1. 11/15/2015 1 Pharmacology

2. 11/15/2015 2 Today’s topics…. What is pharmacology? Drug nomenclature & classification Pharmcokinetics Pharmcodynamics Effects of medications Sources of drug information Antiinflammatories & analgesics Adrenal steroids

3. 11/15/2015 3 What is pharmacology? The science of drugs Why does the athletic trainer need a working knowledge of pharmacology?

4. 11/15/2015 4 Nomenclature & Classification Chemical, generic or trade name Over-the-counter (OTC) Prescription drugs - controlled substances

5. 11/15/2015 5 Pharmacokinetics Pharmaco – Kinetics- How drugs are administered Absorbs, distributes, metabolizes, and eliminates

6. 11/15/2015 6 How drugs are administered? Enteral – digestive system Nonenteral (parenteral) – other pathway

7. 11/15/2015 7 Drug absorption & distribution Definition Diffusion or transport Distributed by circulatory system

8. 11/15/2015 8 Metabolism & excretion Making substances water soluble for excretion in bile or urine Role of the liver

9. 11/15/2015 9 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

10. 11/15/2015 10 Pharmacodynamics… Efficacy – Potency – measure of dose needed to produce a specific effect Tolerance – body built up resistance to drug (increased amounts now needed)

11. 11/15/2015 11 Ill Effects…. Side effect – Allergic & anaphylactic reaction – Drug interaction -

12. 11/15/2015 12 Sources of drug information PDR – NCAA USOC Product information

13. 11/15/2015 13 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

14. 11/15/2015 14 NSAID’s Inhibit inflammatory response Questionable timing of use Side effects GI irritation Renal disorders Reye syndrome Aspirin overdose, intolerance or hypersensitivity

15. 11/15/2015 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

16. 11/15/2015 16 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

17. 11/15/2015 17 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

18. 11/15/2015 18 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)

19. 11/15/2015 19 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

20. 11/15/2015 20 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??

21. 11/15/2015 21 Muscle relaxants Sedation: opioid or non-opioid Side effects: interfere with ADLs Drowsiness, dizziness, vision…..

22. 11/15/2015 22 Non-orthopedic medicines Cough & cold “stuff” Bronchodilators Antibiotics Antifungals Laxatives – antidiarrheals Antiemetics Antacids

23. 11/15/2015 23 Next time….. Psychology of injury….