Making substances water soluble for excretion in bile or urine Role of the liver

11/15/ Pharmacodynamics What effect a drug has on the body How it produces that effect Bind to specific target receptors on cell’s exterior, triggering cellular process Agonists versus antagonists

11/15/ Pharmacodynamics… Efficacy – Potency – measure of dose needed to produce a specific effect Tolerance – body built up resistance to drug (increased amounts now needed)

11/15/ Ill Effects…. Side effect – Allergic & anaphylactic reaction – Drug interaction -

11/15/ Sources of drug information PDR – NCAA USOC Product information

11/15/ Inflammation & drug treatment Inflammation: vascular response Response limits spread of injury-causing agents into adjacent tissues Dispose of cellular debris Sets stage for repair process to begin

11/15/ NSAID’s Inhibit inflammatory response Questionable timing of use Side effects GI irritation Renal disorders Reye syndrome Aspirin overdose, intolerance or hypersensitivity

11/15/ Classes of NSAID’s Grouped according to chemical similarities Few clinical differences Trial & error…?? Acetic acids: indomethacin Enolic acids: phenylbutazon Fenamic acids: meclofenamic Proprionic acids: ibuprofen, naproxen Carboxylic acids: aspirin, salicylate

11/15/ Steroid compounds Glucocorticoids (corticosteroids) Excellent anti-inflammatory action – Reduction of tissue heat, erythema, control swelling, decrease local tenderness Side effects: – Tendon rupture Types: cortisone, hydrocortisone, prednisone, dexamethasone

11/15/ Pain & Analgesics Acute, chronic or iatrogenic ALWAYS 1° treatment goal Pain = signal…masking???? Meds: OTC controlled substances Relationship of NSAIDs and analgesics Non-narcotic and narcotic

11/15/ Non-narcotic pain relievers Salicylates, ibuprofen, acetominophen – Aspirin: fever reducing (antipyretic) also Buffered products Side effects – Ibuprofen: analgesic effect 2-4 hrs? – Acetominophen: analgesic only, safe w/children Can supplement with narcotic agent (codeine)

11/15/ Narcotic pain relievers Limited use for sport injuries Severe pain following surgery Opioids: physical and psychological addiction – Bind w/CNS to interrupt pain transmission – Exogenous: morphine, codeine, heroin – Some (endogenous)are produced in the body Endorphins, enkephalins, dynorphins Side effects: drowsiness, dizziness, blurred vision, nausea, vomiting, constipation

11/15/ Anesthetics & muscle relaxants Surgical use and anti-spasmolytics Surgical anesthesia is technical due to potential C-V effects Local anesthetics: block nerves in area Topical anesthetics?? Epidural injections??

11/15/ Muscle relaxants Sedation: opioid or non-opioid Side effects: interfere with ADLs Drowsiness, dizziness, vision…..

11/15/ Non-orthopedic medicines Cough & cold “stuff” Bronchodilators Antibiotics Antifungals Laxatives – antidiarrheals Antiemetics Antacids

11/15/ Next time….. Psychology of injury….