Chapter 53 - Pharmacology

EHR

Electronic Health Record electronic versions of the reference books

schedule ID number

C stands for controlled substances

CSA specifications

C2

CSA

Controlled Substance Act (CSA) in 1970 certain drugs are classified as controlled substances because they have a potential for addiction or abuse CSA sets guidelines and categories (scheudule 1-5) based on their potentially addictive level of abuse

DEA

DEA- controls drugs drug enforcement administration agency of fed government responsible for drug control enforcement all doctors required to register with the DEA to prescribe dispense or administer controlled substances every doctor has a DA number written on the prescription DEA gives us guidelines to dispose medication

DAW and signature lines

all prescriptions must be signed by the physician if a physician wants only the brand name of a medication and does not want a substitution, the signature will be made on the DAW line if substitutions such as the generic medication is permitted, the physician will sign on the signature line that indicates substitutions permitted

allergies

allergic rxn to med can occur at any time hives, SOB, rashes on the back, anaphylactic response

adverse effects

anaphylactic shock

superscription

contains the patient's name, address, age or DOB, the date prescription was written

synthetic

created in the lab by artificial means

blood thinning med

cumadin anticlotting medication anticoagulation for pt with heart attacks warfarin and cumadin they bleed more during venipuncture cumadin is one of the ten rules of phlebotomy ask if they take cumadin

number of refills

number of times the prescription may be refilled (usually no more than six times)

topical

on the skin creams, neosporin, transdermal patches - release medication by the skin - nicotine

Online resources

online med info reliable resources: web MD Medline

drug tolerance

tolerance after taking a medication for a long period of time they will need a higher dose because it won't serve its purpose or a different medication examples: the same antibiotic over and over, pain medication the dose cannot always be increased because drugs can become toxic - harmful in excessive amounts

FDA

two diff gov agencies FDA - responsible to ensure drugs are safe and effective and that these are honestly, actively, and informatively represented to the public FEDERAL FOOD AND DRUG ADMINISTRATION and Cosmetic Act of 1938 this law was enacted to ensure the safety of food, drugs, and cosmetics sold within US borders regulates safety of medications during pregnancy

pharmacists

doctors in pharmacy specially trained and licensed professionals who specialize in the preparation and dispensation of drugs

dosage and weight

dosages may increase if the patient is heavier or decrease if the patient is lighter if med level is too low for the body weight, the patient will benefit less from the medication if the med level is too high for the weight, the patient could become ill or even have an overdose reaction

drug abuse vs drug dependency

drug abuse - using drug improperly or wrongly drug dependency - relies on the medication or uses med for psychologic support

drug intolerance

drug intolerance or drug sensitivity is a lower threshold to the normal pharmacologic action of a drug vomiting diarrhea abdominal cramping can be indications of intolerance dosage adjusted or changed as needed

EPA

environmental protection agency

drug abuse

epidemic in america either prescribed or schedule 1

bioequivalent

generic drugs have the same strength and action as the brand name version of the drug the active ingredients in generic drugs are required to be bioequivalent

who is more susceptible to effects of medications

geriatric and pediatric patients they require lower doses dont overmedicate

inscription

gives the name of the medication, actual ingredients and dosage

patient weight

important factor to consider when calculating dosages dosages may increase if the patient is heavier

articular

injected into joints corticosteroids

Off labeling Rx

legal one medication is intended for certain thing and used for something else ex. benadryl = antihistamine (allergic reactions) but its indication can also be used for sedative

USP-NF

lists all medicines, dosage forms, drug substances, dietary supplements authorized for use in the US

where do drugs come from

many natural sources: -plants -animals -minerals -others artificially created

drops

medication for eyes or ears

side effects

most cure something but you can get a different side effect food interaction with meds can cause side effect anaphylactic shock - life threatening adverse reaction from drug or food or insect bite or sting resp distress, swelling convulsions unconsciousness use epi pen to open up the airways

bronchodilator

opens up brachial

nonprescription drugs

over the counter such as aspirin, cold meds, antibiotic ointments like neosporin make sure pt tell otc drugs can be unsafe, interfere antacids not be taken with antibiotics aspirin - blood thinning medication

method of administration

parentral most powerful buccal oral takes the longest

brand name

written typically in capital initial letters - is the name given to a drug by a specific manufacturer ex. tylenol is the brand name motrin is brand name for ibuprofen advil is the brand name some pt need the brand name bc the generic might not work for them

inhaled

directly into the nose

classification of drugs

based on their action in the body

reliable references for pharmaceutical products

Physicians' Desk Reference Hospital Formulary United States Pharmacopeia-National Formulary (USP-NF)

prescription

Rx

inventory and recordkeeping

all med inventory maintained in log book at doc office if its a narcotic, it needs to be signed out in narcotic log one or two people have access to narcotics medical assistant - once a month looks at log to ensure that a sufficient supply of each drug is available and that no medication has expired

commonly abused drugs

demerol, vicodin, percocet valium, xanax, librium dalmane, resterol, seconal heroin, LSD, cocaine

classifications

based on drug action antibiotic if pt takes antibiotic such as penicillin - drug classification = antibiotic destroys or inhibits growth of microorganism

chemical name of a drug

chemical formula used by manufacturers and pharmacists the generic name of a drug is usually somehow related to its chemical name

PDR

physician desk references PDR published once a year *contains all the drugs that were approved the previous year meds that are removed - you won't find it information provided by the drug manufacturers broken down into categories color sections white - first white section -manufacturers index with the company names, addresses, phone numbers, emergency contacts, lists of products pink- alphabetical list of generic and brand names blue- lists drugs grouped by therapeutic classes gray/ multicolored - color photos of the most commonly prescribed capsules and tablets white - second white section- product information, reprint of manufacturers package inserts, info for each drug brand and generic names, description, clinical pharmacogy, indications contraindications, warnings, precautions, adverse reactions, dosage, administration, how its supplied green- diagnostic product info, drug pregnancy ratings, poison control, discontinued products contains US pharmacopeia -info of drugs easy to read reference published by a private company and purchased by medical offices and hospitals info provided by the drug manufacturers PDR.com

Dispense as Written, no substitutions

physician must clearly indicate on the prescription that the order is for a brand name drug

controlled substances

powerful medications that pose a high risk of addiction

Signa (sig.)

provides instructions on how the medication should be taken by the patient

habituation

psychologic or physiologic dependence on a drug may develop from narcotics and laxatives

antipyretic

reduces fever ex. tylennol, advil

controlled substances labeled

roman numeral inside a capital letter C

schedule for controlled substances

schedules 1-5 depending on medical use and addiction schedule 1 - highest potential for addiction and no medical use - not prescribed drugs and considered illegal drugs - cocaine, heroin, meth schedule 2 high potential for addiction and abuse the DEA must complete the forms in carbonated copies entirely written in physicians handwriting has to be written because its a controlled substance codeine morphine opium and secobarbital prescription may be filled within 7 days locked cabinets low potential for abuse ex. caffeine, with codeine up to five refills which is indicated on prescription for 6 months schedule 4 lower potential for addiction and abuse ex. chloral hydrate, phenobarbital, diazepam five refills allowed over a six month period schedule 5 low potential for addiction and abuse low strength codeine combined with other drugs to form a cough suppressant, laxatives inventory records must be maintained on these drugs

idiosyncratic

specific to the individual (ex. side effects - meds effect people differently)

pharmacology

study of medications and drugs including their forms, intentions for use, and effects

polypharmacy

taking five or more medications simultaneously meds may interact with each other

subscription

tells the pharmacist how to mix the drug and how much to provide the patient

physical dependency

the abused substance produces changes in the nervous system on which the body begins to rely once the substance is removed, the individual experiences withdrawal symptoms - mild to severe - depending on level of addiction

proprietary name

the brand name name given to a drug by a specific manufacturer 17-20 years

contraindicated

the medications are so dangerous for the infant that the mother must stop breast-feeding while she is taking the drug or she must forgo taking that medication at all

pregnancy categories

this is in the PDR: a-controlled studies showed no demonstrated risk to fetus first trimester or last trimester b- studies on pregnant animals showed no demonstrated risk to the fetus, but controlled studies on pregnant women not conducted c- studies on pre animals showed adverse effect on fetus but not conducted on pregnant women potential for drugs outweighs the potential risks for the pregnant mother d- positive evidence of fetal risk in humans potential benefits may outweigh the potential risk for the pregnant mother x- marketing studies show demonstrated fetal abnormalities and evidence of fetal risk because of adverse reactions risk of use in this category outweighs the potential benefits N- there is no FDA classification on these drugs

drug names

three types generic (nonproprietary or official name of a drug) brand name proprietary name (chemical use)

generic name

typically written in lowercase letters, is the legal name for the drug required to have the same effectiveness, safety, active ingredients, quality, strength, purity, stability as brand name drugs non active ingredients such as dyes or flavorings may differ from brand names not as closely monitored as the brand name so their effectiveness may or may not be equal priced lower acitaminophan

sublingual

under the toungue nitral glycerine for angina

prophylactically

used to prevent the onset of a condition ex. birth control, vaccinations

suppositories

via the vaginal or rectal route

some drugs found in

vitamins in food we eat table of elements ca, iron, magnesium