1. 1 Week 1: Seminar Overview, Basic Concepts

2. Welcome to Pharmacology! Jenny Hayes, PA-C Rosalind Franklin School of Health Sciences, North Chicago, Il Certified Physician Assistant in WI I look forward to getting to know you all through our DiscussionBoards! Some background on myself:

3. Seminar Reminders We begin promptly at 9 pm EST  On Monday evenings  Class is one hour (10-11 pm EST) Please do not announce yourself or apologize if:  you arrive late  you get bumped out due to technical issues

4. Seminar Reminders Be open to new thoughts and ideas There is no such thing as a stupid question... please ask! Type a “?” if you have a question Alternative Seminar Assignments (Seminar Option 2)  due Tuesday 11:59 pm EST of assigned unit

5. Seminar Reminders Intended to be an informed discussion to reinforce material. Active learning is expected. Ask questions and provide comments at any time. (remember the ?) Polls/quizzes/virtual field trips 5

6. Plagerism Policy Plagerism is the use of another person’s words without citing them Taken very seriously by Kaplan Please use your own words and ideas for assignments, DQ board posts. Thank You! 6

7. Course Polices and Procedures Syllabus Announcements Week opens on Wednesdays, assignments due Tuesdays 11:59pm May use ebook (first 3 chapters in Docshare) until receive your own book 7

8. Course Policies and Procedures Discussion Board Post your initial response by Saturday Post responses to your classmates by Tuesday 11:59 pm EST Try to post early in the week 2 responses are required Grading  See Rubric for details in syllabus  Prefer posting on more than 1 day

9. Course Policies and Procedures Projects and Assignments Label your work properly... place your name within the assignment’s file-name, as seen in this example from “John Doe” and his “Unit-3 Calculations” assignment:  Doe_Calculations_Unit3

10. Course Policies and Procedures Projects and Assignments TITLE your work properly... Title example. This is how your Title would appear at the top of your assignment which is being submitted as a Word-document (John Doe again): Week 5 Calculations Assignment John Doe Kaplan University

11. Late Policy: Late work will not be accepted unless there are clear and compelling extenuating circumstances. If you have extenuating circumstances that prevent you from completing course assignments/exams you must contact your instructor immediately—prior to the assignment/exam/quiz due-date unless prevented from doing so by emergency circumstances. Examples of extenuating circumstances are serious personal and/or family illness/hospitalization, death in the family, weather-related evacuation/emergencies, work emergencies, and issues related to active military assignment. Personal computer/software/internet connectivity issues and course blocks are not considered extenuating circumstances. Granting of late-work submission due to extenuating circumstances is at the discretion of the instructor and will require documentation for verification of extenuating circumstances. If late work submission is granted, the instructor will establish new due-dates and requirements without loss of course points. 11

12. Course Policies and Procedures References Must be reputable Must be sited  Take the Plagiarism Policy very seriously!  Any drug-information you turn in that you had to look up... Must be referenced using APA format Unsure how to reference?  Seek help by going to the ‘Writing Center’

13. Course Policies and Procedures References Books - must be current... Published within the last 2 years Websites – these are very useful...  www.rx.com www.rx.com  www.drugs.com  www.webmd.com www.webmd.com  manufacturer’s website when information about a specific brand name drug product is needed, (for example... go to Lilly.com for detailed info on Prozac)

14. Pharmacology Pharmacology course: not for memorization, know resources, find them and have general knowledge. Question: how will this class be helpful in your field? 14

15. What is a Drug? A chemical that alters normal bodily function Why do we prescribe a drug? Page 38-39  Choose an indication  Give me an example of a drug for that indication.

16. Drug Indications  Therapeutic- relieve symptoms  Diagnostic  Replacement  Supplemental- prevent deficiencies  Preventative/Prophylactic  Curative  Maintenance- goal is ‘homeostasis’  Supportive 16

17. Drug components Q: What are the three components of a drug? 17

18. Drug Components Active ingredient  pure, undiluted form of chemical having an effect on body function Inert ingredient  little or no effect on body function  adds flavor, bulk, color Vehicle  inactive agent carrying an active medicinal ingredient (example to cross blood-brain barrier, need a fat-loving molecule or glucose)

19. Pharmacokinetics: How the body processes drugs Q: What are the 4 processes of PK? 19

20. Pharmacokinetics: How the Body Processes Drugs Involves four processes (A-D-M-E):  Absorption—movement of a drug from its administration site into the blood  Distribution—movement of a drug from the blood into tissues and cells  Metabolism—physical and chemical alteration of a drug in the body  Excretion—removal of waste products from the body

21. Questions: What are some factors that will affect absorption? What are 2 factors that influence drug distribution? What is the first-pass effect? How can it be avoided? What organs are involved in excretion? 21

22. Physical Properties and Absorption Rates Solubility—tendency of a drug to dissolve pH—acidic drugs are easily absorbed in the stomach Absence or presence of food in stomach— food slows absorption rate Fat solubility—medications high in fat are easily absorbed in the stomach

23. Length of Contact Topical drugs’ absorption depends on:  Length of time in contact with skin  Skin thickness  Composition/medium-ointment, cream, lotion Topical medications can be dangerous in elderly patients, because their skin may be so thin that absorption is greater than desired.

24. Distribution = ‘D’ Drug is delivered to tissues through blood vessels and capillaries. Drug’s effect takes place in tissues, not blood vessels. Modified from Leahy, JM, Kizilay, PE (1998). Foundations of nursing practice. Philadelphia: Saunders.

25. Drug Blood Level Amount of drug circulating in bloodstream Physicians monitor blood levels with therapeutic drug level test

26. Metabolism (Biotransformation)= ‘M’ Series of chemical reactions altering a drug by converting it into a water-soluble compound for excretion Modified from Leahy, JM, Kizilay, PE (1998). Foundations of nursing practice. Philadelphia: Saunders.

27. Excretion (Elimination) = ‘E’ May occur through... respiration, perspiration, urination, and/or defecation Modified from Leahy, JM, Kizilay, PE (1998). Foundations of nursing practice. Philadelphia: Saunders.

28. What is the difference between an adverse reaction, and an allergic reaction? (see page 40) 28

29. Effects of Drugs Desired effect—intended response to a medication, for example... –Amoxil (an antibiotic) clears up Kyle’s strep throat. Side effect—mild, undesirable response to a medication, for example... –Amoxil causes Kyle to become slightly nauseated

30. Unwanted Effects of Drugs Adverse reaction—unintended, undesirable, often unpredictable effects causing unwanted symptoms, for example... – Amoxil causes Kyle to have recurring episodes of diarrhea. Allergic reaction—”hypersensitivity” to a drug, often after just one dose, for example... –Amoxil causes Kyle to break out in a rash.

31. Oral preparations Capsule: compressed powder, or liquid in a coating Tablet: single dose, compressed powder  SL, enteric-coated, sustained release 31

32. Critical thinking exercise Page 63 32

33. Drug Nomenclature (naming) Chemical name-based on molecular-structure  Ex: 2-(4-isobutlyphenyl)propionic acid Generic/nonproprietary name - always in lowercase, easier than chemical name  Ex: ibuprofen Trade/Brand/proprietary name - owned by the original manufacturer, who holds the Patent rights for 20yrs after FDA approval(given a registered trademark ®)  Ex: Motrin®, Advil®

34. Tablets —Dried Compressed Powder Unscored Scored (for division) Layered (to allow incompatible drugs to be given in one medication)

35. Enteric-Coated Tablets Special coating to allow drug to dissolve in intestines rather than stomach Prevent inflammation of gastric mucosa Always swallowed whole Example: enteric-coated aspirin(EC-ASA)

36. Various Tablet Forms Chewable—Sugared or flavored (antacids, antiflatulents, children’s medications) Sublingual(SL)—dissolve under tongue for rapid absorption, - ex: nitroglycerin tabs Buccal—place between cheek and gum *** Instruct patients taking SL or buccal tablets... Do NOT: 1. take with H 2 O – too quickly absorbed 2. Chew or Swallow tablet – not as effective

37. Capsules Small, cylindrical gelatin containers Two pieces fit together Used when medication has unpleasant taste, odor Can pull apart and add to food

38. Sustained-Release Capsules Medication released over period of time Tiny beads designed for release or disintegration at different times Swallow whole Also called time-release or delayed-action Never open— overdose may occur due to altered absorption rates

39. Gelcaps Soft gelatin shells made in one piece Hold a liquid form of medication Do not chew!—medicine often tastes unpleasant Can squeeze into oral cavity, following physician’s advice May stick to inside of mouth if mouth is dry

40. Troche or Lozenge Hard medications (flat tablet or ‘disc’) Candy or fruit base Dissolve in mouth for local effect Examples: cough drops, sore throat lozenges

41. Liquid Oral Preparations Active ingredients in liquid medium Two major categories –Solutions—active ingredient dissolved in liquid –Suspensions—medication particles suspended in liquid (Shake Well!)

42. cont. -- Liquid Preparations Syrups—water based, sweetened with sugar or sugar substitutes Elixirs—contain sweetener, alcohol, and water –use with caution in diabetics and patients taking Antabuse (Disulfarim reaction) Extracts—highly concentrated preparation achieved through evaporation of a solution

43. Percutaneous Medications Lotions—free-flowing liquids or suspensions in water base –treat skin conditions (calamine lotion) Creams—semisolids in water base –corticosteroid cream Ointments—semisolids in oil base –triple antibiotic ointment

44. 44 Questions