Pharmacology text, chapter 1 to 5

1906 Pure Food and Drug Act
all foods and drugs had to meet a standard of strength and purity
1938 Federal Food, Drug, and Cosmetic Act
required manufacturers to furnish Food and Drug Administration (FDA) with proof of the drug’s safety in humans for all drugs entering interstate commerce and to submit a new drug application for approval by FDA.
1970 Controlled Substances Act
Classifies 5 levels of drugs (controlled substances) that have potential for abuse and restricts their distribution. Establishes the DEA, under the Justice Department, to enforce its regulations.
FDA
Food and Drug Administration. The agency that is responsible for determining if a food or drug is safe and effective enough to be sold to the public.
DEA
federal agency responsible for enforcing laws and regulations governing narcotics and controlled substances.
The first major US drug law was passed in the year?
1906
USP stands for?
United States Pharmacopeia.
NF stands for?
National Formulary
Which drug law established the USP and NF?
Pure Food and Drug Act.
The agency that requires you to keep a record of each controlled substance transaction is the?
DEA
Prescription for schedule C- ——————drugs may be phoned in by the health care practitioner.
four, IV.
How long must you keep an inventory record of each controlled substance transaction at your office?
2 years.
Three responsabilities of the FDA include:
Overseeing testing of all proposed new drugs.
Inspecting plants where foods, drugs, medical devices.
Reviewing new drug – Investigating and removing.
What types of drugs are listed in the C-V schedule?
Promethazine with codeine, low abuse potential.
What method is recommended for securing the controlled substances at your office?
Keep a current drug reference book available all the times.
If a patient calls to request a refill of a Percocet (C-II) prescription, how would you reply?
need to see the doctor and nedd a written prescription only.
Pharmacology
The study of drugs and their origin, nature, properties, and effects on living organisms.
Classifications
A system of organization that puts things into groups. Subcategory or subcategories.
Prototype
the most representative model example of a category.
Generic name
Common or general name assigned to the drug by USAN council; differentiated from the name by initial lowercase letter; never capitalized.
Trade Name
The name by which a pharmaceutical company identifies its product; is copyrighted and used exclusively by that company; can be distinguished from the generic name by capitalized first letter and is often shown on labels and references with the symbol after the name ( for “registered” Trademark).
Chemical Name
The name that describes the chemical composition and the exact molecular formula, structure of a drug.
Official Name
the name under which a drug is listed in one of the official publications (e.g., the United States Pharmacopeia- USP or NF)generally the same as the generic name.
OTC
Over-the-counter; no purchasing restrictions by FDA.
Legend drug
Prescription drug; determined unsafe for over-the-counter purchase because of possible harmful side effects if taken indiscriminately; includes birth control pills, antibiotics,cardiac drugs, and hormones.
Controlled substance
Drug controlled by prescription requirement because of the danger of addiction or abuse; indicated in references by schedule numbers C-I to C-V.
Indications
A LIST OF MEDICAL CONDITIONS OR DISEASES FOR WHICH THE DRUG IS MEANT TO BE USED.
Actions
A description of the cellular changes that occur as a result of the drug.
Contraindications
A list of conditions for which the drug should not be given.
Cautions
A list of conditions or types of patients that warrant closer observation for specific side effects when given the drug.
Side effects and adverse reactions
list of possible unpleasant or dangerous secondary effects other than the desires effect.
Interactions
a list of drugs or foods which may later alter the drug’s affect.
Ototoxicity
Referring to the characteristic of any drug or substance that has a harmful effect on the eighth cranial nerve or the organs of hearing and balance.
Nephrotoxicity
damage to kidneys,resulting in impaired kidney fuction, decreased urinary output, and renal failure.
Photosensitivity
increased reaction to sunlight with danger of sunburn, adverse reaction to certain drugs.
The Physicians’ Desk Reference(PDR)
is one of the most widely used references for drugs in current use.
Sources of drugs
used on the human body; Plants, Minerals, Animals, Synthetic, DNA.
Chemoinformatics
is the application of computer technology, statistics, and mathematics to study info. about the structure, properties, and activities of molecules.
Systemic effect
Reaches widespread areas of the body acetominophen,(Tylenol) suppository, although given rectally, has the ability to be absorbed and distributed throughout the body to cause a general reduction in fever and pain.
Local effect
Is limited to the area of the body where it is administered, (ex. dibucaine ointment [Nuphercainal], applied rectally, affects only the rectal mucosa to reduce hemorrhoidal pain).
Absorption
passage of substances through membranes and into the bloodstream.
Distribution
Moving from the bloodstream into the the tissues and fluids of the body.
Metabolism
Physical and chemical alterations that a substance undergoes in the body. Liver
PH
Drugs of a slightly acidic nature(ex. aspirin and tetracycline) are absorbed well within the acidic stomack enviroment.
Lipid (fat) solubility
Substances high in lipid solubility are quickly and easily absorbed through the mucosa of the stomack.
Presence or absence of food in the stomack:
Food in the stomack tends to slow absorption due to a slower emptying of the stomack.
Selective distribution
refers to an affinity, or attraction, of a drug to a specific organ or cells.
Biotransformation
a drug is broken down and altered to more water-soluble by-products (metabolites).
Cummulative effect
is an increased effect of a drug demonstrated when repeated doses accumulate in the body.
Toxicity
refers to a condition that results from exposure to either a poison or a dangerous amount of a drug that is normally safe when givenin a smaller amount.
Variables
affect the speed and efficiency of drugs being processed by the body. Age, weigh, gender, phychological state.
Placebo
is an inactive substance that resembles a medication, although no drug is present.
Synergism
The action of two drugs working together in which one helps the other simultaneously for an effect that neither could produce alone.
Potentiation
The action of two drug in which one prolongs or multiplies the effect of the other.
Antagonism
The opposing action of two drugs in which one decreases or cancels out the effect of the other.
Desirable Synergism
involves giving small amounts of two drugs for more effectiveness.
Undesirable synergism
Sedatives and barbiturates given in combination can depress the central nervous system to dangerous levels.
Desirable potentiation
To build up a high level of some forms of penicillin in the blood, the drug probenecid can be given simutaneously with tofranil.
Undesirable potentiation
Toxic effect may result when cimetidine is given simutaneously with tofranil.
Desirable antagonism
A narcotic antagonist saves lives from drug overdoses by canceling out the effect of narcotics.
Undesirable antagonism
Antacids taken at the same time as tetracyclinefter the PH and prevent absorption of tetracycline.
Minimun dose
Smallest amount of a drug that will produce a therapeutic effect.
Maximum dose
largest amount of a drug that will produce a desired effect without producing symptoms of toxicity.
Loading dose
Initial high dose ( often maximun dose ) used to quickly elevate the level of the drug in the blood ( often followed by a series of lower maintenance doses).
Maintenance dose
dose required to keep the drug blood level at a steady state in order to maintain the desired effect.
Lethal dose
dose that causes death.
Therapeutic dose
dose that is customarily given (average adult dose based on body weight of 150 lb); adjusted according to the variations from the norm.
Routes of administration
1. Enteral or GI tract routes
a. Oral (PO) b. Nasogastric tube (NG) c. Rectal (R)
2. Parenteral routes, which include any other than the gastrointestinal tract.
a. Sublingual (SL) (under the tongue)or buccal (cheek:absorbed through mucosa, not swallowed) (noted: some classify SL and buccal as oral routes)
b. Injection routes
i. Intravenous (IV) ii. Intramuscular (IM) iii. Subcutaneous (subcu) iv. Intradermal (ID) v. Intracardiac,Intraspinal,Intarventricular, Intracapsular
c. Topical (T)
i. Dermal (D) ii. Mucosal iii.Transdermal(skin patches that allow the drug to be slowly absorbed systenically.)
d. Inhalation.
Teratogenic effect
EFFECT OF A DRUG ADMINISTERED TO THE MOTHER THAT RESULTS IN ABNORMALITIES IN THE FETUS.
Idiosyncracy
Unique,unusual, and unexpected response to a drug.
Paradoxial
Opposite effect from that expected.
Tolerance
Decreased response to a drug that develops after repeated doses are given.
Dependence
being abnormally tolerant to and dependent on something that is psychologically or physically habit-forming (especially alcohol or narcotic drugs).
Pregnancy category A
Didn’t demonstrate a risk to fetus.
Pregnancy category B
Drug studies have not been performed in pregnant women; animal studies have not demonstrated fetal risk.
Pregnancy category C
conclusive drug studies have not yet been performed in pregnant women or animals.
Pregnancy category D
drug studies have revealed adverse risk to fetus and the benefit to risk ratio must be established before use during pregnancy.
Pregnancy category X
Drug studies have shown teratogenic effects and the drug is contraindicated during pregnancy.
Hypersensitivity
allergic reaction; occurs with allergens including insect stings, nuts, medications.
Anaphylactic reaction
a severe allergic reaction that usually occurs immediately after the administration of a drug. CPR.
Drug form
The type of preparation in which a drug is supplied.
Transdermal
entering through the dermis (skin); usually refers to a drug applied to the skin via an adhesive patch.
Parenteral
includes any other route other than the gastrointestinal tract.
Tablet
Solid dosage of a drug in disk form,variety in shape, colors, may be coated.
Enteric-coated tablet
a tablet covered in a special coating to protect it from stomach acid, allowing the drug to dissolve in the intestines.
Capsule
a pill in the form of a small rounded gelatinous container with medicine inside.
Timed-release (sustained-release) capsule
Capsule containing drug particles that have various coatings (often of different colors) that differ in the amount of time required before coatings dissolve.
Lozenge (troche)
Tablet containing palatable flavoring, indicated for local effect on throat or mouth.
Suspension
a liquid dosage form that contains solid drug particles floating in a liquid medium which are easy to compound, but physically unstable; suspensions must be shaken well before they are administered.
Emulsion
Liquid drug preparation that contains droplets of oils and fats in water.
Elixir,fluid extract
liquid medication with an alcohol base.
Syrup
Sweetened,flavored liquid drug form. Cherry syrup drug preparations are common for children.
Solution
Liquid drug form in which the drug is totally and evenly dossolved. Appearence is clear, rather than cloudy or settled.
Suppository
a small plug of medication designed for insertion into the rectum or vagina where it melts at body temperatures.
Enema solution
Drug suspended in solution to be administered as an enema.
Liquid
Drug suspended (suspension, must be shaken before given to a patient) or dissolved (solution) in a sterile vehicle.
Powder
Dry particles of drug. The powder itself cannot be injected. It must be mixed with a sterile diluting solution(sterile water or saline solution) to render an injectable solution.
Intravenous
injected into the vein. with IV
Intramuscular
injected into a muscle, 90 degree angle from the skin.
Subcutaneous
tissue below the dermis, primarily fat cells that insulate the body. a needle and syringe at a 45-degree angle from the skin.
Intradermal
injected just beneath the skin, a 15-degree angle from the skin, (0.1-0.2 ml) Tuberculin skin test.
Epidural
regional anesthesia resulting from injection of an anesthetic into the epidural space of the spinal canal.
Intraosseous
Injected of medication directly into the bone marrow of long bones.
Intraventricular
Drugs injected directly into the heart’s ventricle.
Intraspinal
Injected into the subarachnoid space, which contains cerebrospinal fluid (CSF) that surrounds the spinal cord.
Intracapsular (intra-articular)
Injected into the capsule of a joint, usually to reduce inflammation, as in bursitis.
Cream or ointment
semisolid preparation containing a drug. for external application
-creams & ointments are not the same (dose used differs for each
(if skin is wet-use cream. If skin is dry-use ointment).
Lotion
a liquid preparation applied externally for treatment of skin disorders. Unliked hand lotions,medicated lotions, not rubbed, on the affected skin.
Liniment
Preparation for external use that is rubbing on the skin in cases of bruises, inflammation, etc.
Dermal patch
Skin patch containing drug molecules that can be absorbed through the skin.
Eye,ear, and nose drops(gtt)
-drugs in sterile liquids to be applied by drops
(instillation drops)
Eye ointment
sterile semi-solid preparation for ophthalamic use only.
Vaginal creams
Medicated creams that are to be inserted vaginally.
Douche solution
Sterile solution used to irrigate the vaginal canal.
Spray or mist
Liquid drugs forms that may be inhaled as fine drops via the use of spray bottles, nebulizers, or metered dose inhalers.
Medicine cup
Disposable cups used for dispensing tablets and capsules.
Metal pillcrusher and pill cutter
Crushes and cuts pills.
Mortar and pestle
porcelain; may be used to grind crystals and lumpy chemicals to a powder.
Ampule
A SEALED GLASS CONTAINER THAT USUALLY CONTAINS SINGLE DOSE OF MED. THE TOP IF THE AMPULE MUST BE BROKEN at the neck TO OPEN CONTAINER.
Vial
A closed glass container with a rubber stopper that holds medication. Vials may be multiple dose or unit dose.
Needles
for injections have two measurements that must be noted. Lenght varies from short (3/8 inch) to medium (1-11/2inch) Gauge is a number that represents the diameter of the needle.
Syringes
The three most common disposable syringes for parenteral administration of drugs are the standard hypodermic syringe, the tuberculin (TB) syringe, and the insulin syringe.
Oral syringes
Some oral liquid medications are dispensed in disposable plastic syringes with rubber or plastic covers on the tip.
Which route of administration is used most often?
Oral, because is cheap.
Which route is fastest?
Intravenous (IV)
A tablet dissolved in the mouth for local action:
Lozenge
The parenteral route refers to any route other than the gastrointestinal route. Name 4 parenteral routes:
Intraosseous-
Intraventricular-
Intarspinal-
Intracapsular(intra-articular)
Topical drug forms include those applied to the ————and————–.
Skin, Mucous membranes.
With rubber stopper on top:
Vial
All glass to be broken at the neck:
Ampule
Needles are selected according to two measurements:
Length and Gauge
The 3 most commonly used syringes for injections are:
Hypodermic, tuberculin, and insulin.
Medications Orders contain six parts:
1. Date
2. Patient’s name
3. Medication name
4. Dosage or amount of medication
5. Route or manner of administration (if not route is specified, the oral route is usually the appropriate one). When in doubt, always check with the physician.
6. Time to be administered, or frequency
Metric system
is the prefered system of measurement and is used at the present time., The most widely used method of measurement in pharmacy. It is based on counting by 10s. The basic units of measure in this are the gram (g) and the liter (L). The dosage of a drug is usually given in milligrams (mg). Liquid medications are often measured in milliliters (mL). The client’s weight is often measured in kilograms (kg).
Aphotecary system
grain gr
minim m,mim
dram dr
Ancient system of weight and volume measurements used to measure drug and solution.
Which is the least accurate system for measuring medicine?
metric system or English system
which system of drug measurements is used most frequently throughout the world?
Metric system
which is the oldest system of measurement for medication?
Apothecary system.
Two different types of equipment used to measure drugs are:
Medicine cup and syringes
Common abbreviations for medical orders
cap PO q6h – means (Capsule, by mouth, orally, every 6 hours).
sol 2 gtt – means (Solution 2 drop)
tab bid pc c – means (tablet, twice a day, after meals, with)
supp R prn – means ( suppository, rectal, whenever necessary
Dc – means (Discontinue)
noc – means ( night)
ac – means (before meals)
Metric
5 ml
15 ml
30 ml
240 ml
500 ml
1000 ml
Household
1 tsp
1 tbsp
2 tbsp
1 measuring cup (240ml)
1 pt
1qt
Metric ( Grams)
1g
0.6g
0.5 g
0.3 g
0.2 g
0.1 g
0.06 g
0.05 g
0.03 g
Metric (Milligrams)
1,000 mg
600 mg
500 mg
300 mg
200 mg
100 mg
60 mg
50 mg
30 mg
To convert pounds to kilograms
divide number of pound by 2.2

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