chapter 18,19 basic pharmacology quiz/

Pharmacology
* the study of drugs and their interactions with living organisms
* the study of drug sources, chemical makeup. Preparation and uses of drugs.

pharmacology comes from
the Greek word pharmakon, meaning medicine and the suffix -ology means the study of .

drug
can be any substance, that when administered to a person, produces a change in function.
We commonly mean any MEDICATION that is used for treating disease. ( Key and Lock)

Pharmacodynamics
How drugs produce their effect( actions of drug on the body)

Pharmacokinetics
studies the process of drug absorption, distribution, metabolism and excretion. Based on time and dosage (actions of the body on the drug)

Pharmacotherapeutics
studies the use of drugs in treating disease

Pharmacy
science of preparing and dispensing medicines

Toxicology
study of toxic or poisonous effects of drugs

Clinical Pharmacology
biologic effect a drug has on a patient when used as medicinal treatment. Covers action of a drug over a period of time

medicina
The Latin word for drug is _____ from which we derive medicine

the origins of the three terms pharmacology, medicine, and drugs
Greek, Latin, and Dutch

Medical uses for drugs
* Prevention – vaccines
* Treatment – aspirin, antihistamines
* Diagnose – barium, radiopaque dyes
* Cure – antibiotics
* Maintenance – insulin, vitamins, blood pressure
* Birth Control – (contraception) prevent pregnancy
* Substances body isn’t producing – insulin, Thyroxine

Pharmacology is one of the oldest branches of medicine dating back to the
Egyptians and Sumerians in 2000 B.C.

Drug Sources
Plants
Animals
Mineral
Chemical

Plant drug source
Roots, leaves, seeds
Ex: Purple foxglove – Digitalis – used to tx heart conditions

Animals drug source
Hormones
Ex: Insulin from pigs.
Heparin (anticoagulant) – intestinal lining of pigs and cattle

Minerals drug source
Rocks & crystals
Ex: Iron, Iodine, Calcium & Salt (sodium chloride)

Chemical drug source
Biogenetic – man-made, from a chemist lab

The Food and Drug Act of 1906
• First federal drug law.
• Required accurate labeling
• Passed to protect the public from patent meds.
• Burden of proof still on the government.
• Did not need any approval to market & sell drugs

The Harrison Narcotics Act of 1914
• Identified drugs with potential for abuse and dependence
• Established legal framework for drug control
• Introduced the term narcotic

Food, Drug and Cosmetic Act of 1938
• Result of tragedy – Elixir of Sulfonamide: poisoned over 350 people and many children died. Caused update of 1906 Law
• Food & Drug Administration ( FDA) – to review and evaluate safety of drugs
• Manufactures needed approval
• Burden of proof shifted to drug companies

Durham-Humphrey Amendment – 1951
• Amended 1938 Act
• Defined prescription drugs (legend drugs)
o Drugs that could only be given to patients under the
care of physicians
o Drugs require monitoring by physician to be taken
safely

Kefauver-Harris Amendment – 1962
• Result of thalidomide use in pregnancy for morning sickness – caused limb deformities
• Tightened control on existing drugs & new drugs
• Required manufactures to report adverse side effects from new drugs

The Comprehensive Drug Abuse Prevention & Control Act / The controlled substance Act 1970
• Replaced Harrison Narcotic Act
• DEA was formed : Drug Enforcement Agency
o DEA monitors manufacturing & dispensing of
controlled substances
• Developed five categories / scheduled for controlled substances according to potential for addiction / abuse
• Known as schedule drugs or controlled substances

Orphan Drug Act – 1983 (because of Aids)
• Allow facilitation of new drugs to treat rare disease
• Simplifying process of obtaining FDA approval
• Gives exclusive marketing rights for 7 years
• Incentive credits

Food Allergen Labeling & Consumer Protection Act of 2004
Requires labeling a food if it contains a protein from common allergy-causing foods, such as peanuts, soybeans, cow’s milk, eggs, fish, crustacean shellfish, nuts, and wheat.
Enforcement agency, FDA

Patriot Improvement & Re-authorization Act of 2005 (Combat Meth Act)
Restricts the sale of OTC products containing pseudoephedrine and ephedrine. Makes these products available only by purchase through a pharmacy.
Enforcement agency, congress

Controlled Substances
potentially dangerous or habit-forming drugs whose sale and use are strictly regulated by law
Enforcement agency, DEA
*Has 5 schedules – some states have 6 schedules

Drug classifications
classified according to potential for abuse

Schedule I
High potential for abuse – No currently accepted medical use – illegal drugs
• PCP
• Heroin
• LSD
• MARIJUANA
• CRACK

Schedule II
High potential for abuse – Current medical use
• Requires WRITTEN prescription – NO REFILLS
• Severe physical & psychological dependence may result
• Percodan
• Demerol
• Morphine
• Dilaudid
• Cocaine
• Methadone

Schedule III
Moderate potential for abuse – current medical uses
• Can be ordered orally – called into pharmacy. May have 5 refills in 6 months.
• Moderate physical & psychological dependence may result
• Tylenol with Codeine
• Vicodin
• OxyContin
• Lortab

Schedule IV
Less potential for abuse than schedule III – current medical uses
• Can be ordered orally – called into pharmacy. May have 5 refills in 6 months.
• Limited to moderate physical & psychological dependence may result
• Darvon
• Librium
• Valium
• Ambien
• Ativan

Schedule V
Limited potential for abuse – current medical uses
• Lomotil
• Cough syrups with codeine
• Phenergan

In order to prescribe controlled substances
MUST register with DEA and receive DEA certificate number. Some states require registration with state agency as well as at the federal level. Includes:
• Physicians
• Dentists
• Chiropractors
• Podiatrists
• Nurse Practitioners
• Physician Assistants
• Any other healthcare providers that sate licenses allows prescribing of controlled substances

Security & Packaging of controlled substances
• Label & Packaging must show assigned schedule
• Stored separately from other drugs
• Must be kept locked
• Access restricted
• Log for each drug to include wasted drugs / not administered, but disposed – witnessed

OTC Drugs
• Regulated by FDA
• Assisted by OTC Drugs Advisory Committee – established in 1992
• Can be purchased without prescription
• Considered safe used if directions are properly followed
• Prior to 1983 was clear distinction between Rx and OTC drugs
• Many Rx drugs reclassified as OTC drugs
o If indication is similar to use as Rx drug
o Low rate of side effects / toxicity
o Low potential for abuse
o Does not require any special monitoring
o May be half the dose as Rx strength

DRUG NAMES
• Chemical name
• Generic name
• Brand name

Chemical name
*very lengthy
*describes the chemical composition and molecular structure of the drug

Generic name
*typically shorted version of chemical name*the official nonproprietary name assigned by the manufacturer with the approval of the United States Adopted Names (USAN) Council

Brand name
*Name drug company give drug.
*This is registered with the U.S. Patent Office as a registered trade mark

Official name
usually generic name – How drug is listed in National Pharmacopia Forumulary

SPELLING OF DRUG NAMES
• Some generic drugs reflect chemical structure / classification
• Can indicate disease process to be treated
• Part of body being treated
• Simplify generic name while retaining phonetic sound
• Source of Drug
• Action of Drug
• How often drug is to be taken
• Indicate duration of drug action
• Indicate strength of drug
• Indicate amount of active ingredients
• Reflect name of drug manufacture

ORGINS OF NEW DRUGS
Discovered in two ways:
1. Totally new chemical substance in environment
2. New chemical derived from molecular manipulation of a chemical already in use.

Researchers are always looking in environment for
basis of new drugs

Some areas for new drug research:
• Soil
• Fungal growths
• Cephalosporin – first isolated near a sewer outlet in Sardina
• Streptomycin – isolated from the stomach of chicken

TESTING OF NEW DRUGS
FDA required drug manufactures to follow guidelines to determine safety & effectiveness
• In Vitro – Latin term for in glass – chemical analysis of drug performed in test tubes
• In Vivo – Latin term for in the living – testing in animals and humans
• Therapeutic Index – margin of safety of dose
• Therapeutic Effect – dosage that produces therapeutic effect – reason drug was prescribed
• Toxic Effect – level of dosage that is determined to be toxic. Can be different between animals and humans

Phases of Testing:
• Animal Phase
• Clinical Trials
o PHASE I
o PHASE II – Experimental
o PHASE III – Double Blind Studies

Animal Phase
precedes human testing

Clinical Trials
testing in humans – Has 3 phases
o PHASE I
o PHASE II – Experimental
o PHASE III – Double Blind Studies

Clinical Trial Phase I
Healthy volunteers
Safe dose range
Side effects
Correct dosage identified
Absorption, metabolism and excretion monitored
Volunteers are monitored
Takes about 1 ½ years

Clinical Trial Phase II
Given to people who have disease drug is to treat
Patients are monitored
Takes about 2 years

Clinical Trial Phase III
Drug studies – often performed in physician’s offices
Given to patients with disease to be treated
Monitored
Performance compared to drugs currently on market
Placebo as well as drug is used
Patients nor physician knows who is actually receiving the drug or placebo
Typically lasts 3 ½ years

Once phase III is complete submission of all documentation on drug is given to FDA for approval of drug. Must include:
•Drug Name
•All label information
•Dosage
•Side effects
•Risks & benefits
•How drug is to be packaged
•Ingredients

Once drug is approved
none of the below can be changed without company submitting new drug application.
•Drug Name
•All label information
•Dosage
•Side effects
•Risks & benefits
•How drug is to be packaged
•Ingredients

DRUG PATENTS
Drug company protected with a 17 year patent on any new drug they develop that is approved by FDA. However part of the 17 years occurs during testing prior to FDA approval.

When the patent expires
any other company may manufacture that drug under the general name or new trade name.

DRUG MANUFACTUREING & QUALITY
•Monitored by FDA
•Generic drugs dosage must contain the same amount of active ingredients as trade name
•Inert Ingredients
•Bioavailability

Bioavailability
can be crucial in drugs with low margin of safety. Some inert ingredients can affect bioavailability of certain drugs.

GENERIC DRUG SUBSTITUTION
• Most states have state Law
• Pharmacists are permitted or MUST substitute a
generic drug for trade name UNLESS
o Physician indicated either “no substitution”
or “dispense as written”

DRUG RECALLS
Performed by FDA for different types of manufacturing defects
• Drug does not remain stable for whole time preceding
expiration date
• Contaminated with particulate matter from
manufacturing process
• Does not contain correct amount of active ingredient
• Causes serious side effects / deaths not revealed
during testing process
• Manufacture MUST notify physicians, pharmacies and
hospitals of recall
o Disposal of drug is responsibility of those notified of
recall
o Many drug manufactures and/or FDA use media (TV,
RADIO, NEWSPAPER) to inform public of recalls

MARKETING & DRUG COSTS
• Totally new marketing approach today – as seen on TV commercials
• Extensive consumer approach
• Insurance companies complains – marketing drives cost of drugs
• Company can charge any price for brand name
• New marketing approach leads consumers looking for “new drugs” when perhaps older drugs are just as effective and cost less

How many drug schedules are there?
5

How many phases of clinical trials are there?
3

endogenous
substances made in the body

exogenous
substances made outside the body

xenobiotics
are exogenous drugs

agonist
is any drug that binds to a receptor and activates a receptor.

specificity
whether agonist or antagonist that must be specific size, ionic charge, and shape to interact with a given receptor

absorbed
a drug must be able to be delivered to site of action

Delivery
a drug must be delivered to site of action

elimimation
drug must be able to be eliminated

“ADME”
Absorption,Delivery, Metabolism, Elimination

PH
Measure of akilinity <7 measure of acidity >7

Affinity
How tightly the receptor binds to the drug

EC/ED 50
half the maximum effect

Potency
the concentration of a drug. dilaudid has more potency then morphine smaller dose to equal more effect

Efficacy
Refers to the effect of the drug more drug more efficacious- morphine stronger

Quantal Dose effect curve
the effect is either achieved or not achieved. either light switch is on or off unlike a dimmer switch.Like a drug used to stop seizure or not no in between.

Pharmacology Study of the biological effects of chemicals Pharmacotherapeutics Branch of pharmacology that deals with drugs (clinical pharmacology) WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample Preclinical Drug Trials …

pharmacodynamics study of the mechanism of drugs pharmacokinetics study of the factors that affect the time course of drug events WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample what …

adverse effect drug effects that are not the desired therapeutic effects; may be unpleasanr or even dangerous brand name name given to a drug by the pharmaceutical company that developed it; also called trade name WE WILL WRITE A CUSTOM …

What is pharmacology ? The broad scince of the orgin, mature, chemistry, effects and uses of drugs What is clinical pharmacology? The study of the biological effects of a drug used in a medical treatment and the actions of a …

By what name would a client most easily identify a OTC drug that is equivalent to that of a prescription? by the drugs generic name. If a nurse would like to understand the mechanism of action for a specific drug, …

The branch of pharmacology that uses drugs to treat, prevent, and diagnose disease. Pharmacotherapeutics (Clinical Pharm.) Name given to the drug by the manufacturer. Brand Name WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR …

David from Healtheappointments:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out https://goo.gl/chNgQy