pharmacology

tablet

(as dried powder)is a solid drug form that contains ac active drug plus inert ingredient to provide bulk and ensure a standardized table size.

***apothecary

*** -comes from a Greek word that means storehouse and eventually came to mean the person in charge of the storehouse. a person who prepared and sold medicines and drugs

Colchicine

*** a drug still used to treat gout (A form of arthritis characterized by severe pain, redness, and tenderness in joints.) was used for that same purpose in the sixth century. It originally derived from the autumn crocus know as Colchicum autumnale.

Pure Food and Drug Act

****1906 - Forbade the manufacture or sale of mislabeled or adulterated food or drugs, it gave the government broad powers to ensure the safety and efficacy of drugs in order to abolish the "patent" drug trade. Still in existence as the FDA. (first federal drug law)

Focus on Health Care (DOT)

****Because tuberculosis is such a large and challenging public health problem, patients who refuse to (or are unable to) be compliant with drug treatment may be required to participate indirectly observed therapy (DOT), in which the patient must come to a clinic each day and be observed while actually taking each dose.***

Drugs Used to Treat Gastroesophageal Reflux Disease

****GERD > When the stomach acid refluxes (flows back) into the esophagus > Causes esophagitis with irritation, inflammation, and pain Treated with: > Changes in diet and lifestyle > Antacids, H2 blockers, proton pump inhibitors, and gastric stimulant drugs Antacid drugs for gastroesophageal reflux disease -Originally the only treatment -Weak bases that exert a therapeutic effect by neutralizing hydrochloric acid -Raises the pH of the stomach contents -Decreases the mucous membrane irritation -Also inhibits the action of pepsin Antacid drugs for gastroesophageal reflux disease Antacid drugs contain individual or a combination of these as their active ingredient. -Aluminum -Magnesium -Calcium -Sodium Antacid drugs for gastroesophageal reflux disease Antacid drugs are available without a prescription. Antacid drugs containing aluminum as their active ingredient -AlternaGEL -Amphojel Antacid drugs for gastroesophageal reflux disease Antacid drugs containing magnesium as their active ingredient: Dulcolax Phillip's Milk of Magnesia

Drugs Used to Treat Rheumatoid Arthritis con..

****advanced drug-using today! drugs**** Monclonol antibody drugs for rheumatoid arthritis Bind with tumor necrosis factor to prevent inflammation Adalimumab (Humira) Certolizumab (Cimzia) Golimumab (Simponi) -> mab drug <-

DID YOU KNOW? "cranberry"

***Cranberry juice is effective in preventing urinary tract infections. Cranberries are acidic, which is why eating the berries makes your mouth pucker. -->Cranberries temporarily increase the acidity of the urine. This suppresses the growth of bacteria because the bacteria prefer an alkaline environment. --> Also, cranberry juice contains the simple sugar fructose, which acts as an anti-adhesion factor that keeps bacteria from adhering to the bladder wall.

*** Rx

***latin word for recipe, meaning "take" prescription

*** pharmacology

***the study of drugs and their interactions with living systems -pharmacology comes from. greek word pharmakon which mean medicine or drug, and suffix -logy (study of)

Drug Alert (breastfreeding)

- Breastfeeding was the only way to nourish newborn babies for many centuries. -Bottle feeding of cow's milk became popular when rubber nipples and glass bottles could be sanitized and milk could be stored in an icebox to prevent the growth of bacteria. - Commercially prepared formulas were developed by 1900. -Condensed milk and evaporated milk in cans were popular and recommended by pediatricians in the 1930s. -The Infant Formula Act of 1980 authorized the FDA to assure the quality of infant formulas. -The availability of infant formulas and the trend for women to work outside the home led to a decline in breastfeeding. -This trend was reversed in the 1980s, then reversed again currently. - Colostrum, the first breast milk, contains antibodies from the mother that provide the newborn with passive immunity against some diseases. - Breastfed infants receive these antibodies and have an advantage over bottle-fed infants who do not receive these antibodies. -Commercially produced infant formulas do not contain antibodies, and so they do not provide immunity against diseases. -Their use has also been linked to increased rates of eczema, allergies, obesity, and diabetes mellitus as bottle-fed infants grow up.

Historial Notes

- During the 1800s, the treatment for mental illnesses included the use of the drugs digitalis, ipecac, alcohol, or opium. In 1903, barbiturate drugs were synthesized and used effectively as sedative drugs for agitated, mentally ill patients. - Barbiturate drugs now have only limited used in treating insomnia and producing preoperative sedation before surgery; they are not used as psychiatric drugs.

Fun Fact! Did you know?

- One in every two women and one in every four men over age 50 will have a fracture due to osteoporosis at some time in their lives. Healthcare costs for osteoporosis-related fractures went from $7 billion in 1995 to $14 billion in 2012. - Estrogen drugs for osteoporosis Hormone replacement drugs Used to treat the symptoms of menopause Some are also indicated for the prevention of osteoporosis in postmenopausal women. - Now, however, it is known that this can increase the risk of endometrial cancer, breast cancer, stroke, and myocardial infarction; this has limited the use of these drugs for the long-term treatment of osteoporosis in postmenopausal women.

Drug Alert (with certain type medicine)

---->The beneficial effects of drinking grapefruit juice may turn into toxic effects if you are taking certain drugs. This is because grapefruit juice blocks an enzyme in the intestine that normally breaks down part of a drug dose before it even enters the blood. ----->With decreased levels of this enzyme, a much more active drug enters the blood, and this can result in a toxic level of the drug.

Drug Alert (Gastro. drugs con.)

--> All H2 blocker drugs originally were approved as prescription drugs. --> Then famotidine became the first to be approved by the FDA for over-the-counter use. --> Now each of the prescription H2 blocker drugs has a corresponding over-the-counter version. --> Over-the-counter H2 blocker drugs are only approved for preventing and treating heartburn and acid indigestion. The AR in Axid AR stands for acid reducer. The AC in Pepcid AC stands for the Latin phrase ante cibum, which means before meals, as Pepcid AC is taken before meals. The HB in Tagamet HB stands for heartburn. Measurement of the prescription: Prescription trade name and doses -Tagamet 300 mg, 400 mg, 800 mg -Pepcid 20 mg, 40 mg -Axid 150 mg, 300 mg -Zantac 150 mg, 300 mg Over-the-counter (OTC) trade name and doses -Tagamet HB 200 mg -Pepcid AC 10 mg, 20 mg -Axid AR 75 mg -Zantac 75 mg, 150 mg

Drug alert information: Antibiotic Drugs

--> All aminoglycoside antibiotic drugs have the potential to cause toxic effects to the auditory nerve (ototoxicity) or to the kidneys (nephrotoxicity). Patients receiving aminoglycoside antibiotic drugs are carefully monitored with hearing tests (audiograms) and blood tests (BUN and creatinine) for kidney function. --> Tetracycline drugs can cause permanent discoloration of the teeth; therefore, they are not prescribed for pregnant women (to protect the fetus's developing teeth) or for children under age 8 (whose permanent teeth are still developing).

Drugs Used to Treat Diarrhea

--> Antidiarrheal drugs produce a therapeutic effect by: Slowing peristalsis in the intestinal tract (anticholinergic drugs) --> Absorbing extra water from diarrhea stools (absorbent drugs) -> Some antidiarrheal drugs exert their effect because they contain opium, a narcotic. -> Commonly used for their pain-relieving properties -> Common side effect is constipation (which becomes the therapeutic effect). --> When diarrhea is caused by an infection in the GI tract, antibiotic or anti-infective drugs are given. -> Anticholinergic drugs for diarrhea These over-the-counter drugs decrease the rate of peristalsis in the GI tract. Loperamide (Immodium A-D, K-Pek II) --> Absorbent drugs for diarrhea These over-the-counter drugs contain attapulgite, an absorbent drug to absorb excess water from diarrhea stools. Kaopectate Maximum Strength K-Pek --> Narcotic drugs for diarrhea -> Antidiarrheal drugs that contain opium are classified as controlled substances (Schedule III drugs). -> Opium (paregoric)- is a schedule 3 drug*** --> Antibiotic and anti-infective drugs for diarrhea These drugs are used to treat infections associated with bacterial, viral, or protozoal diarrhea and traveler's diarrhea. --> Antibiotic and anti-infective drugs for diarrhea -> **Bismuth (Kaopectate, Pepto-Bismol) -> Ciprofloxacin (Cipro) -> Doxycycline (Vibramycin, Vibra-Tabs) -> Trimethoprim/sulfamethoxazole (Bactrim, Septra)

Drugs Used to Treat Other Viral Infections

--> Antiviral drugs are used to prevent and treat infections caused by influenza virus, hepatitis virus, and others. Drugs for influenza virus infection These antiviral drugs are used to prevent or treat influenza A or influenza B infections (the "flu") Amantadine (Symmetrel) Influenza virus vaccine (Fluarix, FluMist) Oseltamivir (Tamiflu) Rimantadine (Flumadine) Zanamivir (Relenza) Drugs for hepatitis virus infection For treating chronic hepatitis A, hepatitis B, or hepatitis C Adefovir (Hepsera) Entecavir (Barclude) Interferon alfa-2b (Intron A) Interferon alfacon-1 (Infergen) Lamivudine (Epivir) Drugs for hepatitis virus infection Peginterferon alfa-2a (Pegasys) Peginterferon alfa-2b (PEG-Intron) Ribavirin (Copegus, Rebetol) Telbivudine (Tyzeka) Tenofovir (Viread) Drugs for hepatitis virus infection Vaccines Hepatitis A vaccine (Havrix, Vaqta) Hepatitis B vaccine (Engerix-B, Recombivax HB) Twinrix (hepatitis A and hepatitis B vaccine) Hepatitis B immune globulin (HepaGam B) is used to prevent hepatitis B from developing after exposure. Drugs for herpes virus infection Type 1 Type 2 Herpes zoster Human papillomavirus Fungi and yeasts Can cause disease topically or systemically Opportunistic organisms Grow most successfully when the patient's immune system is already compromised or under stress Fungi and yeasts Opportunistic organisms In immunocompromised patients (patients with cancer, AIDS, bone marrow transplants), infections can become widespread and extremely serious. Treated with the same antifungal (or anti-yeast) drugs The antifungal drugs act by: Binding to a specific receptor on the cell membrane of the fungus or yeast Changing the permeability of the membrane Causing the cellular contents to leak Topical drugs for local fungal infections On the skin, caused by the fungus Tinea Ringworm Athlete's foot Jock itch Onychomycosis (on the nails) can be treated topically if the infection has not reached the nailbed. Drugs for systemic fungal infections When fungal infections become embedded into the nail bed and the nail becomes misshapen, thickened, and discolored Must be treated with oral antifungal drugs that act systemically through the blood to reach the tissues around the nail Drugs for systemic fungal infections Oral and I.V. route Treat severe fungal infections in other parts of the body, such as: Aspergellosis Blastomycosis Crytptococcus Histoplasmosis Drugs for systemic fungal infections Amphotericin B (Fungizone) Capofungin (Cancidas) Fluconazole (Diflucan) Flucytosine (Ancobon) Griseofulvin (Grifulvin) Drugs for systemic fungal infections Itraconazole (Sporanox) Ketoconazole (Nizoral) Posaconazole (Noxafil) Terbinafine (Lamisil) Voriconazole (Vfend) Topical yeast infections caused by Candida can occur in the mouth. Drugs for yeast infections These antiyeast drugs are given orally and I.V. Drugs for yeast infections Act systemically to treat severe infections (candidiasis) in the mouth that extend into the esophagus and stomach or are in other parts of the body Many are also used to treat systemic yeast infections. Drugs for yeast infections Amphotericin B (Fungizone) Anidulafungin (Eraxis) Caspofungin (Cancidas) Fluconazole (Diflucan) Flucytosine (Ancobon) Drugs for yeast infections Itraconazole (Sporanox) Ketoconazole (Nizoral) Micafungin (Mycamine) Posaconazole (Noxafil) Voriconazole (Vfend)

<--the combination antibiotic drugs-->

--> Combination antibiotic drugs Contain Antibiotic drug trimethoprim Blocks one step in the synthesis of folic acid by bacteria Anti-infective sulfa drug sulfamethoxazole Blocks the next step in the same process Drugs work synergistically.

Drug ALERT: chapter 7

--> For example, the antiprotozoal drug metronidazole is used to treat many different diseases besides H. pylori infection of the stomach. --> Metronidazole (Flagyl) is taken orally to treat intestinal amebiasis and pelvic inflammatory disease. --> Metronidazole (MetroGel-Vaginal) is applied vaginally as a gel to treat vaginal bacteriosis. --> Metronidazole (MetroGel) is applied topically to the skin as a gel to treat acne rosacea.

Drugs Used to Treat Gastroesophageal Reflux Disease (con.)

--> H2 (receptors) blocker drugs for gastroesophageal reflux disease ->Histamine -A natural chemical produced by the body -Activates special histamine (H2) receptors -Located in the parietal cells of the stomach -Causes the release of hydrochloric acid --> H2 blocker drugs for gastroesophageal reflux disease -Drugs that block these receptors and prevent the release of acid are known as H2 blocker drugs. -Are prescription drugs, but some are available over-the-counter -Must be taken 30 minutes before a meal --> H2 blocker drugs for gastroesophageal reflux disease -Cimetidine (Tagamet) In 1977, the first H2 blocker drug was created and given the generic name cimetidine. -Famotidine (Pepcid) -Nizatidine (Axid) -Ranitidine (Zantac)

Drugs Used to Treat Osteoporosis. *****

--> Mature bone is hard but is a living tissue. 10% of the entire bony skeleton is rebuilt. Osteoblasts deposit new bone. Osteoclasts break down and remove areas of old or damaged bone. --> Normal bone maintains a healthy balance (homeostasis) between: New bone deposition Bone breakdown --> Normal bone balance is maintained by: Hormones that control the amount of calcium Parathyroid hormone (parathyroid gland) Calcitonin (thyroid gland) Hormones in women Diet Exercise Thinning of bone at the cellular level Risk factors include: Caucasian or Asian race Slender build Smoking Alcohol use Lack of exercise --> More common in post-menopausal women Decreasing levels of progesterone no longer stimulate new bone formation Decreasing levels of estradiol allow osteoclasts to increase the breakdown of bone --> Prevented or treated with: Drugs that decrease the rate of bone resorption Supplemental estradiol and progesterone Supplemental calcium and vitamin D Increasing exercise.

chapter 9 Musculoskeletal Drugs

--> Musculoskeletal drugs are used to treat diseases of the muscles and bones. Osteoporosis Osteoarthritis Bursitis Tendinitis --> Musculoskeletal drugs are used to treat diseases of the muscles and bones. Rheumatoid arthritis Muscle spasms Fibromyalgia Gout

chapter 15 neurologic drugs

--> Parkinson's disease get notes of this -->

OTC drugs (over the counter)

--> The FDA approves a prescription drug being reclassified as an OTC drug if the following criteria are met: --> The OTC drug has a low rate of side effects/toxicity and a low potential for abuse. --> The use of the OTC drug does not require the patient to have any special monitoring or ongoing tests.

HISTORIAL INFORMATION:

--> The most common blood type is O positive and the least common is AB negative. --> Blood type O negative is known as the universal donor because everyone can be given O negative blood without having a transfusion reaction. ---------------------------------------------------- All donated blood is tested for syphilis, hepatitis, and HIV according to guidelines established by the Food and Drug Administration (FDA), the federal organization that is responsible for the safety of blood and blood products in the United States. - Although the United States has the safest blood supply in the world, there is still a small risk of transfused blood being contaminated with either hepatitis or HIV.

Expectorant Drugs

--> Used to treat diseases of the lungs that produce excessive amounts of mucus Reduce viscosity of mucus (sputum) so patients can more easily cough it up Only prescribed for productive coughs Guaifenesin (Humibid, Mucinex, Naldecon, Robitussin) Potassium iodide (SSKI) Dornase alfa (Pulmozyme) --> Enzyme drug used to break apart very thick secretions in patients with acute or respiratory disease Dissolves chemical bonds of mucoproteins and thins mucus so it can be coughed up

Systems of Drug Measurement

-->Apothecary -->Metric -->Other -Avoirdupois -Household Apothecary system of drug measurement Some apothecary measurements are still used today. Liquid measurements of: Pint Quart Gallon

Drugs Used to Treat Gastroesophageal Reflux Disease (***)

-->Proton pump inhibitor drugs for gastroesophageal reflux disease -->Decrease the production of hydrochloric acid in the stomach -->Some are used to treat heartburn and peptic ulcers. All are used to treat: -Esophagitis -GERD Proton pump inhibitor drugs for gastroesophageal reflux disease -Esomeprazole (Nexium) -Lansoprazole (Prevacid) -Omeprazole (Prilosec) -Pantoprazole (Protonix) -Rabeprazole (Aciphex) Combination drugs for gastroesophageal reflux disease -Zegerid --> The proton pump inhibitor drug omeprazole and the antacid drug sodium bicarbonate. Gastric stimulant drugs for gastroesophageal reflux disease -Increase the rate of gastric emptying -Keeps excess acid from: -Accumulating in the stomach -Refluxing into the esophagus -Metoclopramide (Maxolon, Reglan)

Drugs Used to Treat Neurosis and Anxiety (con.)

-> Benzodiazepine anti-anxiety drugs for neurosis and anxiety Most commonly prescribed for the treatment of anxiety and neurosis Bind to several specific types of receptor sites in the brain to provide sedation -> Benzodiazepine anti-anxiety drugs for neurosis and anxiety Affect Thought process Emotional behavior Decrease muscle tension that comes with anxiety All benzodiazepine drugs are Schedule IV drugs. Benzodiazepine anti-anxiety drugs for neurosis and anxiety Alprazolam (Xanax) Chlordiazepoxide (Librium) Clorazepate (Tranxene) Diazepam (Valium) Lorazepam (Ativan) Antidepressant drugs for neurosis and anxiety Different categories of antidepressants are effective in treating anxiety, including: Tricyclic antidepressant drugs Selective serotonin reuptake inhibitor (SSRI) drugs Serotonin and norepinephrine reuptake inhibitor (SNRI) drugs Other drugs for neurosis and anxiety Buspirone (BuSpar) Stimulates serotonin receptors Hydroxyzine (Vistaril) Antihistamine drug with a side effect of sedation to decrease anxiety -> Other drugs for neurosis and anxiety Meprobamate (Miltown) Acts on the thalamus and limbic system to decrease anxiety Schedule IV drug -> Other drugs for neurosis and anxiety Barbiturate sedative/hypnotic drugs are Schedule III and IV. Butabarbital (Butisol) Mephobarbital (Mebaral) Phenobarbital (Luminal)

Combination ENT Drugs

-> Combination antihistamine and decongestant drugs Antihistamine drug -Cetirizine -Desloratadine -Fexofenadine -Decongestant drug -Pseudoephedrine -> Combination antihistamine and decongestant drugs -Allegra-D Fexofenadine, pseudoephedrine -Clarinex-D Desloratadine, pseudoephedrine -Zyrtec-D Cetirizine pseudoesphedrine Combination antibiotic and corticosteroid drugs Antibiotic Ciprofloxacin Neomycin Polymyxin B Corticosteroid Dexamethasone Hydrocortisone Combination antibiotic and corticosteroid drugs Used topically in the ear Treat infections of: External ear (otitis externa) Tympanic membrane (otitis media) Combination antibiotic and corticosteroid drugs Cipro HC Otic Ciprofloxacin, hydrocortisone Ciprodex Ciprofloxacin, dexamethasone Combination antibiotic and corticosteroid drugs -Coly-Mycin S Otic Hydrocortisone, neomycin -Otosporin Hydrocortisone, neomycin, polymyxin B Other combination drugs -Rondec-DM Chlorpheniramine (antihistamine) Phenylephrine (decongestant drug) Dextromethrophan (antitussive drug) -Tussionex Chlorpheniramine (antihistamine) Hydrocodone (narcotic antitussive drug)

Drugs Used to Treat Psychosis and Schizophrenia

-> Phenothiazine drugs for psychosis and schizophrenia Largest chemically-related class of drugs used to treat psychosis and schizophrenia Phenothiazine drugs for psychosis and schizophrenia Block the following receptors in the brain: Dopamine Histamine Alpha Serotonin Phenothiazine drugs for psychosis and schizophrenia Chlorpromazine Fluphenazine Perphenazine Prochlorperazine Thioridazine Trifluoperazine Dibenzapine drugs for psychosis and schizophrenia Block dopamine and serotonin receptors in the brain Asenapine (Saphris) Clozapine (Clozaril, FazaClo) Loxapine (Loxitane) Olanzapine (Zyprexa) Quetiapine (Seroquel) Benzisoxazole drugs for psychosis and schizophrenia Block dopamine and serotonin receptors in the brain Iloperidone (Fanapt) Paliperidone (Invega) Risperidone (Risperdal) Ziprasidone (Geodon) Other drugs for psychosis and schizophrenia Chemically unrelated drugs These drugs block dopamine and serotonin receptors in the brain. Grouped together because each drug category only includes one or two drugs Other drugs for psychosis and schizophrenia Aripoprazole (Abilify) Haloperidol (Haldol) Lurasidone (Latuda) Reserpine Thiothixene (Navane) Aripiprazole (Abilify). This drug is mainly used to treat psychosis and schizophrenia in which there is a loss of touch with reality and delusions and hallucinations. However, it has also been found useful in treating depression and manic-depressive disorder.

Corticosteroid Drugs

-Act by inhibiting the body's immune system -Decrease inflammation and edema of the mucous membranes -Have no decongestant or antihistamine effect -Are not used to treat the common cold -Corticosteroid drugs for the ears Used to decrease inflammation associated with allergies or infections Dexamethasone Fluocinolone (DermOtic) -Corticosteroid drugs for the nose Intranasal steroids (INS) Beclomethasone (Beconase) Also used to treat nasal polyps Budesonide (Rhinocort) Ciclesonide (Omnaris) -Corticosteroid drugs for the nose Flunisolide (Nasalide) Fluticasone (Flonase, Veramyst) Mometasone (Nasonex) Also used to treat nasal polyps Triamcinolone (Nasacort) -Corticosteroid drugs for the mouth Triamcinolone (Kenalog in Orabase) Applied topically as a paste Used to treat: Mouth ulcers Inflammation

Drugs Used to Treat Osteoarthritis

-Also known as degenerative joint disease Occurs when: Cumulative damage causes degeneration of the cartilage pad. Erosion of the bone ends inside a joint. - First joints to exhibit signs Weightbearing joints Hips and knees Joints used constantly Fingers and toes - Symptoms Pain Inflammation Swelling --> Synovial membrane of the joint can also be involved. The damaged bone ends often form bony spurs that irritate adjacent tissues. - Acetaminophen for osteoarthritis Analgesic drug Lacks the ability to inhibit the production of prostaglandins Has no anti-inflammatory action Acetaminophen (Tylenol) -Fever - Salicylate drugs for osteoarthritis Acetylsalicylic acid (aspirin (ASA)) Analgesic and anti-inflammatory effects useful in treating: Pain and inflammation Minor conditions of the bones and muscles Bursitis Tendinitis Muscle sprains -Salicylate drugs for osteoarthritis Aspirin (Bayer, Ecotrin) Magnesium salicylate (Doan's) Long-term therapy Irritating to the stomach Shown to cause gastric ulcers - Salicylate drugs for osteoarthritis Ecotrin Manufactured as an enteric-coated tablet Does not dissolve in the stomach Dissolves only when it comes in contact with the higher pH environment of the duodenum

Drugs Used to Treat Burns, Skin Ulcers, and Wounds

-Burns, skin ulcers, and deep wounds present unique problems in medical management They may contain a large amount of necrotic (dead) tissue that must be removed (debrided) before new tissue can form (granulation). -Burns, skin ulcers, and deep wounds present unique problems in medical management The affected area may produce a large amount of exudate (drainage) that can become infected and must be removed before healing can occur. - Topical drugs for debridement Topical enzymes Dissolve necrotic tissue and scar tissue Allow new tissue to begin to form at the base of a burn, skin ulcer, or wound -Topical drugs for debridement Rx drugs Collagenase (Santyl) Papain (Accuzyme, Panafil) Trypsin (Granulex) OTC drug Dextranomer (Debrisan) -Topical drugs to absorb exudate OTC topical drugs absorb the tissue fluid that flows from damaged tissues and wounds. DuoDerm Sorbsan - Topical drugs to stimulate granulation Becaplermin (Regranex) Particularly for skin ulcers in diabetic patients Growth factor derived from human platelets and produced with recombinant DNA technology -Topical anti-infective drugs for burns Specifically to treat extensive burns and keep them from being infected Mafenide (Sulfamylon) Nitrofurazone (Furacin) Silver sulfadiazine (Silvadene) -Other topical drugs for burns and wounds Chlorophyll derivative (Chloresium) OTC drug that promotes healing and neutralizes the odor from wounds Manuka honey (Medihoney) Taken from actual honey

Plasma and Plasma Volume Expanders

-Do not contain blood cells -Derived from whole blood that has undergone plasmapheresis to remove blood cells -Cannot raise the patient's hematocrit to contribute to oxygen-carrying capacity Plasma -Has an advantage over blood -Does not need to be typed and crossmatched --> Plasma is the largest part of your blood. ... When separated from the rest of the blood, plasma is a light yellow liquid. Plasma carries water, salts, and enzymes. The main role of plasma is to take nutrients, hormones, and proteins to the parts of the body that need it. Cells also put their waste products into the plasma.<-- Given to: -Hemophiliacs who need clotting factors -Severe burns to restore blood volume and electrolytes Fresh frozen plasma -Consists of plasma that contains: -All of the plasma proteins -Clotting factors -Frozen to prolong its shelf life -Thawed to room temperature before being administered I.V. Plasma protein fraction -Derived from plasma -Contains 5% plasma proteins, the most abundant of which is albumin, mixed with normal saline -Contains no clotting factors -Plasmanate -Protenate Albumin plasma protein -Derived from plasma -Contains only the plasma protein albumin -Has no clotting factors Albumin Prepared in: 5% solution -Approximates the concentration of blood 25% solution -Albuminar -Plasbumin Cryoprecipitate a highly concentrated source of fibrinogen -Plasma extract is prepared by freezing and then slowly thawing plasma Contains concentrated amounts of: -Factor VIII -von Willebrand factor -Fibrinogen Cryoprecipitate Used to treat patients with: -Hemophilia -von Willebrand disease Plasma volume expanders Manufactured from: -Complex carbohydrates -Normal saline -Do not need to be refrigerated -Retain their potency for many months -Do not need to be typed or crossmatched Plasma volume expanders -Given I.V. to restore blood volume to normal levels -Dextran (Macrodex, Rheomacrodex) -Hetastarch (Hespan)

Antihistamine Drugs

-Exert their therapeutic effect by blocking histamine (H1) receptors in the nose and throat -Histamine Released from mast cells in the tissues when an antibody-antigen complex is created during an allergic reaction Causes vasodilation in which the blood vessels and mucous membranes become swollen and red Irritates the tissue directly, causing pain and itching -Shrink edematous mucous membranes -Decrease itching and redness -Side effects Older antihistamines cause drowsiness. Newer antihistamines do not cause drowsiness because of a different chemical structure. Azelastine (Astelin) Brompheniramine (Lodrane) Cetirizine (Zyrtec) Chlorpheniramine (Chlor-Trimeton, Efidac) Clemastine (Tavist Allergy) Desloratadine (Clarinex) Dexbrompheniramine Dexchlorpheniramine Diphenhydramine (Benadryl) Fexofenadine (Allegra) Levocetirizine (Xyzal) Loratadine (Claritan, Tavist) Olopatidine (Patanase) Triprolidine (Zymine)

Allergen Extract Drugs

-Form of allergy immunotherapy that has previously only been available with allergy shots -Prepared liquid extracts that contain various allergens, such as animal dander, foods, plants, grasses, pollen -Allergens are injected subcutaneously each week. -Progressively stronger extracts are used until the patient's body no longer reacts to those allergens. -One allergen extract drug specific to grass allergies is available in the form of a sublingual tablet that is taken by mouth. -This drug is an extract of grass pollen from five different seasonal grasses. -Drug dose is measured as an Index of Reactivity (IR). Grass pollen allergen extract (Oralair)

Drugs Used to Treat Anaphylaxis -Dextrose is glucose (sugar)

-In anaphylaxis, massive amounts of histamine are released, causing two life-threatening conditions: -Severe vasodilation -Causes a severe drop in blood pressure and shock -Bronchoconstriction -Severely limits air flow in and out of the lungs -Epinephrine (Adrenalin, EpiPen) -Constricts the blood vessels to restore normal blood pressure -Relaxes smooth bronchial muscle to allow adequate air flow Intravenous Fluids In an emergency, used to: -Administer drugs -Correct a decreased volume of body fluids -Correct a decreased level of electrolytes or glucose -Administer blood or plasma products -Maintain venous access between drug doses Dextrose intravenous fluids -Different concentrations of dextrose and water -Dextrose 2.5% in water -Dextrose 5% in water (D5W) -Dextrose 10% in water (D10W) Dextrose intravenous fluids -Also in concentrations of 20%, 25%, 30%, 40%, 50%, 60%, and 70% -Administered as a bolus injection through an existing -I.V. line to patients with: -Low blood sugar levels -Diabetic patients -Premature infants Sodium intravenous fluids -If a patient does not need dextrose, an I.V. infusion consisting of just sodium (Na+), chloride (Cl-), and water can be administered. -Sodium is an important electrolyte in both the intracellular and extracellular fluids in the body. Sodium intravenous fluids -If a patient does not need dextrose, an I.V. infusion consisting of just sodium (Na+), chloride (Cl-), and water can be administered. -Intravenous fluids contain these electrolytes in proportions that parallel those in tissue fluids. Sodium intravenous fluids -If a patient does not need dextrose, an I.V. infusion consisting of just sodium (Na+), chloride (Cl-), and water can be administered. -Concentration is known as a physiologic salt solution or normal saline (NS). -Sometimes an I.V. fluid of half normal saline is ordered, written as 0.45% NaCl. Combination intravenous fluids -Dextrose in varying concentrations and normal saline or half normal saline can be combined into a single I.V. fluid. -Dextrose 5%, normal saline (D5/0.9% NaCl) -Dextrose 5%, half normal saline (D5/0.45% NaCl) Combination intravenous fluids -Dextrose 10%, normal saline (D10/0.9% NaCl) -Dextrose 10%, half normal saline (D10/0.45% NaCl) Combination intravenous fluids -Dextrose 5% in Lactated Ringer's (D5/LR) -Contains the fixed amount of dextrose and water with sodium, potassium, calcium, chloride, and lactate -Named for English physiologist, Sidney Ringer Combination intravenous fluids -Crystalloid -General category referring to any intravenous fluid that provides dextrose and sodium chloride alone or in combination with other electrolytes Total parenteral nutrition (TPN) -Dextrose and electrolyte I.V. fluids -Maintain fluid and electrolyte balance -Supply calories -Unable to completely meet long-term nutritional needs -Specifically lack protein, fat, and vitamins Total parenteral nutrition (TPN) -Specially prepared I.V. fluid -Used for patients whose nutritional needs cannot be met with dextrose and electrolyte fluids Total parenteral nutrition (TPN) Contains specific amounts of: -Essential amino acids (proteins) -Electrolytes -Vitamins -Minerals Individually tailored to the patient's need according to the physician's order. Total parenteral nutrition (TPN) Also known as hyperalimentation solution Must be administered through a special long-term intravenous catheter (Broviac or Hickman) Inserted into: -Subclavian vein -Super vena cava TPN = ONLY THRU THE VEIN NEED LARGE VEINS!!! --------------------------------------------------- Intravenous lipids -To meet a patient's dietary fat requirement -Separate intravenous solution of lipids may be ordered. Intravenous lipids Contains -Fat in the form of soybean or safflower oil -Water -Glycerin -Egg yolk Intravenous lipids -Lipid fats -More concentrated source of calories than dextrose -Fats contain about 30% more calories per gram than dextrose -Contain essential fatty acids -Only given to patients who are unable to take oral feedings for an extended period of time Intravenous lipids -Lipid fats -Intralipid -Liposyn Intravenous multivitamins Specially formulated combination of 12 vitamins for I.V. administration Contain -9 water-soluble vitamins -3 fat-soluble vitamins There are actually 4 fat-soluble vitamins, but the fourth—> vitamin K—is not given intravenously. --> Vitamins A, D, E, and K are fat-soluble. (ADEK) Intravenous multivitamins -Specially formulated combination of 12 vitamins for I.V. administration -Berocca Parenteral Nutrition -Infuvite -M.V.I.-12

Mast Cell Stabilizer Drugs

-Stabilize the cell membranes of mast cells in the tissues of the nose -Prevent them from releasing histamine during the immune response to an antigen -Prevent edema of the nasal mucous membranes and sneezing in patients with allergic rhinitis -Cromolyn (Nasalcrom)

Drug Alert ENT

-When a trade name drug such as Sudafed is well known to consumers, the drug company may continue to use that trade name, even with a different generic drug. -Sudafed PE is the slightly revised trade name for the generic drug phenylephrine. -These trade name drugs all sound similar to each other but are not related. Nasacort Corticosteroid drug triamcinolone Nasalcrom Mast cell stabilizer drug cromolyn Nasonex Corticosteroid drug mometasone

median effective dose (ED50) median effective dose (TD50) therapeutic index (TI)

-the dose at which 50% of animals tested show a therapeutic response to the drug -the dose at which 50% of animals tested had a toxic level of drug. -the relative margins of safety between the dose that produces a therapeutic effect and the dose that produces a lethal effect in animals.

pharmaceutical timeline

1806- morphine (pain) opium poppy plant*** 1853- syringe injected morphine**** 1899- aspirin is introduced*** 1922- Insulin first drug for diabetes*** 1941- penicillin (antibiotic drug)*** 1948- cortisone is introduced*** 1978- first portable insulin pump is introduced*** 1982- Humulin (human insulin) is introduced *** 1987- AZT(zidovudine, Retrovir) is introduced as the first drug for HIV *** 1996- Nicoderm is an introduced over-the-counter drug for stopping smoking.*** 1998- viagra introduced the first oral drug for erectile dysfunction in men**** 2000- Deciphering of the human genome opens the field of gene therapy in pharmacology **** 2002- Botox is introduced first injection drug for facial wrinkles *** 2006- Gardasil is introduced as the first vaccine against cervical cancer

Diuertic Drug Interactions

A diuretic is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way.

Investigational New Drug (IND)

A drug not approved for marketing by the FDA but available for use in experiments to determine its safety and efficacy; also, the actual name of the category of application that the drug manufacturer submits to the FDA to obtain permission for human (clinical) studies following successful completion of animal (preclinical) studies

Paradoxical Effects of a Drug

A drug that normally produces a specific therapeutic effect produces the opposite effect in certain patients. EX: Benzodiazepines in the anti-anxiety category of drugs causing anxiety and agitation in some patients.

thalidomide

A mild tranquilizer that, taken early in pregnancy, can produce a variety of malformations of the limbs, eyes, ears, and heart.

Focus on Health Care

A person infected with HIV Remains without symptoms for four to five years Progressive decrease in the number of T lymphocytes A person infected with HIV Symptoms Fever Night sweats Weakness Diarrhea Weight loss Fatigue Swollen glands --> Dividing line between diagnosis of HIV infection and a diagnosis of AIDS is determined by the presence of absence of: CD4 lymphocyte count below 200 cells/mm3 --> Presence of opportunistic infections/disease Drug therapy for AIDS Drugs to suppress the virus Drugs to treat any secondary opportunistic infections that develop

gene slicing

A type of gene recombination in which the DNA is intentionally broken and recombined using laboratory techniques. (cutting)

steroid

A type of lipid characterized by a carbon skeleton consisting of four rings with various functional groups attached.

abbreviation for in general:

A.S= Left ear IM= intramuscular IV= intravenous KVO= keep vein open NG= Nasogastric NPO= nothing by mouth O.U= both eyes PO= orally or by mouth SQ= subcutaneous

Drugs Used to Treat HIV and AIDS

AIDS is an eventually fatal disease. HIV attaches to the CD4 receptors on helper T lymphocytes. Directs the lymphocyte to produce more HIV using the lymphocytes own DNA As the newly produced viruses are released, the lymphocyte is destroyed. - HIV attaches to the CD4 receptors on helper T lymphocytes. Infects more helper T lymphocytes and further weakens the immune system -Large numbers of helper T cells are destroyed. The action of suppressor T cells (CD8 lymphocytes) is unopposed. Further suppresses the immune system Although the body produces antibodies against HIV, the immune system is never able to eradicate the virus. HIV transmission Contact with an infected individual Contaminated blood Used needles Infected mother transmits the virus to the fetus or a breastfeeding infant Nucleoside reverse transcriptase inhibitor drugs for HIV and AIDS Inhibit reverse transcriptase An enzyme that the virus needs to reproduce itself Drugs also become part of the viral DNA chain, which causes it to break and the virus dies Nucleoside reverse transcriptase inhibitor drugs for HIV and AIDS abacavir (Ziagen) didanosine (Videx) emtricitabine (Emtriva) lamivudine (Epivir) stavudine (Zerit) zidovudine (Retrovir) Nucleotide analog reverse transcriptase inhibitor drugs for HIV and AIDS Act in the same way as nucleoside reverse transcriptase inhibitor drugs but are slightly modified in molecular structure Stops retrovirus from reproducing Given orally Tenofovir (Viread) Non-nucleoside reverse transcriptase inhibitor drugs for HIV and AIDS Drugs bind directly to reverse transcriptase. An enzyme needed to reproduce viral DNA Disrupts activity, causing the virus to die Non-nucleoside reverse transcriptase inhibitor drugs for HIV and AIDS Delavirdine (Rescriptor) Efavirenz (Sustiva) Etravirine (Intelence) Nevirapine (Viramune) Rilpivirine (Edurant) Protease inhibitor drugs for HIV and AIDS Inhibit the viral enzyme protease Breaks down certain proteins in the virus Important last step that must happen before a virus can reproduce Without the action, the virus dies. Protease inhibitor drugs for HIV and AIDS Atazanavir (Reyataz) Darunavir (Prezista) Fosamprenavir (Lexiva) Indinavir (Crixivan) Protease inhibitor drugs for HIV and AIDS Nelfinavir (Viracept) Ritonavir (Norvir) Saquinavir (Fortovase, Invirase) Tipranavir (Aptivus) Fusion inhibitor drugs for HIV and AIDS Block HIV when it tries to fuse its viral membrane with the cell membrane of the CD4 lymphocyte Because the virus cannot fuse with the lymphocyte, it is unable to reproduce itself. Enfuvirtide (Fuzeon) Integrase inhibitor drugs for HIV and AIDS Integrase strand transfer inhibitor drugs Without integrase, the retroviral DNA strand is complete, but cannot take over and direct the cellular activities of the CD4 lymphocyte. Dolutegravir (Tivicay) Raltegravir (Isentress) Cellular chemokine receptor antagonist drugs for HIV and AIDS Binds to and blocks cellular chemokine receptor on the CD4 lymphocyte Maraviroc (Selzentry) Combination drugs for HIV and AIDS Aptripla (efavirenz, emtricitabine, tenofovir) Combivir (lamivudine, zidovudine) Epzicom (abacavir, lamivudine) Kaletra (lopinavir, ritonavir) Combination drugs for HIV and AIDS Trizivir (abacavir, lamivudine, zidovudine) Stribild (elvitegravir, cobicostat, emtricitabine, tenofovir) Truvada (emtricitabine, tenofovir)

dietary supplement and health and education act

According to the DSHEA, dietary supplements must be intended to enhance the diet. They must be something that can be eaten but are not considered to be a whole meal

Quinapril

Accupril (contains red iron)

Drugs Used to Treat Acne Rosacea

Acne rosacea Adult form of acne Characterized by: Constant blotchy redness Dilated superficial blood vessels Excessive amounts of oil on the face Acne rosacea Exacerbated by: Heat Stress Skin irritation Treatment: Alpha receptor agonist drugs for acne rosacea Antibiotic drugs for acne rosacea Azelaic acid (Azelex, Finacea) Clindamycin (Cleocin T) Metronidazole (MetroCream, MetroGel) Corticosteroid drugs for acne rosacea Dexamethasone (Maxidex)

the controlled substance act

Act to regulate drugs and the prescribing of drugs by health care providers

Drugs Used to Treat Infertility

Actions Stimulate ovaries to produce ova Prepare the endometrium to receive a fertilized ovum Correct hormonal imbalances Often used as part of a program of assisted reproductive technology (ART) Ovulation-stimulating drugs for infertility Stimulate a non-ovulating ovary to develop multiple follicles and then release mature ova (eggs) Appropriate for patients with anovulation (failure to ovulate) Ovulation-stimulating drugs for infertility Not appropriate for patients with infertility due to blocked fallopian tubes and problems that require surgical intervention Ovulation-stimulating drugs for infertility Some drugs act by stimulating the hypothalamus and anterior pituitary gland. Causes a release of follicle-stimulating hormone (FSH) Other drugs act in the same manner as follicle-stimulating hormone or luteinizing hormone. Ovulation-stimulating drugs for infertility Cetrorelix (Cetrotide) Choriogonadotropin alfa (Ovidrel) Clomiphene (Clomid) Degarelix (Firmagon) Follitropin alfa (Gonal-f) Ovulation-stimulating drugs for infertility Follitropin beta (Follistim AQ) Ganirelix Human chorionic gonadatropin (Pregnyl, Profasi) Lutropin alfa (Luveris) Menotropins (Repronex) Urofollitropin (Bravelle) Drugs for chronic diseases are given to protect the health of both the mother and fetus. Hypothyroidism Diabetes mellitus Hypertension Antibiotics for acute infections Pregnant women are prescribed prenatal vitamins, iron, and folic acid.

Drugs Used to Treat Withdrawal from Addiction

Addiction Substance-related disorder The frequent or constant use and abuse of drugs or chemicals to achieve a desired physical or emotional effect (a "high," sedation, or hallucination) Addiction After a brief period of abuse, the person experiences dependence Need for the drug to prevent withdrawal Later, the person exhibits tolerance Decreasing effect even with increasing amounts of the drug A state of complete physical and psychological dependence on a drug Drugs commonly used by addicts Schedule drugs Heroin Cocaine Narcotic drugs Barbiturate drugs Antianxiety drugs Alcohol Withdrawal process Emotionally, physically painful Symptoms Irritability Sweating Runny nose Abdominal cramps Nausea and vomiting Withdrawal process Symptoms Diarrhea Confusion Tremors Muscle aches Schedule III narcotic drugs to treat withdrawal from addiction to heroin, cocaine, or narcotic drugs Buprenorphine (Buprenex, Subutex) Schedule II narcotic drugs to treat withdrawal from addiction to heroin, cocaine, or narcotic drugs Methadone (Diskets, Dolophine) Also used on a long-term basis to prevent re-addiction Can go to a clinic to obtain a daily dose Prevents withdrawal symptoms Does not produce euphoria that causes drug-seeking behavior and addiction. Clonidine (Catapres) Stimulates alpha2 receptors on the brain stem Naltrexone (ReVia, Vivitrol) Narcotic antagonist drug Combination drugs for narcotic drug addiction Contains a narcotic agonist-antagonist (buprenorphene) and narcotic antagonist (naloxone) Suboxone

vaginal route

Administering a drug into the vagina using a medicated suppository

buccal route

Administration of a tablet or capsule by placing it in the oral cavity between the gum and the cheek.

the pharmacy

After prescription submitted It becomes the property of the pharmacy. The pharmacy is responsible for keeping it on file. Kept for several years Specified by state law --> Hospital (inpatient) pharmacy Only dispenses to patients admitted to the hospital Satellite pharmacies One large central pharmacy for large hospital complexes Medication carts For transporting patients' drugs Moved to each patient's room --> Hospital (inpatient) pharmacy A nurse administers, then charts medication on the patient's medication administration record (MAR) Abbrev. e-MAR in the electronic health record Outpatient pharmacy Or ambulatory pharmacy Hospital's ambulatory clinic ***Outpatient pharmacy Clinic Community pharmacy Compounding pharmacy Prepares, mixes, and packages drug ingredients under sterile conditions ****Telepharmacy Communities in remote locations --> Pharmacoinformatics (pharmacy informatics) Computerized database to store drug information and automate its retrieval when needed Bar code technology Pill imaging technology Corporate pharmacy chain --> Online pharmacies Provide convenient service to patients Order prescriptions over the Internet Drugs are mailed to the patients at home. Legitimate pharmacies have a seal on the home page of their website: "Verified Internet Pharmacy Provider Site"

Basic of drug effect

Agonist drug A drug that is able to unlock and activate a receptor and produce an effect Antagonist and blocker drugs Some drugs fit, but cannot unlock (activate), certain receptors. Therapeutic action is to occupy the receptor site. Block hormones, neurotransmitters, other drugs from activating the receptor. One drug can act as a master key. Unlocks several different receptors in different organs and tissues Accounts for: The therapeutic effect of the drug Various side effects of drug

Drugs Used to Treat Alopecia

Alopecia usually begins in middle age. Inherited tendencies cause it to occur at an earlier age. In women Onset of menopause Levels of estradiol lower than levels of androgens cause the hair to thin. Alopecia usually begins in middle age In men Lowered testosterone Decreased blood flow to the scalp Cause hair follicles to shrink Male pattern baldness The hair on the top of the head eventually disappears. Fringe of hair at the back of the head Drugs are used to treat mild-to-moderate alopecia Not effective in all cases Must be continued indefinitely to maintain any new hair growth Two different therapeutic effects Finasteride (Propecia) This drug blocks an enzyme that must be present in order to produce DHT. Healthy scalp hair follicles contain small amount of the substance DHT. Shrinking hair follicles on balding scalp contain an increased amount of DHT. Minoxidil (Rogaine) Dilates the arteries in the scalp to increase blood flow Stimulates hair growth

antibiotic drugs

Aminoglycoside antibiotic drugs Group of drugs that kill bacteria Interfere with the synthesis of protein in the bacterial wall Disrupts intracellular contents and causes the bacterium to die Primarily effective against gram-negative bacteria Aminoglycoside antibiotic drugs Some (kanamycin, neomycin) are not absorbed from the intestine into the blood, so they are given orally as a bowel prep to inhibit bacteria prior to abdominal surgery. Used to treat a wide variety of gram-negative and some gram-positive bacterial infections Aminoglycoside antibiotic drugs Amikacin (Amikin) Gentamicin Kanamycin (Kantrex) Neomycin Paromomycin (Humatin) Streptomycin Tobramycin (TOBI, Tobrex) Tetracycline antibiotic drugs Inhibit the growth of bacteria by inhibiting protein synthesis in the cell wall of the bacterium Used to treat Wide variety of gram-negative and gram-positive bacterial infections Other bacterial infections Sexually transmitted diseases Tetracycline antibiotic drugs Demeclocycline (Declomycin) Doxycycline (Vibramycin, Vibra-Tabs) Minocycline (Dynacin, Minocin) Tetracycline (Sumycin) Carbapenem antibiotic drugs Interfere with the structure of the cell wall of the bacterium and cause cell death Effective against some gram-negative and gram-positive bacteria Doripenem (Doribax) Ertapenem (Invanz) Meropenem (Merrem I.V.) Monobactam antibiotic drugs Interfere with the structure of the cell wall of the bacterium and case cell death Effective against gram-negative bacteria Aztreonam (Azactam) Quinolone antibiotic drugs Interfere with the bacterium's DNA and cause cell death Effective against gram-negative bacteria Cinoxacin Nalidixic acid (NegGram) Fluoroquinolone antibiotic drugs Inhibit an enzyme essential to bacterial DNA replication and cause cell death Effective against Gram-negative bacteria Some gram-positive bacteria Other types of bacteria Fluoroquinolone antibiotic drugs Ciprofloxacin (Cipro) Gemifloxacin (Factive) Levofloxacin (Levaquin) Moxifloxacin (Avelox) Norfloxacin (Noroxin) Ofloxacin (Floxin)

Human Genome Project

An international collaborative effort to map and sequence the DNA of the entire human genome.

OTC

An over-the-counter (OTC) drug is defined as one that can be purchased without a prescription and is generally considered safe for consumers to use if the label's directions and warnings are followed carefully. The FDA approves a prescription drug being reclassified as an OTC drug if the following criteria are met: The indication for the drug's OTC use is similar to its use as a prescription drug. The patient can easily monitor his or her own condition when using the OTC drug. --> The FDA approves a prescription drug being reclassified as an OTC drug if the following criteria are met: The OTC drug has a low rate of side effects/toxicity and a low potential for abuse. The use of the OTC drug does not require the patient to have any special monitoring or ongoing tests.

Drug Alert

Anaphylactic shock is not common but is often associated with antibiotic drugs, although other drugs may also produce it. Interestingly, a patient may take several courses of an antibiotic drug over the years without any reaction, but then the next course of the drug will cause an allergic reaction Idiosyncratic Reactions to a Drug ---> Drug reaction, not a side effect --->Not based on an allergic reaction ---->Individual's unique reaction Has basis in the genetic makeup of the individual Genetic factors are responsible for variations in: --Metabolism of drug --Action of drug Certain ethnic groups have well-studied idiosyncratic reactions. Asian people Jewish people People of African descent Pharmacogenetics Study of how the genetic makeup of different people affects their response to certain drugs This is the reaction: Malignant hyperthermia Uncontrolled elevated body temperature --> given to inhaled anesthetic drug halothane

Topical Anesthetic Drugs for the Skin and Eyes

Anesthetic drugs applied to the skin in the form of: Creams Gels Ointments Sprays Local, Regional, Spinal, and Epidural Anesthetic Drugs Local anesthesia An anesthetic drug is given by subcutaneous injection into the skin. Anesthetizes a small area of skin and adjacent tissue Used during minor surgical procedures Regional anesthesia An anesthetic drug is given by subcutaneous injection near a nerve plexus (group of nerves) and its branches. Used during surgery on an extremity Provides anesthesia for just that region Also known as nerve block anesthesia Spinal anesthesia An anesthetic drug is given by injection into the subarachnoid space between the vertebrae of the lumbar region of the back. Epidural anesthesia An anesthetic drug is given by injection into the epidural space. Moves into the subarachnoid space to produce anesthesia Bupivacaine (Marcaine, Sensorcaine) Chloroprocaine (Nesacaine) Lidocaine (Xylocaine) in 1948 Mepivacaine (Carbocaine, Polocaine) Procaine (Novacain) Ropivacaine (Naropin) Tetracaine (Pontocaine) cocaine is part of this family: is anesthesia Drug Alert This pair of generic-name drugs looks and sounds very similar. Chloroprocaine and procaine Combination Anesthetic Drugs Used to provide local or regional anesthesia Duocain Bupivacaine Lidocaine

Drugs Used to Treat Eating Disorders

Anorexia nervosa Extreme, chronic fear of being fat Patient weighs much less than expected for age and height Continues to diet Decreases food intake to the point of starvation Denies being thin, and actually feels fat Bulimia nervosa Patient is of normal weight, but wishes to be thinner To lose weight the patient will: Diet Vomit Use laxatives Alternatively binges or eats large quantities of food, then purges Treated with: Tricyclic antidepressant drugs Desipramine (Norpramin) SSRI antidepressant drugs Fluoxetine (Prozac) Fluvoxamine (Luvox) Treated with: MAO inhibitor antidepressant drug Isocarboxazid (Marplan) Anticonvulsant drug Topiramate (Topamax) Lithium

Antiemetic drugs (con.)

Antiemetic drugs for motion sickness or vertigo -> Vertigo -> The sensation of lightheadedness, dizziness, and whirling -> Caused by irritation or infection in the inner ear -> Upsets the balance and stimulates the vomiting center Antiemetic drugs for motion sickness or vertigo -> Block inner ear stimuli from reaching the chemoreceptor trigger zone and the vomiting center in the brain -> Reduce the sensitivity of the inner ear to motion Antiemetic drugs for motion sickness or vertigo -Given orally -Cyclizine (Marezine) -Dimenhydrinate (Dramamine) -Meclizine (Antivert) A transdermal patch is worn behind the ear -scopolamine (Transderm-Scop)

Drugs Used to Treat a Drug Overdose, Suicide Attempt, or an Accidental Poisoning

Any drug or substance, when ingested in large amounts, can be toxic and fatal. Treatment consists of: -Emetic drugs -Remove the drug from the stomach Treatment consists of: -Absorbent drugs -Bind the ingested drug to another substance to make it inert -Antagonist drugs -Inactivate the drug in the blood Emetic drugs: -emesis means vomiting. -Ipecac syrup (not to give a person who asleep:(unconscious) aspiration.) -Drug that induces vomiting -Only useful if the patient is conscious and will not aspirate vomited stomach contents -Not helpful if the overdosed drug has already been absorbed from the stomach into the blood Adsorbent drugs -Drugs that bind drug or substance so it cannot be absorbed from the stomach into the blood -Not effective if the overdosed drug or toxic substance has already been absorbed into the blood Adsorbent drugs -Activated charcoal -Administered -Orally to patients who are conscious -Via nasogastric tube (A nasogastric tube (NG tube) is a special tube that carries food and medicine to the stomach through the nose.) to patients who are unconscious Narcotic drug antagonist drugs Given intravenously Compete for the same receptors sites as the drug -Block receptors Decrease the drug's effect -Nalmefene (Revex) -Naloxone (Narcan) is narcotic drug Antianxiety drug antagonist drugs Benzodiazepine type Competes for same receptor sites -Blocks receptors Decreases antianxiety drug's effects -Flumenazil (Romazicon) antianxiety Antidepressant drug antagonist drugs Trycyclic-type antidepressant Competes for same receptor sites -Blocks receptors Decreases antidepressant drug's effects -Physostigmine (Antilirium) is antidepresent Other drugs for a drug overdose Digoxin immune fab (Digibind, DigiFab) Not uncommon for older adult patients to experience digoxin toxicity Low therapeutic index Long half-life -Acetylcysteine (Acetadote) that drug overdose Used to treat acetaminophen overdose Protects the liver Other drugs for a drug overdose Fomepizole (Antizol) Ethylene glycol (antifreeze) and methanol (wood alcohol) poisoning -------------------------------------------------------- Other drugs for a drug overdose Drugs to treat lead, mercury, arsenic, gold, iron, or aluminum toxicity Deferasirox (Exjade) Deferoxamine (Desferal) Dimercaprol (BAL In Oil) Edetate calcium disodium (Calcium Disodium Versenate) Succimer (Chemet)

Topical Route of Administration

Applied to the skin, eyes, or ears Local therapeutic effect Sometimes extends beyond local area

Drugs Used to Treat Benign Prostatic Hypertrophy

BPH common in men over 50 Incidence increases with age. --> Prostate gland hypertrophies (enlarges). The chain reaction in which testosterone is acted on by an enzyme in prostatic cells Enzyme converted to dihydrotestosterone Causes the prostate gland to enlarge Enlargement is benign and not cancerous. --> Symptoms Difficulty initiating urination Hesitancy Decreased urinary stream Treatment Androgen inhibitor drugs Alpha1- receptor blocker drugs --> Androgen inhibitor drugs for BPH Androgen refers to all of the various male hormones. Actions Inhibit the male hormone dihydrotestosterone Reduce its effect on the prostate gland --> Androgen inhibitor drugs for BPH Need to be taken for 6 to 12 months to see if it is effective in decreasing the size of the prostate Dutasteride (Avodart) Finasteride (Proscar) antihibrator drugs- remember Has also been found to decrease the incidence of cancer of the prostate gland. --> Alpha1-receptor blocker drugs for BPH Block alpha1 receptors in the smooth muscle of the walls of the urethra and prostate gland Causes the smooth muscle to relax Causes urine to flow more easily --> Alpha1-receptor blocker drugs for BPH Few alpha1 receptors in the neck of the bladder The drug does not relax the muscles in the bladder. The drug does not cause incontinence. --> Alpha1-receptor blocker drugs for BPH Alfuzosin (Uroxatral) Doxazosin (Cardura) Tamsulosin (Flomax) Terazosin (Hytrin)

Drugs Used to Treat Bacterial Infections of the Skin

Bacterial infections of the skin occur anytime the skin is broken. Bacteria are always on the surface of the skin. Superficial abrasions, cuts, and burns that become infected are treated with topical antibiotic drugs. Used to treat skin infections that develop as a result of: Skin diseases, such as acne vulgaris, contact dermatitis Bacterial invasion into areas of fungal or viral skin infections Topical anti-infective and antibiotic drugs OTC and Rx Treat superficial bacterial skin infections Inhibit the growth of bacteria (bacteriostatic action) or kill bacteria (bactericidal action) by blocking their ability to maintain a cell wall Topical anti-infective and antibiotic drugs Bacitracin Gentamicin Mupirocin (Bactroban) Retapamulin (Altabax) Sulfacetamide (Ovace) Topical antibiotic combination drugs OTC combination drugs contain two or three topical antibiotic drugs (bacitracin, neomycin, polymyxin B). Neosporin Original Bacitracin, neomycin, polymyxin B Polysporin Bacitracin, polymyxin B Topical antibiotic combination drugs OTC combination drugs contain two or three topical antibiotic drugs (bacitracin, neomycin, polymyxin B). Triple Antibiotic Bacitracin, neomycin, polymyxin B Topical antibiotic combination drugs These OTC combination drugs contain three antibiotic drugs (bacitracin, neomycin, polymyxin B) and an anesthetic drug (lidocaine, pramoxine) to treat bacterial skin infections and control pain Lanabiotic Bacitracin, neomycin, polymyxin B, lidocaine Topical antibiotic combination drugs These OTC combination drugs contain three antibiotic drugs (bacitracin, neomycin, polymyxin B) and an anesthetic drug (lidocaine, pramoxine) to treat bacterial skin infections and control pain Neosporin Plus Pain Relief Bacitracin, neomycin, polymyxin B, pramoxine Systemic antibiotic drugs For serious or widespread bacterial infections of the skin, oral or intravenous antibiotic drugs that work systemically are prescribed.

Drug Alert (Gastro. Drug)

Baking soda (sodium bicarbonate) dissolved in water is an old home remedy for indigestion and heartburn. Although sodium bicarbonate neutralizes acid, it is not recommended as a long-term treatment for heartburn because the large amounts of sodium it contains are absorbed systemically. --> Physicians recommend the moderate use of salt (sodium), even for patients without hypertension and other medical conditions. -->However, even over-the-counter antacid drugs contain large amounts of sodium. --> One dose of the antacid drug Regular Alka-Seltzer contains 1,700 mg of sodium, and one dose of Bromo Seltzer contains over 2,700 mg. ---> For patients on a low-salt diet, this exceeds their recommended allowance of sodium for the entire day.

chapter 17 Dermatologic Drugs

Because of superficial nature and location of most dermatologic diseases, they respond well to topical drug therapy. Includes many OTC as well as Rx drugs Some dermatologic diseases become: Widespread Severe Deeply penetrated below the skin Oral drugs that act systemically are given Drugs Used to Treat Acne Vulgaris Acne vulgaris Form of acne that is commonly seen during adolescence Characterized by large amounts of oil that harden and block the hair pore, forming reddish papules As bacteria feeds on the oil, they cause infection. This draws white blood cells to the area, forming pustules (whiteheads) Acne vulgaris Characterized by large amounts of oil that harden and block the hair pore, forming reddish papules As bacteria feeds on the oil, they cause infection. Hardened oil turns black as it is exposed to air, forming comedos (blackheads). Topical drugs Cleanse away oil and dead skin (keratolytic action) Close the pores (astringent action) Kill skin bacteria (anti-infective action) Ointments are not used to treat acne vulgaris because their high oil content clogs the pores. Topical keratolytic drugs for acne vulgaris Salicyclic acid (Clearasil, Fostex, Stri-Dex) OTC drug has a keratolytic effect that removes oil and dead skin to cleanse the pores. Topical antibiotic drugs for acne vulgaris Antibiotic drugs kill bacteria on the skin, used to treat the pustules of acne vulgaris. Prescription drugs Azelaic acid (Azelex, Finacea) Benzoyl peroxide (Benzac, Desquam, PanOxyl) Topical antibiotic drugs for acne vulgaris Antibiotic drugs kill bacteria on the skin, used to treat the pustules of acne vulgaris. Prescription drugs Clindamycin (Cleocin T) Erythromycin (Emgel, Eryderm) Topical combination drugs for acne vulgaris Contain a keratolytic drug and an antibiotic drug Rx drugs BenzaClin (benzoyl peroxide, clindamycin) Benzamycin (benzoyl peroxide, erythromycin) Topical combination drugs for acne vulgaris Rx drugs Clenia (sodium sulfacetamide, sulfur) Duac (benzoyl peroxide, clindamycin) Plexion (sodium sulfacetamide, sulfur) Sulfoxyl (benzoyl peroxide, sulfur) Oral antibiotic drugs for acne vulgaris Provide systemic treatment for cases of severe acne vulgaris Travel through the blood to kill bacteria in the deeper layers of the skin Belong to the tetracycline antibiotic drug category Oral antibiotic drugs for acne vulgaris Doxycycline (Vibramycin, Vibra-Tabs) Minocycline (Dynacin, Minocin) Tetracycline (Sumycin) Topical vitamin A-type drugs for acne vulgaris Vitamin A Known as retinoic acid Deficiency can produce abnormal changes in the epithelial cells of the skin, such as those that occur with acne vulgaris. Topical vitamin A-type drugs for acne vulgaris Vitamin A Retinoid drugs are structurally similar to vitamin A or similar to metabolites of vitamin A. Topical vitamin A-type drugs for acne vulgaris Cause epidermal cells to multiply more rapidly, preventing the pores from becoming clogged Decrease the inflammation associated with acne vulgaris Topical vitamin A-type drugs for acne vulgaris Rx drugs Adapalene (Differin) Tazarotene (Tazorac) Tretinoin (Retin-A) Oral vitamin A-type drugs for severe acne vulgaris Severe cystic acne vulgaris that is unresponsive to other drugs is treated systemically. Isotretinoin (Accutane) Causes epithelial cells to multiply more rapidly Oral vitamin A-type drugs for severe acne vulgaris Isotretinoin (Accutane) Prevents clogged pores from becoming infected and forming cysts Only used to treat severe cystic acne vulgaris, not common acne vulgaris

Glaucoma

Beta-blocker drugs used to treat glaucoma Betaxolol (Betoptic S) Carteolol Levobunolol (Betagan) Metipranolol (OptiPranolol) Timolol (Timoptic)

Biphasic oral contraceptive triphasic oral contraceptive drugs

Biphasic oral contraceptive drugs Two phases of hormone tablets in each pill pack Phase one provides fixed doses of: Progestin (desogestrel, levonorgestrel, norethindrone) Estrogen (ethinyl estradiol) Phase two Increased dose of progestin Same dose of estrogen Biphasic oral contraceptive drugs LoSeasonique Mircette Ortho-Novum 10/11 Seasonique Triphasic oral contraceptive drugs Three phases of hormone tablets in each pill pack Phase one provides fixed doses of: Progestin (desogestrel, levonorgestrel, norethindrone, norgestimate) Estrogen (ethinyl estradiol) Triphasic oral contraceptive drugs Phase two Either one or both of the hormone doses increases in each hormone tablet. Phase three Either one or both of the hormone doses increases or decreases in each hormone tablet in the pill pack. Triphasic oral contraceptive drugs Cyclessa Estrostep Ortho-Novum 7/7/7 Ortho Tri-Cyclen Tri-Norinyl Triphasil Four-phasic oral contraceptive drugs Four phases of hormone tablets Phases last for different lengths of times and provide different hormone drugs in different doses. Natazia (dienogest, estradiol valerate) Quartette (levonorgestrel, ethinyl estradiol) Other hormone contraceptive drugs Provide daily fixed doses of a progestin and estrogen NuvaRing In the form of a ring that is inserted in the vagina Other hormone contraceptive drugs OrthoEvra Transdermal patch that is applied to the skin

Blood and Blood Products

Blood for transfusion is available as: -Units of whole blood -Packed red blood cells -Platelets Whole blood, citrated -Contains all cellular components -Red blood cells -White blood cells -Platelets Whole blood, citrated -Contains plasma and all its constituents -Albumin -Globulins -Clotting factors -Electrolytes Whole blood, citrated Citrated refers to the anticoagulant (citrate) that is commonly used to: -Preserve whole blood -Prolong its refrigerated shelf life -Whole blood provides: -Complete correction of blood loss -Blood cells and plasma in the correct proportions Whole blood, citrated -Before whole blood can be given as a transfusion -The patient and the unit of blood must be: -Typed for blood type (MATCH THE RECIPIENT) -Cross-matched to each other (DONOR TRANSFUSION) Whole blood, citrated -Before whole blood can be given as a transfusion -Assures compatibility -Avoids transfusion reaction -Hemolysis of red blood cells due to incompatibility of blood types Packed red blood cells (PRBCs) -Concentrated preparation of RBCs in a small amount of plasma has an advantage over whole blood. -They can be given without causing fluid overload -Special importance in patients with CHF and premature infants who cannot tolerate increased blood volume Packed red blood cells (PRBCs) -Concentrated preparation of RBCs in a small amount of plasma has an advantage over whole blood. -Do not contain the plasma proteins and clotting factors -Must be typed and cross-matched before being administered Platelets are used for clotting. -Extracted from whole blood -Suspended in a small amount of plasma -Crossmatched for best results -Unmatched It May be given in an emergency Does not provoke a transfusion reaction The body's antibodies quickly destroy them Less effective than matched platelets Platelets Given to patients with: -Thrombocytopenia - a condition in which you have a low blood platelet count. -Leukemia- blood cancer -Suppressed bone marrow- chemotherapy, bone cancer they not producing the platelets.

CR ER LA CD SR XL Caplets

CD- controlled delivery CR- controlled releases ER-extended release LA- long acting SR-slow release XL- extended length Caplets- are coated tablets shaped into the form of an elongated capsule.

capsules

Cap or caps One-piece gelatin shell with liquid inside Hard shell in two pieces, powder or granules inside

Drugs Used to Treat Tuberculosis

Caused by the bacterium Mycobacterium tuberculosis, a gram-positive bacterium -> Spread by airborne droplets expelled by coughing If immune system is strong, the infection can remain dormant for several years without causing symptoms. M. tuberculosis Has a unique waxy coating around its bacterial wall Makes it difficult to kill Resistant to antibiotic drugs that are effective against other gram-positive bacteria Treatment A combination (not just one) of the following special antitubercular drugs: Ethambutol (Myambutol) Isoniazid (INH, Nydrazid) Pyrazinamide Treatment A combination (not just one) of the following special antitubercular drugs: Rifampin (Rifadin, Rimactane) Rifapentine (Priftin) Streptomycin Over a period of 9 month

side effects of chemo drugs

Chemotherapy drugs Nausea Vomiting Chills Fever Chemotherapy drugs Loss of hair Depression of bone marrow FDA does not take the drug off the market because of the treatment. Life-threatening cancer more of a concern than side effects.

Bronchodilator Drugs

Combination bronchodilator drugs Beta-agonist bronchodilator drug and anticholinergic bronchodilator drug Combivent Albuterol, ipratropium Corticosteroid Drugs Hormones secreted naturally by the adrenal gland Suppress the inflammatory response of the immune system Reduce Inflammation Tissue edema associated with: Asthma Other chronic lung diseases Prevent acute attacks Do not dilate the bronchioles Cannot be used to treat acute attacks Must also take a bronchodilator drug Most drugs are given by an inhaler device. Dosage is prescribed by the number of puffs or actuations. Prednisone is given orally. Beclomethasone (QVAR) Budesonide (Pulmicort) Ciclesonide (Alvesco) Flunisolide (AeroBid, AeroSpan) Fluticasone (Flovent) Mometasone (Asmanex) Prednisolone (Orapred, Pediapred)

Drugs for ADHD

Combination drugs for ADHD Adderall Amphetamine Dextroamphetamine An isomer of amphetamine Drug that has the same chemical formula and identical types and numbers of atoms as another drug but atoms are arranged differently Combination drugs for ADHD Adderall Amphetamine Dextroamphetamine An isomer of amphetamine Molecular weight is a right-handed (dextr/o- means right) mirror image of the amphetamine molecule. Several times more potent as a stimulant drug.

Drugs Used to Treat Diarrhea : combination

Combination drugs for diarrhea An anticholinergic drug to reduce the rate of peristalsis -Atropine -Absorbent drugs to absorb excess water from diarrhea stools -Attapulgite, kaolin, pectin --> Combination drugs for diarrhea An anti-infective drug (bismuth) Schedule IV or Schedule V narcotic to slow peristalsis (difenoxin, diphenoxylate) --> Combination drugs for diarrhea -Imodium Multi-Symptom Relief -Loperamide -Simethicone -Kapectolin -Kaolin -Pectin --> Combination drugs for diarrhea -Lomotil -Atropine -Diphenoxylate -Motofen -Atropine -Difenoxin

Combination Drugs

Combine one or more of the following: A bronchodilator drug Albuterol Dyphylline Formoterol Ipratropium Salmeterol Theophylline Combine one or more of the following: A corticosteroid drug Budesonide Fluticasone An expectorant drug Guaifenesin Potassium iodide An anticholinergic drug Umeclidinium Anora Ellipta Vilanterol, umeclidinium Advair Salmeterol, fluticasone Breo Ellipta Vilanterol, fluticasone Combivent Albuterol, ipratropium Dulera Formoterol, mometasone Lufyllin-GG Dyphylline, guaifenesin Symbicort Formoterol, budesonide

control drugs ()

DEA number Prescription form If drug has potential for abuse Controlled substance Assigned federal DEA number in order for prescription to be valid Consists of 9 characters

component Date *****Refills Prescription form How many times the patient is permitted refills Preprinted Refills area: 0 (sometimes NR for "no refills"), 1, 2, or 3 Only be refilled for a year No refills for Schedule II

Date Prescription form The physician writes full date Month/day/year Prescription good for: 1 year from date of prescription 6 months for Schedule III through Schedule V drugs 7 days for Schedule II drugs

chapter 19 Ears, Nose, and Throat Drugs

Decongestant Drugs -> Act as vasoconstrictors by stimulating alpha-receptors in the smooth muscle around the blood vessels -Reduce blood flow to edematous mucous membranes in the nose, sinuses, and pharynx -> Decrease the swelling of mucous membranes -Alleviate nasal stuffiness and sinus congestion -Allow secretions to drain -Help open up eustachian tubes to the ears -> Commonly prescribed for colds and allergies -Can be administered topically as nose drops or nasal sprays or orally Naphazoline (Privine) Oxymetazoline (Afrin 12-hour, Duration) Phenylephrine (Afrin, Sudafed PE) Pseudophedrine (Dimetapp, Drixoral, Sudafed, Triaminic) Tetrahydrozoline (Tyzine) Xylometazoline (Otrivin)

Antitussive Drugs

Decrease coughing by: Suppressing the cough center in the brain Anesthetizing stretch receptors in the respiratory tract Main purpose is to control dry, nonproductive coughs. -Non-narcotic antitussive drugs Benzonatate (Tessalon) Prescription drug Dextromethorphan (Robittusin, Vicks 44) Over-the-counter drug Commonly seen in combination drugs used to treat coughs and colds -Narcotic antitussive drugs Some antitussive drugs contain codeine or hydrocolone, Schedule III narcotic drugs. These Rx drugs are used to treat severe, nonproductive coughs. Codeine Hydrocodone (Hycodan)

Drugs Used to Treat Depression

Depression is a mood disorder characterized by: Insomnia Crying Lack of pleasure in any activity Increased or decreased appetite Lack of ability to act or concentrate Depression is a mood disorder characterized by: Guilt Helplessness Hopelessness Worthlessness Thoughts of suicide and death Depression is caused by decreased levels of neurotransmitters in the brain. Norepinephrine Serotonin Bupropion (Aplenzin, Wellbutrin) treat depression Treatment involves the use of antidepressant drugs also known as mood-elevating drugs. Treatment not only alleviates the symptoms of depression but also: Increases mental alertness Normalizes sleep patterns Normalizes the appetite Decreases suicidal ideation Several categories of antidepressant drugs Tricyclic antidepressant drugs -Tetracyclic antidepressant drugs -Selective serotonin reuptake inhibitor drugs (SSRI) -Several categories of antidepressant drugs -Serotonin and norepinephrine reuptake inhibitor drugs (SNRI) -Monoamine oxidase (MAO) inhibitor drugs Tricyclic antidepressant drugs Inhibit the reuptake or prolong the action of norepinephrine or serotonin Helps correct the low levels Increase the sensitivity of receptors on the neurons to available norepinephrine and serotonin Tricyclic antidepressant drugs Affect the levels of histamine and acetylcholine Common side effects Dry mouth Dry eyes Blurry vision Constipation Urinary retention Tricyclic antidepressant drugs Named because of the triple-ring configuration of their chemical structure Amitriptyline Amoxapine Desipramine (Norpramin) Doxepin (Sinequan) Tricyclic antidepressant drugs Imipramine (Tofranil) Nortriptyline (Aventyl, Pamelor) Protriptyline (Vivactil) Trimipramine (Surmontil) Tetracyclic antidepressant drugs -> Although slightly different in chemical structure, tetracyclic antidepressant drugs have essentially the same therapeutic effect as tricyclic antidepressant drugs. Maprotiline Mirtazapine (Remeron) 5-HT receptor agonist drugs for depression 5-hydroxytryptamine (serotonin) Bind to and stimulate the same receptors that natural serotonin would stimulate if it were present in normal amounts Vilazodone (Viibryd) Selective serotonin reuptake inhibitor (SSRI) drugs for depression Block the normal reuptake of free serotonin by nerve cells When serotonin levels are low in patients with depression, these drugs allow the available serotonin to bind with more receptors for a longer period of time before it is broken down and recycled Selective serotonin reuptake inhibitor (SSRI) drugs for depression Do not affect histamine or acetylcholine levels Do not cause the side effects that are seen in tricyclic antidepressant drugs Selective serotonin reuptake inhibitor (SSRI) drugs for depression Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac) Fluvoxamine (Luxor) Paroxetine (Paxil) Sertraline (Zoloft)

What you need to know ? (In depth)

Did you know? --> Viagra was the first drug for treating erectile dysfunction. --> Even former presidential candidate Bob Dole appeared in a television commercial, candidly discussing ED and urging viewers to ask their doctor about appropriate treatment. --> Prostaglandin is a naturally occurring body substance that was first isolated from the prostate gland, from which it derives its name. Prostaglandins are present in many different tissues in the body and, when used as drugs, they have several different actions. -->Prostaglandin E1 drugs cause vasodilation, which is useful in treating erectile dysfunction. Prostaglandin E1 drugs are also used to keep open a patent ductus arteriosus to sustain life in a newborn with a congenital heart defect such as the tetralogy of Fallot. --> Prostaglandin E2 drugs stimulate the smooth muscle in the wall of the uterus and are used to induce premature labor and terminate a pregnancy.

Transdermal Route of Administration

Different than topical route Applied to skin but therapeutic effect always felt systemically and not at site of administration Delivered through a patch Drug slowly released

Nasogastric route

Drug delivery through the nasal passages and into the stomach.

basic Drug effects

Drug effects are initiated through receptors. Special protein molecules located on the cell membrane of every cell Drug effects are initiated through receptors. Specifically designed to interact with natural body chemicals -Hormones -Enzymes Neurotransmitters Also, interact with drugs -Lock and key -Receptors are the lock. -Drugs are the key. -->Certain drugs can unlock (activate) receptors. -> Chemically similar drugs activate the same receptor Produce similar effects

Side Effects of a Drug

Drug effects other than the therapeutic effect Mild and temporary Moderate and annoying Severe FDA may not approve the drug. Once FDA approved, must list side effects Advertisements Informational literature Prescribing information Package inserts Common side effects listed as the drug is tested No drug is entirely safe and without potential side effects.

Therapeutic Effect of a Drug

Drug's main activity for which it was prescribed Selected to: Prevent a disease Diagnose a disease Treat disease by controlling, improving, or curing the symptoms Can be directed toward a specific area of the body Target organ Not always directed towards a target organ Antibiotic drugs Sometimes therapeutic effect actually a side effect Antihistamines Insomnia

chapter 13 GYN drugs = gynecologic and obstetric drugs

Drugs Used to Prevent Pregnancy -> Pregnancy occurs at the moment that an ovum is fertilized by a spermatozoon. Drugs used to prevent pregnancy -> Change the hormonal environment of the female reproductive tract so that a mature ovum is not produced or released by the ovary Drugs used to prevent pregnancy Kill spermatozoa Keep a fertilized ovum from implanting in the endometrium Oral contraceptives or birth control pills Exert a hormonal influence to prevent pregnancy 99% effective if taken as directed Oral contraceptives or birth control pills Change the hormonal environment of the female reproductive tract Divided into three groups Monophasic Biphasic Triphasic Oral contraceptives or birth control pills Contain a combination of the hormone drug categories Progestins Estrogen Doses Fixed Varied

chapter 18 Ophthalmic Drugs

Drugs Used to Treat Eye Infection Superficial bacterial, fungal, and viral infections can occur in the: Eye Eyelid and surrounding structures Cornea Conjunctiva Tear duct Treated topically with: Antibiotic drugs for bacterial infections Sulfonamide drugs for bacterial infections Antifungal drugs for fungal infections Antiviral drugs for viral infections Topical antibiotic drugs for bacterial eye infections Disrupt the cell wall of bacteria Not effective against viral infections Azithromycin (AzaSite) Bacitracin (AK-Tracin) Besifloxacin (Besivance) Ciprofloxin (Ciloxan) Erythromycin (Ilotycin) Topical antibiotic drugs for bacterial eye infections Gatafloxacin (Zymar) Gentamicin (Garamycin, Gentacidin, Gentak) Levofloxacin (Quixin) Moxifloxacin (Vigamox) Ofloxacin (Ocuflox) Tobramycin (AK-TOB, Defy, Tobrex) Topical sulfonamide drugs for bacterial eye infections Sulfacetamid (AK-Sulf, Sulster) Topical anti-infective drugs not classified as antibiotic drugs, but as an anti-infective drugs. Unlike antibiotic drugs that kill bacteria, this drug inhibits the growth of bacteria and are used to treat bacterial infections of the eyelids and eye. Topical antifungal drugs for fungal eye infections Natamycin (Natacyn) Topical antiviral drugs for viral eye infections Trifluridine (Viroptic) Anti-infective drugs are only affective against viruses. Herpes simplex virus, type 1 and type 2 Topical antiviral drugs for viral eye infections Ganciclovir (Vitrasert) Administered as an implant that is placed within the eye in the vitreous humor so that the drug will come in contact with the retina Also used topically to treat cytomegalovirus retinitis

diagnostic use

Drugs are used in radiologic procedures and other types of medical tests to provide evidence of a disease process.

preventive use

Drugs are used to prevent the occurrence of diseases or conditions

Drugs Used to Treat Diseases-of the Intestines (con.)

Drugs for irritable bowel syndrome Serotonin receptor blocker drugs -Alosetron (Lotronex) -Chloride channel activator drugs -Lubiprostone (Amitiza) -Antispasmodic drugs -Dicyclomine (Bentyl) -Hyoscyamine (Levbid, Levsin) Drugs for irritable bowel syndrome -Guanylate cyclase-C agonist drug -Linaclotide (Linzess) -Antibiotic drug -Rifaximin (Xifaxan)

Local Versus Systemic Effects of Drugs

Drugs have one of two effects. Local effect Limited to site of administration Tissues immediately surrounding it Systemic effect Felt throughout the body Always local Vaginally administered drugs Always systemic Orally administered drugs (usually) Exception Some drugs that are not absorbed exert a local effect on the GI tract Intramuscularly administered drugs Intravenously administered drugs Either local or systemic Depends on the type of drug administered Inhaled drugs Subcutaneously administered drugs Rectally administered drugs

Immune Globulin Drugs (pathogen that are bacteria= pic.)

Drugs that are made by processing human blood plasma and extracting the antibodies (immunoglobulins) Given to patients to provide short-term, temporary protection against a disease after the patient has been exposed to that disease and does not have their own antibodies Examples include varicella and rabies. The Process of Immunization Immunization Inserts vaccine into the body Immun/o- means immune response, and the suffix -ization means the process of creating. Also known as vaccination or inoculation Routes of administration Oral route Adenovirus Rotavirus Most vaccines cannot be given by this route because they are not absorbed from the intestines. Intranasal route One type of immunization for influenza Routes of administration Subcutaneous route Measles Mumps Rubella Varicella Herpes zoster Intramuscular route All other vaccines are given by this route.

Vaccines

Drugs that are produced and administered with the sole purpose of preventing the occurrence of a specific disease caused by a bacterium or a virus Forms Live but attenuated (weakened) bacteria or viruses Grown in several different types of cultures to weaken it Grown at temperatures that do not allow it to reproduce easily Target mutagenesis DNA/RNA mutations Less virulent Forms Intact but inactivated (killed) bacteria or viruses Killed with heat or chemicals Cannot reproduce Antigens on the outside surface of the bacteria can still provoke a response from the patient's immune system. Forms Subunits The part that contains just the antigens from the surface of a bacterium or virus Toxoids Only the toxin produced by certain gram-negative bacteria Inactivated by formaldehyde so it can no longer cause fever and infection Forms Toxoids Tox/o- means poison, and the suffix -oid means resembling. Toxoid vaccines resemble the poisonous endotoxin produced by the bacteria. Polysaccharide versus conjugate vaccines Polysaccharides Carbohydrate molecules found in the walls that surround certain bacteria Do not provoke strong immune response Conjugate (joined) vaccine Polysaccharide taken from capsule around bacterium is joined to a protein carrier. Polysaccharide versus conjugate vaccines Haemophilus influenzae type b vaccine First produced in 1987 Pneumococcal pneumonia vaccine Valence Monovalent Contain single type of antigen or strain of one pathogen Trivalent Contain three types Multivalent Contain several types Most vaccines for the "flu shot" Valence Example Gardasil is a quadrivalent vaccine. Contains four different strains of human papillomavirus infection One type of pneumococcal pneumonia vaccine contains 23 different strains; it is a 23-valent vaccine. Single versus combined vaccines -Several vaccines often combined into a single dose to avoid multiple injections -M-M-R II -Measles, mumps, and rubella -ProQuad -Measles, mumps, rubella, and varicella Booster shots -Second, third, or fourth vaccine following the initial one -Used to "boost" the immune response to that disease after some time has elapsed Example Adults should receive a tetanus vaccine booster every 10 years.

Drugs Used to Treat Obesity

Drugs used to treat obesity act in one of two ways. - They keep dietary fat from being absorbed in the intestines. - They suppress the appetite to decrease the total amount of food being eaten. Lipase inhibitor drugs for obesity -Chemically bond to the enzyme lipase -Cannot break down dietary fat in the intestines -Fat is excreted rather than absorbed. -Orlistat (Alli, Xenical) Appetite-suppressant drugs for obesity - Similar in chemistry to amphetamines, but less addictive properties - Suppress the appetite by affecting dopamine or serotonin levels in the satiety center of the brain - Also known as anorexiant drugs Appetite-suppressant drugs for obesity -Limited to short-term treatment of obesity in conjunction with dietary restrictions -If drugs are discontinued abruptly, patients may: -Develop drug dependence -Experience withdrawal symptoms Appetite-suppressant drugs for obesity Schedule III and IV drugs -Benzphetamine (Didrex) -Lorcaserin (Belviq) -Phendimetrazine (Prelu-2) -Phentermine (Pro-Fast) -Antidepressant -Bupropion (Wellbutrin) Combination drugs for weight loss Schedule IV drug and anti-seizure drug -Qsymia -Phentermine, topiramate -Narcotic antagonist and antidepressant drug -Contrave -Naltrexone, bupropion

mislabeled and dangerous drugs

During the 1700s and 1800s Commonly sold without regulation Accompanied by extravagant claims of cures Often contained addicting ingredients without its presence being listed Opium Morphine Cocaine

Drugs for Emergency Resuscitation

Emergency drugs Used to correct a life-threatening cardiac arrhythmia in which the heart is: -Beating extremely fast -Beating extremely slow -Stopped completely (asystole) -Also used to increase extremely low blood pressure Drugs for life-threatening cardiac arrhythmias and asystole -Ventricular fibrillation -Lidocaine (Xylocaine) -Indicated for the management of life-threatening ventricular fibrillation -Drug of choice -Inhibits flow of sodium into myocardial cells Drugs for life-threatening cardiac arrhythmias and asystole -Ventricular fibrillation -Lidocaine (Xylocaine) -Slows electrical impulses that cause the heart to fibrillate -Has no therapeutic effect when the heart is already in asystole -Epinephrine also used Drugs for life-threatening cardiac arrhythmias and asystole -Bradycardia -Atropine -Blocks the action of acetylcholine released from the vagus nerve -Part of the parasympathetic division of the nervous system, the vagus nerve innervates the heart, -When acetylcholine is released, the heart rate slows. Drugs for life-threatening cardiac arrhythmias and asystole -Bradycardia -Atropine -Used specifically to treat: -Severe bradycardia -Bradyarrhythmias such as heart block Drugs for life-threatening cardiac arrhythmias and asystole -Asystole -Epinephrine (Adrenalin) -Acts as a neurotransmitter released by the sympathetic division of the nervous system in response to pain, danger, or stress Drugs for life-threatening cardiac arrhythmias and asystole -Asystole -Epinephrine (Adrenalin) -Makes the myocardium more responsive to the use of a defibrillator that can restore a normal rhythm -In asystole, can help actually stimulate the contractions of the myocardium. Drugs for life-threatening cardiac arrhythmias and asystole -Asystole -Epinephrine (Adrenalin) -Stimulates the heart to beat, also helps to maintain blood pressure and blood flow to the heart and brain (improves chances of successful resuscitative efforts) Drugs for life-threatening cardiac arrhythmias and asystole -Calcium chloride -Used to stimulate the myocardium to contract more forcefully -May even stimulate a contraction when the heart is in asystole and has failed to respond to epinephrine. Vasopressor drugs -Stimulate beta1 receptors to increase the heart rate -Stimulate alpha receptors in the blood vessels to produce vasoconstriction and raise blood pressure -Maintain blood flow to the kidneys so that kidney ischemia from hypotension does not later result in renal failure Vasopressor drugs -Dopamine -Epinephrine (Adrenalin) -Isoproterenol (Isuprel) -Norepinephrine (Levophed) -Phenylephrine (Neo-Synephrine) Drugs for metabolic acidosis -During cardiac and respiratory arrest -The pH of the blood decreases rapidly. -Carbon dioxide and waste products accumulate in the blood. -In the environment of severe acidosis, the effectiveness of any emergency drug is greatly diminished. Drugs for metabolic acidosis -Sodium bicarbonate -Controversy as to the true effectiveness -May actually increase acidosis through a chemical reaction that releases more CO2 into the blood -American Heart Association guidelines recommend only using it after other measures have failed. Drugs for metabolic acidosis -Tromethamine (Tham) -Corrects the acidosis -Buffers excess hydrogen ions -Returns the blood pH to within a normal range

chapter 14 endocrine drugs

Endocrine system Consists of many glands that secrete hormones into the blood When glands malfunction, they secrete either: A decreased amount of hormone An increased amount of hormone Insulin Drugs Used to Treat Diabetes Mellitus Insulin Secreted by the beta cells in the islets of Langerhans in the pancreas Plays an essential role in glucose metabolism Lowers blood glucose levels by enabling cells to utilize glucose Insulin Transports glucose to the cell Binds with an insulin receptor on the cell membrane Transports glucose inside the cell The glucose is metabolized to provide energy. Diabetes mellitus The disease of the pancreas and body cells Type 1 The pancreas does not produce any insulin. Diabetes mellitus Type 2 The pancreas produces too little insulin. The number of or sensitivity of insulin receptors on body cells is decreased. Type 1 diabetes mellitus Previously known as: Insulin-dependent diabetes mellitus (IDDM) Juvenile-onset diabetes mellitus Treated with subcutaneously injected insulin Type 2 diabetes mellitus Previously known as: Non-insulin-dependent diabetes mellitus (NIDDM) Adult-onset diabetes mellitus Treated with antidiabetic drugs Insulin may be needed. Untreated or uncontrolled diabetes mellitus results in consistently elevated blood glucose levels. Eventually leads to the diabetic complications of: Diabetic retinopathy Diabetic neuropathy Untreated or uncontrolled diabetes mellitus results in consistently elevated blood glucose levels. Eventually leads to the diabetic complications of: Arteriosclerosis Ketoacidosis Death ( The word insulin is derived from the Latin word insula meaning island, a reference to the islets of Langerhans) (The abbreviation NPH stands for neutral protamine Hagedorn.)

Drugs Used to Treat Erectile Dysfunction****

Erectile dysfunction is the inability of a man to achieve and maintain an erection during intercourse. Sexual stimulation activates the chemical cGMP. Relaxes the smooth muscle in the arteries of the penis Increases blood flow Creates an erection --> Afterwards, enzyme PDE5 metabolizes cGMP and the erection resolves. Phosphodiesterase type 5 (PDE5) inhibitor drugs for ED Avanafil (Stendra) *** Sildenafil (Viagra) Tadalafil (Cialis) Vardenafil (Levitra) --> Prostaglandin E1 drugs for ED Act locally to relax the smooth muscle in the arteries of the penis Increase blood flow and create an erection --> Prostaglandin E1 drugs for ED After receiving training, the patient: Injects the drug (Caverject, Edex) into the side of the penis Inserts a pellet (Muse) into the urethra Alprostadil (Caverject, Edex, Muse)

The Seven Rights of Drug Administration

Every year, 1.5 million people are harmed by drug errors. Institute of Medicine (IOM) recommendations All prescriptions should be created electronically drug information and inserts by standardized. Each patient has approximately one medication error per day. Archives of Internal Medicine found that drug errors occur in 1 of every 5 doses administered in the hospital. 1. The right drug Generic drug names are often complex. Trade name drugs can have similar-sounding names. 2. The right drug Check the drug name against the medication order When the drug is taken from the cart or shelf As it is being poured or placed in a paper cup Before giving it to the patient Never administer a drug prepared by another person 3. The right drug form The same generic or trade name can be manufactured in several different forms. Drug form is noted on the prescription or medication order so that there is no confusion. 4. The right drug dose Calculating drug doses is an extremely important process. Standard adult dosage is appropriate for most adults. Preset by the drug company during clinical trials Patients who fall outside the adult dosage range may need to have dose adjusted (elderly, thin, obese). 5. The right drug dose Pediatric dosages Especially for infants and premature babies Must be calculated with great accuracy Based on the total weight of the patient not the age Expressed as mg/kg/day Milligrams of drug per kilogram of body weight per 24-hour period 6. The right drug dose Chemotherapy drug doses Calculated based on the patient's total body surface area Customizes the dose for each patient to maximize the effectiveness of the drug Minimizes side effects Expressed as mg/m2 Milligrams of drug per meter squared of body surface area 7. The right route of administration Important to check the prescribed route of administration Make sure the drug form is compatible with that route. 8. The right time Measured in the frequency of dosage Number of commonly used abbreviations that indicate the frequency Based on Latin phrases Chronotherapy Attempts to coordinate administration and metabolism of a drug to the body's own biological rhythms 9. The right patient In-home situations, dispensing to yourself is not difficult. In healthcare facilities, many patients receive drugs. Patient identification becomes crucial. -social security number -name, D.O.B 10. The right documentation Only after the drug administered should the information be entered in the medical or medication administration record MAR Drug name, form, dose, unit of measurement, route of administration Signature or initials of the administering healthcare professional

excretion

Excretion Other organs involved, to a limited degree lungs saliva, tears, sweat breast milk The drug is not automatically excreted just because it reaches the renal artery.

extraversion vs. vesicant

Extravasation When intravenous fluid accidentally administered into subcutaneous tissues instead of vein Vesicant Intravenous drug known to be very irritating, causing blisters or tissue death if contacting subcutaneous tissue

Drugs Used to Treat Eye Allergy Symptoms

Eye allergy symptoms occur for same reason as other parts of the body. Foreign substance enters the body antibodies attach to the antigen, forming an antigen-antibody Eye allergy symptoms occur for same reason as other parts of the body. Antigen-antibody can be destroyed, in the process histamine is released causes vasodilation of the blood vessels tissues become swollen, inflamed, and red irritates tissues causing pain and itching Antihistamine drugs for eye allergies Block the effect of histamine Alcaftadine (Lastacaft) Azelastine (Optivar) Emedastine (Emadine) Epinastine (Elestat) Ketotifen (Claritin Eye, Zaditor, Zyrtec Itchy Eye) Olopatadine (Pataday, Patanol) Mast cell stabilizer drugs for eye allergies Act as antihistamine drugs, prevent the cell membrane of mast cells in the eyes from releasing histamine Bepotastine (Bepreve) Cromolyn Mast cell stabilizer drugs for eye allergies Lodoxamide (Alomide) Nedocromil (Alocril) Pemirolast (Alamast) Decongestant drugs for eye allergies Constrict the blood vessels in the conjunctiva to reduce redness Naphazoline (Albalon) Oxymetazoline (Visine LR) Phenylephrine (Mydfrin) Tetrahydrozoline (Murine Tears Plus, Visine)

Food and Drug Administration Modernization Act of 1997

FDA the authority to accelerate the approval process for certain types of drugs. (6 months)

Powder

Finely ground form of a drug Capsules Glass vials Must be reconstituted with sterile water before injecting Oral use Reconstituted Canister

Metabolism

First-pass effect Initial metabolism by the liver The drug must first pass through the liver before entering the general circulation. For some drugs, most of the drug dose is immediately metabolized. The drug must be given by a different route in order to be therapeutic.

Gastrostomy and Jejunostomy Routes of Administration

For patients who cannot take oral medications Surgically implanted feeding tubes Gastrostomy Deliver liquid drugs to the stomach Jejunostomy Deliver liquid drugs to the jejunum Any liquid drug that can be given orally

Intravesical Route of Administration

For treating pain and burning of inflammation and infection in the bladder Instilled into bladder through catheter Chemotherapy drugs into bladder

Potassium Chloride Drugs (K Cl)

Frequently prescribed for patients taking thiazide and loop diuretic drugs To avoid excessive loss of potassium Manufactured as: Liquids Patients often object to the taste. Powders Effervescent tablets To be dissolved in water Capsules Tablets

Drugs Used to Treat Fungal or Yeast Infections of The Skin

Fungi and yeast Grow in areas that are: Dark Warm Moist Fungi and yeast Areas at risk Feet Perineal area Groin area Underarms Scalp Fungus infections include: Ringworm (tinea capitis, tinea corporis) Athlete's foot (tinea pedis) Jock itch (tinea cruris) Fungal infections of the nails (onychomycosis) Yeast infections Caused by Candida albicans Most frequently occur in the: Mouth Vagina Skin (diaper rash) Fungal and yeast infections can be effectively treated with topical antifungal and anti-yeast drugs. Alter the cell wall of the fungus or yeast Disrupt its enzyme activity resulting in cell death Some drugs are used to treat fungal infections also to treat yeast infections because they are closely related (biologically) to each other. Topical antifungal drugs OTC and RX drugs used to treat superficial fungal infections of the skin or nails Butenafine (Lortimin Ultra) Ciclopirox (Loprex, Penlac Nail Lacquer) Clotrimazole (Cruex Cream, Desenex Cream, Lotrimin AF 1%) Econazole (Spectazole) Topical antifungal drugs OTC and RX drugs used to treat superficial fungal infections of the skin or nails Efinaconazole (Jublia) Ketoconazole (Nizoral A-D, Xolegel) Luliconazole (Luzu) Miconazole (Lotrimin AF 2%, Micatin, Ting 2%) Topical antifungal drugs OTC and RX drugs used to treat superficial fungal infections of the skin or nails Naftifine (Naftin) Oxiconazole (Oxistat) Sertaconazole (Ertaczo) Sulconazole (Exelderm) Topical antifungal drugs OTC and RX drugs used to treat superficial fungal infections of the skin or nails Terbinafine (DesenexMyax, Lamisil AT) Tolnaftate (Aftate, Tinactin, Ting 1%) Undecylenic acid (Cruex, Desenex) Systemic antifungal drugs When fungal infections penetrate deeply into the skin or nails, cover large areas, or are particularly severe, they are treated with drugs that act systemically

side effects

Gastrointestinal side effects Anorexia Nausea Vomiting Diarrhea Constipation (narcotic drugs) Central nervous system drugs Drowsiness Excitement Depression Antidepressant drugs Blurred vision Dry mouth Fatigue

Drugs Used to Obtain General Anesthesia

General anesthesia Loss of consciousness as a means of producing generalized anesthesia throughout the body A technique that distinguishes it from all other types of anesthesia General anesthesia in the operating room Induction of anesthesia First given a drug to induce general anesthesia Generally given intravenously General anesthesia in the operating room Maintenance of anesthesia Anesthetic drugs are given to maintain general anesthesia throughout the procedure. It May be given intravenously or by inhalation Intravenous drugs for general anesthesia Provide a rapid loss of consciousness Help the anesthesiologist to initiate anesthesia quickly while minimizing patient anxiety Intravenous drugs for general anesthesia Include: Ultrashort-acting barbiturate drugs Narcotic drugs Sedative drugs Antianxiety drugs Intravenous drugs for general anesthesia Some drugs are used by themselves to provide light sedation during short procedures. Usually, one (or more) of these drugs is used in combination with an anesthetic gas to provide a balanced and sustained level of general anesthesia. Intravenous drugs for general anesthesia Classified as Schedule II, III, or IV drugs, but the short duration of use during surgery eliminates the possibility of addiction Barbiturate drugs for general anesthesia Induce general anesthesia In combination with other drugs, maintain general anesthesia Depress the central nervous system and produce sedation Barbiturate drugs for general anesthesia In higher doses Produce unconsciousness No analgesic effect Methohexital (Brevital) Narcotic drugs for general anesthesia Used to induce general anesthesia Used in combination with other drugs to help maintain general anesthesia Bind with opiate receptors in the brain to block pain In higher doses, produce unconsciousness Narcotic drugs for general anesthesia Schedule II Alfentanil Fentanyl Meperidine (Demerol) Morphine (Duramorph) Nalbuphine (Nubain) Narcotic drugs for general anesthesia Schedule II Oxymorphone (Numorphan, Opana) Pentazocine (Talwin) Remifentanil (Ultiva) Sufentanil (Sufenta) Narcotic drugs for general anesthesia Schedule III Ketamine (Ketalar) Schedule IV Fospropofol (Lusedra) Midazolam Not Scheduled Etomidate (Amidate) Propofol (Diprivan) Inhaled gases for general anesthesia Induce or maintain general anesthesia Used in conjunction with one or more of the intravenous anesthetic drugs Inhaled gases for general anesthesia Desflurane (Suprane) Enflurane (Ethrane) Isoflurane (Forane) Nitrous oxide Sevoflurane (Ultane)

medication orders

Generic substitution Prescription form Some states mandate pharmacists fill prescriptions with a generic drug. If the physician wants trade name, must specifically state so Dispense as written ("DAW") No substitution

Types of Prescriptions

Handwritten prescription Single preprinted form from a prescription pad Must be written in ink Must be recorded in the patient's medical record The traditional way in which prescriptions have been written for centuries. --> Computerized or electronic prescription Typed into the medical office's software system Copy of prescription is printed out. Signed by the physician and given to the patient It may be faxed directly to the pharmacist --> Computerized or electronic prescription Generated by a computer Not signed by the physician A digital electronic signature is automatically imprinted. May also be faxed directly to the pharmacist --> Verbal prescription (******) Given over the telephone If not for a controlled substance, the pharmacist can fill the prescription without: A printed-out prescription The physician's signature

Drug Alert: Prescriptions

Handwritten prescriptions can be notoriously difficult to read. Various studies have found that 5 percent or 16 percent or even 25 percent of all handwritten prescriptions are illegible. Pharmacists often become familiar with a particular physician's handwriting and can decipher illegible handwriting. --> However, when in doubt, the pharmacist always calls the physician to confirm the drug and dose. Some states, such as Florida, have passed a law that all handwritten prescriptions must be legible.

***HIPPA

Health Insurance Portability and Accountability Act of 1996 protect their information, sign consent form to release their information.

Helicobacter pylori

Helicobacter pylori Helical (spiral) bacteria that have flagella (thin, whip-like tails) Live in the gastric or duodenal mucosa Are the cause of some peptic ulcers --> Drugs for peptic ulcer disease caused by H. pylori infection Successful treatment involves the use of a combination of drugs. Antibiotic drugs, antiprotozoal drugs, bismuth Disrupt the cell wall that surrounds this bacterium Causes cell death --> Drugs for peptic ulcer disease caused by H. pylori infection Only drugs indicated for the treatment of H. pylori infections are: H2 blocker ranitidine Proton pump inhibitors Esomeprazole (Nexium) Lansoprazole (Prevacid) Omeprazole (Prilosec) Combination drugs for H. pylori infection Antibiotic drug Amoxicillin, clarithromycin, tetracycline Anti-infective drug Bismuth Antiprotozoal drug Metronidazole --> Combination drugs for H. pylori infection Proton pump inhibitor drug Lansoprazole Helidac Bismuth, metronidazole, tetracycline Prevpac Amoxicillin, clarithromycin, lansoprazole --> Combination drugs for H. pylori infection Pylera Bismuth, metronidazole, tetracycline (most common were peptic ulcer: stomach, duejium)

Drugs Used to Treat Attention-Deficit/Hyperactivity Disorder

Hyperactive children exhibit symptoms of: Restlessness Short attention span Distractibility Emotional lability Impulsiveness Disruptive behavior Complex of symptoms previously known as: Minimal brain dysfunction Attention deficit disorder (ADD) Now known as attention-deficit/hyperactivity disorder (ADHD) Cause of ADHD may be: Brain damage at birth Genetic factors Other abnormalities 2007 study of progressive MRI scans of ADHD children indicated that it was not a disease but a delay in brain development. Five times more common in boys than girls Most children outgrow the symptoms of ADHD in late childhood. Amphetamines and other related CNS-stimulating drugs Regulate the levels of norepinephrine and dopamine Exert what is known as a paradoxical effect in that they: Do not overstimulate but actually reduce impulsive behavior Lengthen the attention span Drug therapy is accompanied by: Psychological counseling Special educational intervention, as needed Amphetamine drugs for ADHD Stimulant drugs Have a paradoxical (reverse) effect when given to patients with hyperactivity instead of increasing their hyperactivity, they actually lessen it These drugs are classified as Schedule II drugs and have a high potential for addiction. Amphetamine drugs for ADHD Dextroamphetamine (Dexedrine) Lisdexamfetamine (Vyvanse) Methamphetamine (Desoxyn) Other central nervous system stimulant drugs for ADHD Stimulate the central nervous system but are not amphetamines Dexmethylphenidate (Focalin) Methylphenidate (Concerta, Daytrana, Quillivant, Ritalin) Schedule II drugs because of their high potential for abuse Other drugs for ADHD Antidepressant drugs Atomoxetine (Strattera) Bupropion (Aplenzin, Wellbutrin) Imipramine (Tofranil) Antipsychotic drugs Chlorpromazine (Thorazine) Haloperidol (Haldol) Other drugs for ADHD Stimulate alpha2 receptors in the brain Clonidine (Catapres) Guanfacine (Tenex)

Types of Immunity

Immunity Natural immunity The state of the body's own immune system is able to identify, attack, and destroy disease-causing pathogens Acquired immunity Results from some type of exposure to a pathogen Provoked by another source (fetus's mother), drug, or vaccine Types of acquired immunity Passive immunity is naturally acquired Occurs when the fetus is still in the uterus Extends during first 18 or so months of life IgG antibodies Passive immunity, artificially acquired Immune globulin drug is given after patient exposed to disease such as rabies Types of acquired immunity Active immunity, naturally acquired After exposure to a disease-causing pathogen Begins at 18 months of age Active immunity, artificially acquired Basis of vaccines Prevent disease from ever occurring in the patient

control group

In an experiment, the group that is not exposed to the treatment; contrasts with the experimental group and serves as a comparison for evaluating the effect of the treatment.

Urinary Tract Analgesic Drugs

Indications Urinary tract infections or diseases Interstitial cystitis Urinary tract surgery Endoscopic procedures Symptoms Burning Urgency Painful urination --> Exert a local, pain-relieving effect on the mucous membranes of the urinary tract even though drugs are given orally -Pentosan (Elmiron) -**Phenazopyridine (Pyridium, Urogesic) remember** --> red-orange color, make sure not to take it.

Drugs Used to Treat Eye Inflammation

Inflammation of the eye can be due to: Injury Trauma Contact with chemicals Allergies Infection Drugs treat areas of inflammation in the: Eyelid Cornea Conjunctiva Tear duct Corticosteroid drugs for eye inflammation Used topically to treat inflammation Suppress the immune system's local inflammatory response Dexamethasone (Maxidex) Difluprednate (Durezol) Important: Silver nitrate produces conjunctival irritation/swelling, which may interfere with mother-child bonding, and it is ineffective in preventing eye infections due to Chlamydia (another sexually transmitted disease). Erythromycin does not produce irritation and is effective against Chlamydia. Corticosteroid drugs for eye inflammation Fluorometholone (Flarex, FML) Loteprednol (Alrex, Lotemax) Prednisolone (Econopred Plus, Pred Forte) Rimexolone (Vexol) Corticosteroid drugs for eye inflammation These anti-inflammatory drugs are administered within the eye into the vitreous humor to treat uveitis Dexamethasone (Oxudex) is an implant. Fluocinolone (Retisert) is an implant. Triamcinolone (Trivaris) is injected as a solution. Nonsteroidal anti-inflammatory drugs for eye inflammation Treat pain and inflammation often after cataract or LASIK surgery on the eye Bromfenac (Xibrom) Diclofenac (Voltaren) Ketorolac (Acular) Epafenac (Nevanac) Mydriatic/cycloplegic drugs for eye inflammation Dilate and fix the pupil Treat inflammation of iris and uveal tract Atropine Scopolamine

gas

Inhaled Example General anesthetic gas to produce unconsciousness prior to surgery

subcutaneous route

Injection of drugs into the tissues between the skin and muscle

intradermal route

Injection of drugs within or between the layers of the skin

chapter 24 Anesthetic Drugs

Intro: Anesthesia -The absence of feeling, sensation, or pain -Can be obtained: -On the skin by topical application -In the skin and deeper tissues by subcutaneous local injection -In one body part by regional nerve block Anesthesia Can be obtained: In the trunk and lower extremities by epidural or spinal anesthesia In the entire body by general anesthesia produces unconsciousness Anesthetic Prefix an- (without; not) Combining form esthet/o- (sensation; feeling) Suffix -ic (pertaining to) Means pertaining to being without sensation or pertaining to not feeling.

chapter 25 Emergency Drugs, Intravenous Fluids, and Blood Products

Introduction Types of life-threatening emergencies requiring prompt drug intervention -Cardiac or respiratory arrest -Shock from trauma or infection -Anaphylaxis -Drug overdose Effects unless corrected within a matter of minutes -Oxygen levels in the blood decrease. -Carbon dioxide and lactic acid levels in the blood increase. -The blood pH becomes acidic. -Cellular metabolism in the vital organs slowly comes to a halt -Patient dies Basic life support -Cardiopulmonary resuscitation (CPR) -Mechanically circulating the blood -Inflating the lungs with air Advanced cardiac life support (ACLS) Includes the use of drug therapy -Crash cart -Contains all necessary emergency drugs and resuscitative equipment -Available in hospitals, doctor's offices, clinics, and other healthcare facilities

Chapter 8 Gastrointestinal Drug

Introduction: Gastrointestinal drugs -->Used to treat diseases of: -Esophagus -Stomach -Small intestine -Large intestine -Liver -Gallbladder Gastrointestinal drugs These include: -Peptic ulcer disease -Helicobacter pylori infection -Gastroesophageal reflux disease -Gastrointestinal spasms -Diarrhea Gastrointestinal drugs These include: -Hemorrhoids -Constipation -Ulcerative colitis -Nausea and vomiting -Hepatitis -Gallstones -Obesity

chapter 16 Psychiatric Drugs

Introduction: Psychiatric drugs treat diseases of the mind, otherwise known as mental illness. Includes a variety of emotional disorders that involve abnormalities of: Personality Mood Behavior -> Estimated nearly 50% of hospital admissions are in some way related to a mental health problem. Anxiety Depression Suicide Postpartum depression Psychosis -> Estimated nearly 50% of hospital admissions are in some way related to a mental health problem. Eating disorders Panic attacks Social phobias Obsessive-compulsive disorder (OCD) -> Estimated nearly 50% of hospital admissions are in some way related to a mental health problem. Psychosomatic illness Attention-deficit/hyperactivity disorder (ADHD) Posttraumatic stress disorder (PTSD) Drug addiction Alcoholism

Nexium (purple pill)***

It can treat gastroesophageal reflux disease (GERD). It can also lower the risk of bleeding after endoscopy in patients with ulcers.

Monoclonal Antibody Drugs

Keep immunoglobulin E (IgE) from binding to receptors on: Mast cells Basophils Trigger the release of histamine Used to treat moderate-to-severe, persistent asthma Given by subcutaneous injection in the doctor's office Omalizumab (Xolair)

Diuretic Drugs

Kidneys continuously filter the circulating blood. Depending on the needs of the body Extract and excrete waste products of metabolism --> Depending on the needs of the body Extract and either excrete or reabsorb non waste products Water Sodium Potassium Other electrolytes The positive or negative charge Glucose Diuretic drugs keep sodium and potassium from being reabsorbed from the tubules back into the blood. Extra sodium and potassium cause an increase in the volume of urine. --> By causing sodium, potassium, and water to be excreted, diuretic drugs are useful in the treatment of: Hypertension Edema associated with congestive heart failure Renal failure Cerebral edema --> Divided into several categories based on the site of the drug's action in the nephron Thiazide diuretic drugs Loop diuretic drugs Potassium-sparing diuretic drugs Osmotic diuretic drugs Carbonic anhydrase inhibitor diuretic drugs --> Thiazide diuretic drugs Act at the loop of Henle and the distal convoluted tubules in the nephron Block sodium and potassium from being reabsorbed from the tubule back into the blood. --> Thiazide diuretic drugs More sodium and potassium than usual are excreted in the urine and therefore more water as well. ******Called potassium-wasting ****** --> Thiazide diuretic drugs Bendroflumethiazide (Naturetin) Chlorthalidone (Hygroton) Chlorothiazide (Diuril) -Hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide)- remember this one! --> Thiazide diuretic drugs indapamide (Enduron) methyclothiazide (Enduron) metolazone (Zaroxolyn) Note: The ending -thiazide is common to generic thiazide diuretic drugs.

Leukotriene Formation Inhibitor Drugs and Leukotriene Receptor Blocker Drugs

Leukotriene A substance that is produced by the body in response to inhaled antigens Causes Airway edema Bronchospasms Inflammation Leukotriene inhibitor drugs Inhibit production of leukotriene Zileuton (Zyflo) Leukotriene receptor blocker drugs Block the action of leukotriene at the receptor level Block the production of leukotriene Used to treat asthma Not used for other respiratory diseases Leukotriene receptor blocker drugs Montelukast (Singulair) Zafirlukast (Accolate)

Drugs Used to Treat Bipolar Disorder

Manic-depressive disorder is characterized by two opposite emotions. Depression Mania Associated with increased levels of norepinephrine in the brain Hyperactivity Manic-depressive disorder is characterized by two opposite emotions. Mania Agitation Euphoria Rapid talking and thinking Devising grandiose plans Showing poor judgment Patient's mood swings between these two opposite poles. A more common, but less well-known, type of bipolar disorder is characterized by mood swings between depression and anger and impulsiveness. Drugs used to treat manic-depressive disorder lessen the severity and frequency of mood swings. Mood-stabilizing drugs Categories Antipsychotic drugs Anticonvulsant drugs Antidepressant drugs Plus other drugs that effectively treat the mania phase of manic-depressive disorder Antipsychotic drugs used to treat both phases disorder Aripiprazole (Abilify) Asenapine (Saphris) Olanzapine (Zyprexa) Quetiapine (Seroquel) Risperidone (Risperdal) Ziprasidone (Geodon) Benzodiazepine antianxiety drug to treat both phases Clonazepam (Klonopin) Schedule IV drug Anticonvulsant drugs used to treat both phases Carbamazepine (Equetro) Lamotrigine (Lamictal) Topiramate (Topamax) Valproic acid (Depakene, Depakote)) Lithium: Antipsychotic found effective in treating only the manic phase Combination drugs for manic-depressive disorder Symbyax Olanzapine (Dibenzapine antipsychotic drug) Fluoxitine (SSRI antidepressant drug)

Drug-Drug and Drug-Food Interactions

Many patients take more than one drug daily. Older adults Makeup 15% of the population Take 33% of the prescription drugs Polypharmacy Patients may take both prescription drugs and over-the-counter drugs Increases the likelihood of a drug-drug interaction Synergism Occurs when the two drugs combine to produce an effect The effect is greater than the independent effect of each drug. Synergism In many cases, synergism is beneficial. Tylenol was taken with codeine Potassium-wasting diuretic taken with a potassium-sparing diuretic Antagonism Occurs when two drugs combine to produce an effect The effect is less than the intended effect of either drug. Example Tetracycline is taken with an antacid Drug-food interactions Examples Tetracycline cannot be taken with milk. MAO inhibitors cannot be given with foods rich in tyramine.

Potassium Chloride Drug measured

Measured in milliequivalents (mEq) The presence of K in each trade name refers to the K+ symbol for the chemical element potassium. Kay Ciel K-Dur K-Lor Klor-Con The presence of K in each trade name refers to the K+ symbol for the chemical element potassium. Klorvess Klotrix K-Lyte K-Tab Micro-K

Medication Orders and Other Types of Orders

Medication order A written record of a physician's orders Handwritten on a large preprinted order sheet known as the physician's order sheet Located in the front of the patient's medical record Medication order For facilities with electronic records Typed into the computer on a designated screen The screen serves as the physician's order sheet. Verbal order (telephone orders) When a patient is in the hospital The physician may give a verbal order over the phone to a licensed nurse. The nurse writes the order on the physician's order sheet. Verbal order (telephone orders) It is marked as a verbal order (V.O.). The nurse signs his or her name. A physician must personally sign the order within a specific amount of time.

Systems of Drug Measurement-->

Metric system of drug measurement Invented by the French in 1790 Officially known as the International System of Units (SI) Adopted as the exclusive unit of measurement by the AMA Metric system of drug measurement Based on: Meter, for length measurements Kilogram, for weight measurements Liter, for volume measurements Metric length measurements include the meter and centimeter. A centimeter is equivalent to 1/100 of a meter. Other drug measurements Unit Some drugs are never measured by the metric system, but instead by a special designation called a unit. All types of insulin, defined on a weight basis of pure insulin Manufactured with 100 units per milliliter Abbreviated as U-100 The exact value varies from drug to drug. EX: A dose of this insulin is always measured in units. The insulin vial in this box contains 100 units of insulin per milliliter (mL) Other drug measurements Drop Abbreviated gtt Eye and ear liquid drugs prescribed as drops to be given. Other drug measurements Milliequivalent An equivalent is the molecular weight of an ion divided by the number of hydrogen ions it reacts with. A milliequivalent is 1/1000 of an equivalent. Abbreviated mEq EX: This potassium drug is measured in both milliequivalents (10 mEq).

Drugs Used to Prevent Pregnancy

Monophasic oral contraceptive drugs One (mono-) phase of treatment Each hormone tablet of the pill pack has fixed doses of: Progestin Levonorgestrel Norethindrone Norgestrel Norgestimate Monophasic oral contraceptive drugs Each hormone tablet of the pill pack has fixed doses of: Estrogen Ethinyl estradiol Mestranol In a 21-day pill pack, there are 21 hormone tablets. Monophasic oral contraceptive drugs In a 28-day pill pack, there are only 21 hormone tablets and 7 inert sugar tablets to complete a 28-day menstrual cycle. Monophasic oral contraceptive drugs Alesse Brevicon Demulen Desogen Loestrin Lo/Ovral Monophasic oral contraceptive drugs Lybrel Modicon Norinyl Ortho-Cept Ortho-Cyclen Ortho-Novum Monophasic oral contraceptive drugs Ovcon Ovral Seasonale Yasmin YAZ

Oral Route of Administration

Most convenient and most commonly used route Tablets, capsules, liquids Absorbed in the stomach or small intestine PO, p.o. (Latin per os, through the mouth) AND Disadvantages of oral route Difficult for some patients to swallow Cannot be used in unconscious patients Cannot be used in patients who are vomiting AND Disadvantages of oral route Some drugs are inactivated by stomach acid. Some drugs are metabolized to quickly by the liver. Some drugs cannot be taken with certain foods or beverages.

trade name/brand name

Name that is registered by the manufacturer and is followed by the trademark symbol; the name can be used only by the manufacturer; a drug may have several trade names; depending on the number of manufacturers; the first letter of the trade name is capitalized

Neuromuscular Blocker Drugs Used During General Anesthesia

Neuromuscular blocker drugs Given intravenously Block nerve transmissions throughout the body to reduce resistance to endotracheal intubation Produce skeletal muscle relaxation Neuromuscular blocker drugs Particularly important during abdominal surgery when the muscles of the abdominal wall must relax in order to allow adequate visualization of the operative field Atracurium (Tracrium) Cisatracurium (Nimbex) Mivacurium (Mivacron) Pancuronium Rocuronium (Zemuron) Succinylcholine (Anectine, Quelicin) Vecuronium (Norcuron) Drugs used to reverse the effects of neuromuscular blocker drugs used during general anesthesia Edrophonium (Enlon, Reversol) Neostigmine (Prostigmin) Pyridostigmine (Mestinon)

Non-steroidal anti-inflammatory drugs for osteoarthritis Drugs Used to Treat Osteoarthritis

Nonsteroidal anti-inflammatory drugs for osteoarthritis Diclofenac (Cataflam, Voltaren) Fenoprofen (Nalfon) Ibuprofen (Advil, Motrin) Indomethacin (Indocin) Ketoprofen Nonsteroidal anti-inflammatory drugs for osteoarthritis Meloxicam (Mobic) Naproxen (Aleve, Naprosyn) Oxaprozin (Daypro) Piroxicam (Feldene) Sulindac (Clinoril) --> COX-2 inhibitor drugs for osteoarthritis <-- Belong to the larger category of NSAIDs Selectively inhibit cyclooxygenase-2 (COX-2) An enzyme that decreases the production of prostaglandins that cause pain and inflammation Celecoxib (Celebrex) -> Corticosteroid drugs for osteoarthritis<- Betamethasone (Celestone) Dexamethasone Hydrocortisone (Cortef, Solu-Cortef) Methylprednisolone (Depo-Medrol, Medrol) Prednisone (Deltasone, Meticorten) Triamcinolone (Aristospan Intra-articular, Kenalog) - Other drugs for osteoarthritis Hyaluronic acid Drugs are derivatives of hyaluronic acid. Injected into the joint Improve viscosity and lubricating quality of synovial fluid Hyaluronic acid (Hyalgan, Synvisc) = Hyaluronic acid (Hyalgan, Synvisc). This drug is derived from the combs of chickens! Hyaluronic acid is also used as a gel-type filler that is injected under the skin to provide fullness and minimize wrinkle lines on the face.Source: kyslynskyy/Fotolia

Did you know?! :

N—naloxone (Narcan) A—atropine V—vasopressin E—epinephrine (Adrenalin) L—lidocaine (Xylocaine) ---------------------------------------------------------- L—lidocaine E—epinephrine A—atropine N—naloxone

Drug Alert GYN

Oral contraceptive drugs can have serious adverse effects, such as blood clots, stroke, and heart attack, because of their estrogen content. Because of these risks, most physicians choose to prescribe an oral contraceptive drug that contains 35 mcg of estrogen or less in each tablet. - The risk of these adverse effects increases significantly for patients who are older than 35 years of age and who smoke. All oral contraceptive drugs also carry the warning that they do not protect against sexually transmitted diseases, including HIV.

Chapter 6 ***study Definition of a Prescription

Origin comes from Latin praescriptio, meaning a written order. Prescription The action of writing [that takes place] before [a drug is dispensed] pre- (before) script/o- (write) -ion (action) --> A written, computerized, electronic, or verbal order from a physician (or other qualified healthcare providers) to a pharmacist, giving instructions as to how to dispense a drug to a specific patient.

Drugs Used to Induce Labor

Oxytocin (Pitocin) A hormone produced by the posterior pituitary gland Stimulates the uterus by binding to special receptors on the smooth muscle cells of the uterus Oxytocin (Pitocin) Drug works in the same way as the hormone. Increases both: Frequency of uterine contractions Strength of uterine contractions Not used when prolonged labor is due to cephalopelvic disproportion Labor consists of: Uterine contractions Uterine dilation (widening) Effacement (thinning) of the cervix -> Dysmenorrhea Painful menstrual cramps Caused by an increase in prostaglandins Cause the uterus to contract painfully -> Amenorrhea (the absence of menstruation) -> Menorrhagia (abnormally heavy menstruation) Progesterone drugs act directly on the tissues of the endometrium to restore a normal menstrual cycle. Yeast infections Caused by Candida albicans Infection is known as candidiasis. Cause white discharge with vaginal itching Vaginal yeast infections Treated with these over-the-counter drugs: Butoconazole (Gynazole-1, Mycelex-3) Clotrimazole (Gyne-Lotrimin, Mycelex) Miconazole (Monistat 3, Monistat 7, Vagistat-3) Vaginal yeast infections Treated with these over-the-counter drugs: Nystatin Sulfanilamide (AVC) Terconazole (Terazol) Tioconazole (Monistat 1, Vagistat-1) Many drugs used to treat candidiasis end in the suffix -azole. Many antifungal drugs also end with this suffix because yeast and fungi are closely related. Drugs that are effective against one often are effective against the other. Bacterial vaginal infections (bacterial vaginosis) Caused by several different bacteria, including: Haemophilus Gardnerella Corynebacterium Bacterial vaginal infections (bacterial vaginosis) Topical anti-infective drugs used to treat bacterial vaginal infections Clindamycin (Cleocin) Metronidazole (MetroGel-Vaginal) Tinidazole (Tindamax) Drugs for syphilis ( penicillin) Caused by the gram-negative spirochete Treponema pallidum Can cause: Fever Rash with a lesion (chancre) in the genital area that ulcerates and forms a crust Drugs for syphilis -> Oral antibiotic drugs from several different categories are effective in treating syphilis. Drugs for chlamydial infections Caused by Chlamydia trachomatis, a gram-negative coccus Symptoms Painful urination Thin discharge Oral antibiotic drugs from several different categories are effective in treating chlamydia. Drugs for an acquired immunodeficiency syndrome Caused by the human immunodeficiency virus (HIV), a retrovirus HIV invades CD4 lymphocytes in order to reproduce. Large numbers of CD4 lymphocytes are destroyed Drugs for genital herpes Caused by a herpes simplex virus type 2 infection in the genital area Herpes simplex virus type 1 infections involve other areas of the body, particularly the mouth, and are known as cold sores. Genital herpes lesions are treated topically and with oral drugs. Drugs for genital warts Human papillomavirus causes: Common warts (verrucae) Genital or venereal warts (condylomata acuminata) Topical drugs used to treat genital warts Drugs for trichomoniasis Caused by protozoan Trichomonas vaginalis. Causes a greenish-yellow, frothy vaginal discharge with a foul odor Tinidazole (Tindamax) Oral antiprotozoal drug menopause:

Transdermal Patch

Patches that contain drugs Applied to the skin Releases small amount over a period of time Exert a systemic effect, not topical

Antibiotic Drugs (anti)

Penicillin antibiotic drugs Group of drugs that kill bacteria Share the common molecular structure of a beta-lactam ring Interfere with the cell wall that surrounds a bacterium Penicillin antibiotic drugs Disrupt the intracellular content causing cell death Human cells have a cell membrane, not a cell wall, so are not affected. Penicillin antibiotic drugs Used to treat a wide variety of: Gram-positive bacterial infections Gram-negative bacterial infections Anaerobic bacterial infections Sexually transmitted diseases Broad-spectrum antibiotic drugs Able to kill a variety of different types of bacteria Penicillin antibiotic drugs Drugs in the penicillin category differ from each other in the following ways: Some are inactivated by gastric acid and cannot be taken orally (penicillin G drugs). Most are inactivated by penicillinase. Exceptions are dicloxacillin, nafcillin, and oxacillin. Penicillin antibiotic drugs Drugs in the penicillin category differ from each other in the following ways: Most are inactivated by penicillinase. An enzyme produced by penicillin-resistant bacteria Also known as beta lactamase because it inactivates penicillin by breaking its chemical structure at the site of the beta-lactam ring Penicillin antibiotic drugs Drugs in the penicillin category differ from each other in the following ways: Most have little antibiotic activity against gram-negative bacteria Exceptions are piperacillin and ticarcillin. Penicillin antibiotic drugs Amoxicillin (Amoxil, Moxatag) Ampicillin (Principen) Dicloxacillin Nafcillin Oxacillin Penicillin antibiotic drugs Penicillin G potassium (Permapen, Pfixerpen) Penicillin G procaine Penicillin V (Penicillin VK, Veetids) Piperacillin Combination antibiotic drugs Penicillin drug Substance that inacivates penicillinase Clavulanate potassium/clavulanic acid Sulbactam Tazobactam Combination antibiotic drugs Augmentin Amoxicillin, clavulanate potassium Timentin Ticarcillin, clavulanic acid Unasyn Ampicillin, sulbactam Zosyn Piperacillin, tazobactam -cillin represents has beta-lactam rings -cillin all represent penicillin Cephalosporin antibiotic drugs Group of drugs that kill bacteria Interfere with the cell wall that surrounds each bacterium, causing disruption of the intracellular contents and cell death Cephalosporin antibiotic drugs Further divided into therapeutic antibiotic properties First-generation Second-generation Third-generation Cephalosporin antibiotic drugs First-generation cephalosporin drugs A fairly broad spectrum of effectiveness against bacteria Not effective against bacteria that produce penicillinase Cefadroxil Cefazolin Cephalexin (Keflex) Cephalosporin antibiotic drugs Second-generation cephalosporin drugs More effective than first-generation against bacteria that produce penicillinase Also effective against more gram-positive bacteria Cephalosporin antibiotic drugs Second-generation cephalosporin drugs Cefaclor (Ceclor) Cefotetan Cerfoxitin Cefprozil Cefuroxime (Ceftin, Zinacef) Cephalosporin antibiotic drugs Third-generation cephalosporin drugs Most effective of all the cephalosporin drugs against penicillin that produce penicillinase Show the greatest effectiveness against gram-negative and gram-positive bacteria Cephalosporin antibiotic drugs Third-generation cephalosporin drugs Also pass through the blood-brain barrier, useful for treating meningitis Cost is higher than that of other cephalosporin drugs. Cephalosporin antibiotic drugs Third-generation cephalosporin drugs Cefidinir (Omnicef) Cefditoren (Spectracef) Cefepime (Maxipime) Cefixime (Suprax) Cefotaxime (Claforan) Cephalosporin antibiotic drugs Third-generation cephalosporin drugs Cefpodoxime (Vantin) Ceftazidime (Ceptaz, Fortaz) Ceftibuten (Cedax) Ceftizoxime (Cefizox) Ceftriaxone (Rocephin) Cephalosporin antibiotic drugs Fourth-generation cephalosporin drugs Only effective against some gram-positive and gram-negative bacteria Cefepime Fifth-generation cephalosporin drugs Only effective against some gram-positive bacteria Ceftaroline (Telflaro)

Drugs Used to Treat Gastroesophageal Reflux Disease (**)

Peptic ulcer --> caused by irritation of the mucous membranes lining the gastrointestinal tract Located anywhere in the: -Esophagus -Stomach -Duodenum Peptic ulcer --> Excessive amounts of hydrochloric acid --> Strips away protective mucus of the mucous membranes --> Subsequent action of pepsin begins to break down the underlying membrane. Peptic ulcer (stomach, and deuidium) These also irritate the mucous membranes and can contribute to ulcer formation. -Aspirin -NSAIDs -Alcohol -Caffeine Proton pump inhibitor drugs for peptic ulcer disease -Esomeprazole (Nexium) -Lansoprazole (Prevacid) -Omeprazole (Prilosec) -Rabeprazole (Aciphex)

Apothecary

Pharmacists prepared the drugs they dispensed. Measured out drugs Apothecary system of measurement Minims Drams Ounces Grains Scruples

Pellet, Bead, Wafer, and Insert

Placed within a body cavity Slowly releases drug Examples Septopal beads implanted in bone to treat chronic infection Mirena inserted in uterus to prevent pregnancy

Drugs Used to Treat Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder (PMDD) Mood disorder that includes Physical and emotional symptoms of premenstrual syndrome Depression, anxiety, and sleep disturbances that significantly interfere with life

Antibiotic Drugs

Prescribed for colds caused by bacterial infections, particularly streptococci that causes strep throat. -> Common cold Not effectively treated because it is usually caused by a virus Although antibiotic drugs may be prescribed to prevent subsequent superimposed bacterial infections from developing, this practice is not recommended. -> Applied topically as a solution to the external ear canal to treat bacterial infections Swimmer's ear External otitis Infections of the tympanic membrane (otitis media) Ciprofloxacin (Cetraxal) Oxfloxacin (Floxin Otic) -Sulfonamide drugs are a type of anti-infective drug that inhibits the growth of bacteria. These drugs are given orally to treat an infected tympanic membrane (otitis media) in the ear. Sulfadiazine Sulfisoxazole (Gantrisin Pediatric)

Rx

Prescription abbreviation. Prescriptions have been written since ancient times. The practice of medicine began with the Romans and Greeks, and the familiar abbreviation Rx stands for the Latin word recipere, meaning to take. Prescriptions were, in the past, actually recipes listing several ingredients to be mixed by the apothecary before dispensing.

progestins- only contraceptive drug

Progestins-only contraceptive drugs Only contain a progestin (norethindrone, norgestrel) Slightly less effective Then combination oral contraceptive drug Particularly if a patient forgets to take even one daily tablet Progestins-only contraceptive drugs Contain no estrogen Risk of blood clots avoided Other adverse effects of estrogen are avoided. Useful for mothers who have just given birth and want to breastfeed The drug does not interfere with milk production Progestins-only contraceptive drugs ****************** Camila Errin Heather Jolivette Ortho Micronor ******************* Progestins-only contraceptive drugs Implant Inserted under the skin Within a T-shaped device that is inserted into the uterus Contraceptive effects last from one to five years depending on the amount of drug in the device. Etonogestrel (Implanon, Nexplanon) Levonorgestrel (Mirena) Progestins-only contraceptive drugs Taken orally but only after unprotected intercourse to prevent pregnancy Levonorgestrel (Plan B, Plan B One-Step) Ulipristal (Ella)

Drugs Used for Topical Anesthesia

Provide brief periods of anesthesia Limited depth in the skin Block movement of sodium ions across the cell membrane, part nerve impulse transmission Provide temporary symptomatic relief to treat: Pain of herpes zoster (shingles) Postherpetic neuralgia Abrasions Minor burns Cold sores Provide temporary symptomatic relief to treat: Rashes Sunburn Eczema Insect bites Benzocaine (Dermoplast) Dibucaine (Nupercainal) Lidocaine (Lidoderm, Xylocaine, Zingo) Pramoxine (Tronothane) Topical combination anesthetic drugs These combination drugs contain two or three topical anesthetic drugs. Used to prevent pain during procedures that involve the skin Biopsy Removal of a skin lesion Insertion of an intravenous line Topical combination anesthetic drugs Cetacaine Benzocaine Butamben Tetracaine EMLA Lidocaine Prilocaine Topical combination anesthetic drugs Synera Comes in the form of a patch Lidocaine Tetracaine

Drugs Used to Treat Psoriasis

Psoriasis Chronic, autoimmune skin disorder Scaly, raised, silvery-red patches on the skin Often resistant to treatment Psoriasis The skin is abnormal at the cellular level. Abnormally accelerated rate of epithelial cell division Abnormality of the epithelial cells that produce keratin (keratinocytes) Topical coal tar drugs for psoriasis Balnetar, Neutrogena T/Gel, Zetar Decrease the rate of epithelial production Correct abnormalities of keratinocytes Cleanse away dead skin (keratolytic action) Decrease itching (antipruritic action) OTC drug Topical vitamin A-type drugs for psoriasis Deficiency of vitamin A can produce abnormal changes in the epithelial cells of the skin, such as those that occur with psoriasis. Tazarotene (Avage, Tazorac) Rx retinoid drug Normalizes the abnormal production of epithelial cells Oral vitamin A-type drugs for psoriasis Acitretin (Soriatane) Rx drug Acts systemically to treat severe psoriasis that cannot be controlled with topical drugs treatment: Topical vitamin D-type drugs for psoriasis The red, scaly patches of psoriasis are caused by abnormal keratinocytes within the skin Synthetic vitamin D-type drugs activate vitamin D receptors in the keratinocytes and slow their abnormal growth Calcipotriene (Dovonex) Topical and oral corticosteroid drugs for psoriasis Decrease the inflammation and itching associated with psoriasis For severe itching Immunosuppressant drugs for psoriasis Rx to treat moderate-to-severe, chronic psoriasis that has not responded to other drugs Monocolonal antibodies Adalimumab (Humira) Infliximab (Remicade) Ustekinumab (Stelara) Immunosuppressant drugs for psoriasis Drugs that suppress overactive immune response Alefacept (Amevive) Cyclosporine (Neoral, Gengraf, Sandimmune) Sirolimus (Rapamune) Given orally Immunosuppressant drugs for psoriasis Immunomodulator drug Etanercept (Enbrel) Chemotherapy drug Methotrexate (Trexall) Psoralen drugs for psoriasis Severe, disabling psoriasis may also be treated by exposure to ultraviolet light in combination with a psoralen drug that sensitizes the skin to the effects of ultraviolet light. Methoxsalen (Oxsoralen) Psoralen drugs for psoriasis The treatment is known as psoralens/ultraviolet wavelength A (PUVA). This combined treatment damages cellular DNA and decreases the rate of cell division. Other topical drugs for psoriasis Topical drugs for psoriasis either inhibit the production of cellular DNA or are toxic to epithelial cells. Either action decreases the rate at which epithelial cells divide. Other topical drugs for psoriasis Anthralin (Dritho-Scalp, Psoriatec) Calcitrol (Vectical) Pyrithione zinc (Denorex, Head and Shoulders) Available OTC Combination drugs for psoriasis Topical prescription combination drugs contain: Vitamin D-type drug (calcipotriene) to slow the rate of abnormal epithelial cell growth Corticosteroid drug (betamethasone) to control inflammation in psoriasis Combination drugs for psoriasis Neutrogena T/Sal (coal tar, salicylic acid) Taclonex (calcipotriene, betamethasone)

Rapid-acting insulin drugs (Insulin regular (Humulin R). Humulin R insulin is an insulin regular drug. It belongs to the rapid-acting insulin drug category. The R in its trade name means regular. The U-100 on the drug box indicates a standardized concentration of 100 units/mL, and this means that the drug must be administered with a special insulin syringe that is calibrated in units. The phrase rDNA origin means that this drug was created by recombinant DNA technology.) (Insulin lispro (Humalog). This is a rapid-acting insulin analog drug. It also has U-100 and rDNA on its drug box because its drug dose is measured in units and it was created using recombinant DNA technology.)

Rapid-acting insulin drugs Taken in the morning or before eating The onset of therapeutic effect is almost immediate. Can begin to lower blood glucose levels in as little as 15 minutes The therapeutic effect lasts 2 to 12 hours. Intermediate-acting insulin drugs Two types Those with added protamine and zinc (NPH insulin drugs) to prolong the therapeutic effect of insulin Those with different sizes of insulin crystals (Lente insulin drugs) to slow down the onset of action NPH insulin drugs produced by recombinant DNA technology Humulin N Novolin N NPH is reflected in the drug's trade name as the abbreviation N Derived from pig pancreas Lente Iletin II

Medication order

Refills Prescription form How many times the patient is permitted refills Preprinted Refills area: 0 (sometimes NR for "no refills"), 1, 2, or 3 Only be refilled for a year No refills for Schedule II

Focus of health care

Rescue inhaler Contains quick-acting bronchodilator drug to relieve and "rescue" patients from acute asthma symptoms Most commonly contain beta-agonist bronchodilator drugs, particularly albuterol

Rectal Route of Administration

Reserved for: When a patient is vomiting or unconscious Medication that cannot be given by injection Systemic absorption is slow and unpredictable Not used often Preferred to relieve constipation or to treat hemorrhoids

Chapter 10 Respiratory Drugs

Respiratory drugs Used to treat diseases of the: Bronchi Bronchioles Lungs Respiratory drugs Diseases include: Asthma Reversible obstructive airway disease Bronchitis Chronic obstructive pulmonary disease (COPD) Bacterial and viral infections of the lung Bronchodilator Drugs Used to prevent or treat Asthma Bronchospasm Exercise-induced bronchospasm Chronic obstructive pulmonary disease (COPD) Emphysema Beta-agonist bronchodilator drugs Work by: Relaxing the smooth muscle the surrounds the bronchioles Allowing the bronchioles to dilate Increases airflow Beta-agonist bronchodilator drugs Sympathomimetic bronchodilator drugs Stimulate beta2 receptors in the smooth muscle around the bronchioles Albuterol (Proventil HFA, Ventolin HFA) Arformoterol (Brovana) Formoterol (Foradil Aerolizer) Indacaterol (Arcapta) Beta-agonist bronchodilator drugs Sympathomimetic bronchodilator drugs Levalbuterol (Xopenex) Metaproterenol Pirbuterol (Maxair Autohaler) Salmeterol (Serevent Diskus) Xanthine bronchodilator drugs Directly relax smooth muscle around the bronchioles Stimulate the respiratory centers of the brain Aminophylline Dyphilline (Lufyllin) Theophylline (Elixophyllin) Anticholinergic bronchodilator drugs Block the action of acetylcholine on muscarinic receptors in the smooth muscle around the bronchioles Aclidinium (Tudorza) Ipratropium (Atrovent) Tiotropium (Spiriva)

Drugs Used to Treat Rheumatoid Arthritis

Rheumatoid arthritis caused by: An autoimmune reaction The body's own antibodies target and destroy Cartilage Connective tissue Joints Thought to be triggered by a virus Rheumatoid arthritis produces symptoms of: Pain Inflammation Swelling Joint deformity Loss of joint function Rheumatoid arthritis caused by: An autoimmune reaction The body's own antibodies target and destroy Cartilage Connective tissue Joints Thought to be triggered by a virus Salicylate drugs, NSAIDs, COX-2 inhibitor drugs, and corticosteroid drugs for rheumatoid arthritis Treated with many of the same drugs used to treat osteoarthritis Drugs used as the first line of treatment Salicylate drugs NSAIDs COX-2 inhibitors Salicylate drugs, NSAIDs, COX-2 inhibitor drugs, and corticosteroid drugs for rheumatoid arthritis ***Acetaminophen is not used because it is not effective against inflammation. (tyn)

Routes of Administration for Emergency Drugs

Routes used to administer emergency drugs are different than routes normally used. -Need to have the drug take an immediate effect throughout the body Most routes result in too slow an absorption rate for the drug to produce a therapeutic effect. ------------------------------------------------------------- Intravenous route By far the most common route for administering emergency drugs -Drugs are injected by: -Intravenous (I.V.) line -I.V. push -Bolus Intravenous route Produce a maximum drug effect in the shortest period of time Following successful resuscitation, I.V. drip infusion is used. Endotracheal route Drugs are placed into an endotracheal tube. As lungs are mechanically ventilated, the drug solution is propelled into the lungs. Absorbed by the lung tissue and rapidly enters the blood Endotracheal route Therapeutic systemic drugs can be achieved. Only certain drugs can be administered by this route Intracardiac route Not used frequently, but can be valuable when other routes have failed to produce a therapeutic effect Intracardiac route If not properly placed in the left ventricle, carries the risk of: -Pneumothorax air in the heart. -Cardiac tamponade fluid in the heart. -Coronary artery laceration is a cut in the artery. -Only calcium chloride and epinephrine (Adrenalin) can be given by intracardiac administration.

Did You Know? BPH

Saw palmetto, a small palm tree that is native to the coast of the southeastern United States, is effective in treating BPH. Its fruit was used by the Seminole Indians to treat genitourinary conditions. Today, it is available as an over-the-counter dietary supplement.

Drugs Used to Treat Scabies And Pediculosis

Scabies Caused by tiny, barely visible parasites called mites Tunnel under the skin and cause itchy lesions Lay eggs under the skin which then hatch within a week and continue the cycle Scabies Lesions occur on the trunk, pubic area, and in skin folds; the scalp is rarely affected. Can be transmitted through contact with furniture, clothing, bedsheets, towels, or close personal contact, or sexual intercourse Topical Rx drugs used to treat scabies Crotamiton (Eurax) Lindane Permethrin (Acticin, Elimite) Pediculosis Caused by an infestation of lice and their eggs (nits) Can be found on the scalp, body, and pubic area Lice feed on human blood. Bites cause severe itching. Eggs are attached to body hair, particularly on the scalp and pubic area. Pediculosis Lice easily transmitted from one person to another Hairbrushes Combs Hats Headphones Pediculosis Lice easily transmitted from one person to another Towels Clothing Upholstery Carpets Close personal contact Sexual intercourse Topical prescription drugs used to treat pediculosis Ivermectin (Sklice) Lindane Malathion (Ovide) Permethrin (Elimite) Spinosad (Natroba) Combination topical drugs to treat pediculosis OTC drugs contain two pediculocide drugs (pyrethrin, piperonyl). RID Tisit

Schedule Drugs (control drugs) (classes 1-5)

Schedule I Extremely high potential for abuse and addiction No currently accepted medical use Not available under any circumstances, even with a prescription Schedule II High potential for abuse and addiction Currently accepted medical uses Requires an official prescription form Severe physical and psychological dependence may result. Schedule III Less potential for abuse and addiction than Schedule II drugs Currently accepted medical uses Moderate physical and psychological dependence may result Schedule IV Less potential for abuse and addiction than Schedule III drugs Currently accepted medical uses Limited-to-moderate physical or psychological dependence may result. Schedule V Limited potential for abuse Currently accepted medical uses

ointment

Semisolid emulsion of oil and water Oil dominant ingredient Absorbed into the area applied Local vs. systemic effect

cream

Semisolid emulsion of oil and water Water dominant ingredient Absorbed into the skin Local vs. systemic effect

Drugs Used to Treat Viral Infections of the Skin

Several different types of viruses can cause skin infections Herpes simplex virus, type 1 Cold sores Herpes simplex virus, type 2 Genital herpes Several different types of viruses can cause skin infections Herpes zoster virus Chickenpox, shingles Human papilloma virus (HPV) Common warts and genital warts Drugs for herpes simplex virus type 1 Infection only involves the face and mouth. Known as cold sores Drugs for herpes simplex virus type 1 Drugs interfere with cellular DNA synthesis and keep the virus from reproducing. Rx Drugs Acyclovir (Zovirax) Famciclovir (Famvir) Penciclovir (Denavir) Valacyclovir (Valtrex) Drugs for herpes simplex virus type 1 Drugs interfere with cellular DNA synthesis and keep the virus from reproducing. OTC drug Docosanol (Abreva) Drugs for herpes simplex virus type 2 Infections are sexually transmitted. Also known as genital herpes Drugs (Rx only) Acyclovir (Zovirax) Famciclovir (Famvir) Valacyclovir (Valtrex) Drugs for herpes varicella-zoster virus Due to the reemergence of the same virus that first caused chickenpox After initial infection as a child, virus remains dormant in the body Later in life when stress or illness triggers its emergence Lesions are particularly painful. Also known as shingles Drugs for herpes varicella-zoster virus Oral drugs Keep the virus from reproducing Working systemically through the blood and in the deeper tissues of the skin Rx drugs Acyclovir (Zovirax) Famciclovir (Famvir) Valacyclovir (Valtrex) Drugs for herpes varicella-zoster virus Topical drugs Do not treat the viral infection, but only treat the pain associated with lesions Exert a local anesthetic effect Capsaicin (Capsin, Zostrix) OTC drug Lidocaine (Lidoderm Patch) Rx drug Capsaicin. The drug capsaicin is a derivative of the habanero hot pepper plant. The amount of capsaicin in hot pepper is measured in Scoville units, a measurement invented in 1912 by pharmacist Thomas Scoville. Habanero hot peppers are rated the highest of all peppers—up to 300,000 Scoville units. Drugs for human papillomavirus HPV causes both: Common warts (veruccae) Genital warts (condylomata acuminata) Drugs for human papillomavirus OTC and Rx keratolytic drugs are applied topically. Treat common warts and plantar warts (verrucae) Remove dead layers of skin, which then removes the wart Also used to remove corns, calluses, and skin plaques associated with psoriasis Drugs for human papillomavirus OTC and Rx keratolytic drugs are applied topically. Monochloroacetic acid (Mono-Chlor) Salicylic acid (Compound W, Dr. Scholl's) Drugs for human papillomavirus Prescription drugs applied topically or injected to treat genital warts (condylomata acuminata) Imiquimod (Aldara) Interferon alfa-2b (Intron A) Interferon alfa-n3 (Alferon N) Monochloroacetic acid (Mono-Chlor) Drugs for human papillomavirus Prescription drugs applied topically or injected to treat genital warts (condylomata acuminata) Podofilox (Condylox) Podophyllum (Podocon-25) Trichloroacetic acid (Tri-Chlor)

Adverse Effects of a Drug

Severe side effects often referred to as adverse effects Not as commonly observed as side effects Become apparent only after a drug is on the market Can cause the FDA to remove a drug from the market even after approval -Fenfluramine (Pondimin) was removed from the market; the other drug, phentermine (Fastin), was allowed to remain on the market as an appetite suppressant. -"Fen-phen" At the same time, the chemically related drug dexfenfluramine (Redux) was also taken off the market. Both fenfluramine (Pondimin) and dexfenfluramine (Redux) were linked to cases of patients developing primary pulmonary arterial hypertension and damage to the heart valves.

Drugs Used to Treat Social Anxiety Disorder

Social anxiety disorder Characterized by fear of: Social situations Crowds, stores, meetings, parties Personal encounters On the telephone Meeting or greeting a new person Speaking To strangers or authority figures In front of a group Physical symptoms Extreme nervousness Sweating Blushing Tremors Nausea Stammering Inability to think clearly Fear that everyone is looking at you Best treated with SSRI and SNRI antidepressant drugs Professional actors, musicians, singers, and others in the public eye take propanolol (Inderal) to block the physical effects of excess epinephrine in response to performance anxiety. Not daily SSRI or SNRI Drugs Used to Treat Panic Disorder Panic disorder Also known as panic attacks Characterized by a sudden, overwhelming sense of great fear in the absence of any situation or reason that would create anxiety or fear Schedule IV drugs Alprazolam (Xanax) Clonazepam (Klonopin) Certain antidepressant drugs Tricyclic antidepressant drugs Selective serotonin reuptake inhibitor (SSRI) antidepressant drugs Serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant drugs Drugs Used to Treat Obsessive-Compulsive Disorder Obsessive-compulsive disorder (OCD) is characterized by: Thoughts that cause anxiety Repetitive actions to relieve or escape the anxiety of a perceived threatening situation Although the person knows the behavior is excessive and unreasonable, they are unable to stop it. Treated with: Antidepressant drugs Antipsychotic drugs Psychosis Loss of touch with reality, resulting in: Delusions Hallucinations Inappropriate moods Bizarre behaviors Drugs Used to Treat Psychosis and Schizophrenia Psychosis Symptoms are based on overactivity of neurotransmitter dopamine either from (histamine) overproduction of dopamine, or from a hypersensitivity of dopamine receptors Thought to play a role in psychosis are imbalances in neurotransmitters and histamine. Serotonin Acetylcholine Norepinephrine Schizophrenia is the most common form of psychosis. Treatment involves the use of antipsychotic drugs, also known as neuroleptic or major tranquilizer drugs. Block dopamine receptors in many areas of the brain Includes the limbic system, which controls emotion Antipsychotic drugs Without causing confusion or sedation, decrease psychotic symptoms of: Hostility Agitation Paranoia These drugs are not scheduled drugs and are not addictive.

Suppository

Solid base of glycerin or cocoa butter containing the drug Manufactured in appropriate sizes Vaginal Rectal Adult Pediatric Can be inserted into mouth for treating yeast infections

Urinary Tract Antispasmodic Drugs

Spasms of smooth muscles of the urinary tract due to: Infection Catheterization Kidney stones Urinary retention Relax the smooth muscle Bethanechol (Urecholine) Flavoxate (Urispas) Hyoscyamine (Anaspaz, Cystospaz)

Intranasal Route of Administration

Spraying a drug into the nasal cavity Usually done topically Some nasal spray drugs work systemically. AND Inhaling of a drug in a gas, liquid, or powder form Absorbed through the alveoli

Sublingual and Buccal Routes of Administration

Sublingual Placing medication under the tongue Provides faster therapeutic effect than oral route Buccal Placing a medication in the pocket between the cheek and lower teeth Few drugs are administered by the buccal route. AND Medication slowly disintegrates The dissolved drug is absorbed quickly Through oral mucous membranes Into large blood vessels

chapter 21 Anti-Infective Drugs

Sulfonamide Anti-Infective Drugs Group of drugs that inhibit bacterial growth Bacteriostatic Not categorized as antibiotic drug Do not kill bacteria Folic acid Interferes with the growth of some bacteria that must manufacture their own folic acid Human cells (as well as other types of bacteria) that can utilize folic acid from sources outside their cell are not affected by sulfonamide drugs. Effective against many gram-negative and gram-positive bacteria Commonly used to treat: Otitis media in the ear Urinary tract infections Meningitis Also known as sulfa drugs Sulfadiazine Sulfisoxazole (Gantrisin Pediatric) Often combined with generic trimethoprim (TMP) to become SMZ/TMP (Bacrtim, Septra)

Drugs Used to Treat Overactive Bladder

Symptoms Urinary urgency Urinary frequency Urinary incontinence (at times) Due to involuntary contractions of the bladder wall as the bladder fills with urine --> Drugs block the action of acetylcholine. Anticholinergic Darifenacin (Enablex) Fesoterodine (Toviaz) Oxybutynin (Ditropan, Gelnique, Oxytrol) remember Solifenacin (Vesicare) Tolterodine (Detrol) Trospium (Sanctura) --> Drugs block the action of acetylcholine. Reduce the smooth muscle tone of the bladder wall Mirabegron (Myrbetriq) Relax bladder contractions Onabotulinumtoxin A (Botox)

Drugs Used to Treat Neurosis and Anxiety

Symptoms of neurosis include: Anxiety Anxiousness Tension All at a more intense level than normal As well as a feeling of: Apprehension Vague, unsubstantiated fears Patients with anxiety or neurosis never experience any loss of touch with reality. Treatment includes the use of: Antianxiety drugs also known as anxiolytic drugs Minor tranquilizer drug

Drug Alert (tardive dyskinesia)

Symptoms of tardive dyskinesia include involuntary, repetitive movements of the face (grimacing, smacking the lips, chewing, blinking the eyes, sticking out the tongue, rocking back and forth, marching in place, humming, or grunting), but can also include athetoid (writhing) movements of the arms, legs, and fingers. -> The physician may recommend that the patient take a drug holiday from his or her antipsychotic drugs to lessen the symptoms of extrapyramidal side effects.

Clinical drug trials

Testing drugs on humans

Chapter 23 Vaccines

The Body's Immune Response Immune response Coordinated effort between blood and lymphatic system to destroy microorganisms that invade the body Microorganisms that cause disease are known as pathogens. Path/o- means disease. Suffix -gen means that which produces. Each type of pathogen has antigens. Immune system identifies antigens as being foreign to the body and something that must be destroyed. Once a pathogen is detected, the body attacks it in several different ways. White blood cells Antibodies Neutrophils Engulf and destroy bacteria Some bacteria release toxins that damage body tissues. Lymphocytes Mainly attack viruses NK (natural killer) cells recognize foreign cells before the body cell is coated with antibodies. Lymphocytes B lymphocytes (B cells) activate when a monocyte presents them with fragments of a bacteria or virus it has eaten. T lymphocytes (cytotoxic T cells) produce toxic granules to kill cells infected with a virus. Memory T cells are inactive until the next time the virus they were exposed to enters the body. Monocytes Engulf and destroy bacteria and virus-infected cells that have been coated with antibodies Produce interferon Produces antiviral substance that keeps viruses from entering other cells and spreading throughout the body Stimulates NK cells to attack virus-infected cells Monocytes Also, produce tumor necrosis factor that destroys endotoxins Antibodies (immunoglobulins) Produced by B lymphocytes 5 types total Immunoglobulin M (IgM)= (Think of mom the one who took care of you!!) Produced the first time the body encounters bacterium or virus Antibodies (immunoglobulins) Immunoglobulin G (IgG) Most abundant Provides active immunity Can pass from mother to fetus Immunoglobulin A (IgA) Found in body secretions, mucous membranes, and colostrum

genetic engineering (gene splicing)

The direct manipulation of genes for practical purposes.

introduction chapter 5***study

The effect a drug exerts is directed toward: -Prevention -Diagnosis -Treatment Can exert other undesirable effects Drug effects can be altered by interaction with: -Drugs -Food

did you know?

The first oral contraceptive pill was introduced in 1960. Ortho Evra, introduced in 2001, was the first transdermal patch contraceptive drug. It is produced by the same drug company that introduced the very first oral contraceptive drug in 1931.

continuous parental route

The intravenous route of administration Equipment Bag of I.V. fluid Connecting tubing Roller clamp to control flow Needle or flexible catheter to patient's vein Infusion pump AND Central venous line Used to continuously administer intravenous fluids or drugs Special catheter tunneled through the subcutaneous tissue of the upper chest Positioned in the superior vena cava AND Endotracheal tube Used to administer drugs through a tube inserted in the mouth into the trachea Useful if no established intravenous access The drug is absorbed through the lung tissue and into the blood NAVEL (naloxone, atropine, Valium, epinephrine, lidocaine) AND Implantable port Special intravenous access Used to administer chemotherapy drug Thin metal or plastic reservoir placed in the subcutaneous pocket of tissue Reservoir attached to a catheter that is threaded into superior vena cava

belly of the muscle

The middle part of the muscle

Rectal route

The most accurate route to take temperature, and the result is as close to core temperature as possible without using more invasive measures

chemical name

The name that describes the chemical composition and molecular structure of a drug. (international union of pure and apply chemistry- IUPAC)

Drug Alert.

The phrase minor tranquilizer drug is somewhat of a misnomer in that it implies that this class of drugs is somehow less effective than the major tranquilizer drugs (which are used to treat psychosis) or that the minor tranquilizer drugs are just major tranquilizer drugs given at a lower dose. - In fact, minor tranquilizer drugs are chemically unrelated to major tranquilizer drugs. Minor tranquilizer drugs are extremely effective drugs with a specific therapeutic effect for treating neurosis.

Pharmacogenetics

The study of the interrelation of hereditary constitution and response to drugs

Pharmacodynamics frequency distribution curve half-life

The study of what the drug does to the body -the numbers of animals who respond or do not respond to the drug and at what dose. -the time required for the drug level in the blood to decrease from 100% to 50%.

What you need to know? focus on healthcare

The use of epinephrine is contraindicated in certain areas of the body, such as the top of the nose, and the fingers and toes, and the ears, because the blood supply there is limited, and excessive local vasoconstriction would lead to necrosis and skin sloughing. In those areas, an anesthetic drug without epinephrine is used for local anesthesia. The local anesthetic drugs bupivacaine and lidocaine are available with or without epinephrine in the solution. Epinephrine (Adrenalin) is a powerful vasoconstrictor that decreases blood flow to the tissues where it is injected. This therapeutic effect controls bleeding and prolongs the anesthetic action of the drug. For centuries, the South American Indians chewed the leaves of the coca bush for their euphoric effects. Cocaine, which is derived from these leaves, was recognized as a topical anesthetic drug in 1880 and is still used as a topical anesthetic and vasoconstrictor drug for ENT procedures. (Euphoria is a desirable and natural occurrence when it results from happy or exciting events. An excessive degree of euphoria that is not linked to events is characteristic of hypomania or mania, abnormal mood states associated with bipolar disorders.)

Parenteral Routes of Administration

Theoretically includes all routes of administration other than oral Intradermal route of administration Using a syringe to inject a liquid drug into the dermis Used for allergy scratch test and Mantoux test AND Subcutaneous route of administration Abbreviated subQ, SQ, subcu Using a syringe to inject a liquid drug into the subcutaneous tissue Only a few blood vessels in this fatty layer Drugs are absorbed more slowly than by intramuscular route. AND ****Intramuscular route of administration Abbreviated IM, I.M. Injection of a liquid drug into the belly of a muscle Muscles are well supplied with blood vessels. Absorbed more quickly than subcutaneous AND ****Intramuscular route of administration Better able to absorb large amount of liquid drug Muscle large enough so as not to injure a nerve In adults, the deltoid, ventrogluteal, dorsogluteal, and vastus lateral AND Intravenous route of administration Abbreviated IV, I.V. Injection of liquid drug into a vein Fluid is hung from an I.V. pole, gravity moves the fluid through the tubing. Alternatively, an I.V. pump can be used. The therapeutic effect is often seen immediately AND The intravenous route of administration I.V. infusion Injected into the fluid of a large I.V. bag Administered over several hours Known as an I.V. drip I.V. piggyback injected into the fluid of a small I.V. bag attached to the existing I.V. line.

Toxic Effects of a Drug

Therapeutic index The narrow margin of safety between a therapeutic dose and toxic dose When a drug with a low therapeutic index is administered it is not uncommon to see toxic symptoms When toxic symptoms occur The physician may elect to: Decrease the dose of a drug Lengthen the time between doses Discontinue the drug altogether When toxic symptoms occur Patients on drugs known to frequently cause toxic effects will be scheduled for: Blood tests to monitor drug levels Other laboratory tests to monitor the function of particular organs affected

Drugs Used to Treat Conditions Related to HIV and AIDS

These uncommon diseases have an unusual opportunity to attack the compromised immune system of patients with HIV, and so they are known as opportunistic infections. HIV patients are also prone to: Developing rare cancers Kaposi sarcoma Burkitt lymphoma AIDS wasting syndrome, which is characterized by: Weight loss Loss of muscle mass Drugs for cytomegalovirus retinitis These antiviral drugs are used to prevent CMV infections in AIDS patients and organ transplant patients Cidofovir (Vistide) Foscarnet Ganciclovir (Cytovene) Valganciclovir (Valcyte) Drugs for Mycobacterium avium-intracellulare complex infection A common, late-stage complication of AIDS Occurs in about 40% of AIDS patients Drugs for Mycobacterium avium-intracellulare complex infection Caused by two related bacteria Mycobaterium avium Myocobacterium intracellulare Affects the intestines and other organs in the body Drugs for Mycobacterium avium-intracellulare complex infection Drugs used to treat a MAC infection include: Antituberculosis drugs Macrolide antibiotic drugs Fluoroquinolone antibiotic drugs Aminoglycoside antibiotic drugs Orphan drugs Drugs for Mycobacterium avium-intracellulare complex infection Amikacin (Amikin) Azithromycin (Zithromax) Carithromycin (Biaxin) Rifabutin (Mycobutin) Drugs for Pneumocystis jiroveci pneumonia Formerly Pneumocystitis carinii pneumonia (PCP) The most common serious infection and complication of AIDS Eventually affects about three-fourths of all AIDS patients Drugs for Pneumocystis jiroveci pneumonia Protozoan that seldom causes symptoms in healthy individuals Life-threatening in AIDS patients Drugs for Pneumocystis jiroveci pneumonia Atovaquone (Mepron) Pentamidine (NebuPent, Pentam 300) Combination drugs Bactrim Sulfamethoxazole, trimethoprim Septra Sulfamethoxazole, trimethoprim Drugs for AIDS wasting syndrome Drugs used to: Stimulate the appetite of AIDS patients Build muscle mass Treat extreme weight loss Drugs for AIDS wasting syndrome Dronabinol (Marinol) Megestrol (Megace) Oxandrolone (Oxandrin) Oxymetholone (Andadrol-50) Somatropin (BioTropin, Serostim)

film

Thin, dissolvable substance that contains a dose of drug Sublingual or transbuccal administration Enters blood through oral mucosa, bypassing stomach and digestion

Drugs Used to Treat Inflammation and Itching

Topical corticosteroid drugs are indicated to treat inflammation and itching caused by: Contact dermatitis Poison ivy Insect bites Psoriasis Topical corticosteroid drugs are indicated to treat inflammation and itching caused by: Seborrhea(located on your head/ dry scalp) Eczema Yeast or fungal infections Topical corticosteroid drugs Alclometasone (Aclovate) Betamethasone (Diprolene, Diprosone, Maxivate) Clobetasol (Temovate) Clocortolone (Cloderm) Desonide (DesOwen) Desoximetasone (Topicort) Topical corticosteroid drugs Dexamethasone (Decadron, Decaspray) Diflorasone (Maxiflor, Psorcon E) Fluocinolone (Capex) Fluocinonide (Lidex) Flurandrenolide (Cordan) Fluticasone (Cutivate) Halcinonide (Halog) Topical corticosteroid drugs Halobetasol (Ultravate) Hydrocortisone (Dermolate, Westcort) Available in both OTC and Rx strength Mometasone (Elocon) Prednicarbate (Dermatop E) Triamcinolone (Kenalog) Antihistamine drugs for inflammation and itching Inhibit inflammation, redness, and itching due to the release of histamine Released during an allergic reaction such as contact dermatitis As a group, these drugs are known as antipruritic drugs (pruritus is a Latin word that means itching). Antihistamine drugs for inflammation and itching Diphenhydramine (Benadryl) Doxepin (Zonalon) Hydralazine (Vistaril) Levocetirizine (Xyzal) Promethazine (Phenergan) Other topical drugs for inflammation and itching Available OTC Colloidal oatmeal (Aveeno) Burow's solution Created by Dr. Karl Burow, German surgeon in the mid-1800s Calamine Ainc oxide Topical combination drugs for inflammation and itching A topical antihistamine drug (diphenhydramine) to decrease itching An astringent drug (calamine, zinc oxide) to decrease oozing and exudates A topical anesthetic drug (benzocaine) to relieve itching and numb the skin Topical combination drugs for inflammation and itching Caladryl Calamine Diphenhydramine Calamycin Benzocaine Calamine Zinc oxide Topical combination drugs for inflammation and itching Ziradryl Diphenhydramine Zinc oxide

Drugs Used to Treat Wrinkles

Topical vitamin A-type drugs Muscle relaxant drugs to relax the muscles that pull the skin into wrinkle lines Filler drugs to plump up the skin to minimize wrinkles Drugs injected under the skin, effects last several months Sometimes given simultaneously Botulinum toxin type A (Botox) Calcium hydroxalapatite (Radiesse) Human collagen (CosmoDerm, CosmoPlast) Hyaluronic acid (Juvederm, Restylane) Treats: Poly-L-lactic acid (Sculptra) Tazarotene (Avage) Tretinoin (Renova)

Allergic Reactions to a Drug

Type of side effect but differs from other side effects Has specific underlying cause Release of histamine Occurs when the body's immune system identifies a foreign substance (antigen) Initiates an antibody response against it Antigen does not provoke an allergic reaction in everyone, only in certain hypersensitive people. Histamine Produces mild-to-severe allergic symptoms Depends on the amount released Mild-to-severe to life-threatening reactions The most severe symptoms of an allergic reaction are collectively known as anaphylaxis or anaphylactic shock. Mild allergic reaction Itching Swelling Redness Sneezing Severe to a life-threatening allergic reaction Bronchospasm Edema Shock Death

types of receptors

Types of receptors Adrenergic receptors α - adrenergic receptors Alpha1 Alpha2 Respond to: Norepinephrine Sympathetic nervous system neurotransmitter Drugs that act in a similar way Types of receptors Adrenergic receptors β - adrenergic receptors Beta1 Beta2 Respond to: Epinephrine Sympathetic nervous system neurotransmitter Drugs that act in a similar way Types of receptors Cholinergic receptors Respond to: Acetylcholine Parasympathetic neurotransmitter Certain drugs Histamine receptors H1 and H2 receptors Allergic reactions

Drugs Used to Treat Urinary Tract Infections

UTIs are treated with drugs that are particularly effective against gram-negative bacteria. Eschericia coli from the GI tract frequent cause of UTIs There are several categories of drugs that act systemically to treat UTIs. --> Categories of drugs that act systemically to treat UTIs Penicillin antibiotic drugs Cephalosporin antibiotic drugs Quinolone antibiotic drugs Fluoroquinolone antibiotic drugs Sulfonamide anti-infective drugs Folic acid antagonist drugs --> Quinolone antibiotic drugs Cinoxacin Nalidixic acid (NegGram) Trade name selected by the drug company because the drug is effective against gram-negative bacteria --> Folic acid antagonist drugs for UTIs Block the formation of folic acid in bacterial cells Interferes with the ability of some bacteria to grow and reproduce Trimethoprim (Primsol, Proloprim, and bactrim) --> Other antibiotic-type drugs for UTIs Drug metabolized to an acid that is excreted in the urine, where it kills bacteria The drug changed in the urine into chemicals of ammonia and formaldehyde, which kills bacteria --> Other antibiotic-type drugs for UTIs The drug has given orally but changed by bacteria themselves into a substance that interferes with DNA and bacterial reproduction Acetohydroxamic acid (Lithostat) Fosfomycin (Monurol) Methenamine (Hiprex, Urex) Nitrofurantoin (Macrobid, Macrodantin) remember

Drugs Used to Treat Diseases-of the Intestines

Ulcerative colitis Chronic disease of the colon and rectum The cause is unknown. Crohn disease Chronic disease of the ileum and colon Areas of inflammation Followed by normal mucosa (skip areas) The cause is unknown. Ulcerative colitis and Crohn disease are characterized by: -Diarrhea -Abdominal pain -Inflammation -Ulcers -Treated with antispasmodics and drugs to decrease inflammation 5-aminosalicylic acid drugs for ulcerative colitis ->Decreases intestinal inflammation by blocking the production of prostaglandins Drugs contain: -> 5-ASA as the active ingredient -Or ingredient metabolized by 5-ASA by colon bacteria -> 5-aminosalicylic acid drugs for ulcerative colitis Can be administered -Orally -Rectally As a suppository As a solution -> 5-aminosalicylic acid drugs for ulcerative colitis -Balsalazide (Colazal) -Mesalamine (Asacol, Lialda, Pentasa, Rowasa) -Olsalazine (Dipentum) -Sulfasalazine (Azulfidine) Corticosteroid drugs for ulcerative colitis ->Drugs contain corticosteroid drugs. ->Exert a more powerful anti-inflammatory effect than aminosalicylic acid ->Administered as an aerosol foam that is placed into the rectum Corticosteroid drugs for ulcerative colitis -Betamethasone (Celestone) -Budesonide (Entocort EC) -Hydrocortisone (Cortifoam) -Methylprednisolone (Medrol) -Prednisolone (Orapred, Pediapred) Drugs for Crohn disease -Monoclonal antibody-drug -Adalimumab (Humira) -Certolizumab (Cimzia) -Infliximab (Remicade) -Natalizumab (Tysabri) -Antibiotic and antiprotozoal drug -Metronidazole (Flagyl) Drugs for irritable bowel syndrome Chronic disease of the colon Characterized by: -Severe spasms -Cramping -Abdominal pain -Bloating -Excessive mucus secretion -Diarrhea alternating with constipation

introduction: chapter 7

Urinary drugs include: Diuretic drugs Potassium supplements Taken concurrently with some diuretic drugs Drugs used to treat urinary tract infections Urinary tract analgesic drugs Urinary tract antispasmodic drugs --> Urinary drugs include: Diuretic drugs Potassium supplements Taken concurrently with some diuretic drugs Drugs used to treat urinary tract infections Urinary tract analgesic drugs Urinary tract antispasmodic drugs

Nasogastric Route of Administration

Used for patients who cannot take oral medications Accomplished through a nasogastric tube Inserted through the nose and through the esophagus Into the stomach Any liquid drug that can be given orally

Laxative Drugs

Used for short-term treatment of constipation With attention also given to: -Adequate water intake -Dietary fiber/bulk -Other measures to promote bowel regularity Osmotic laxative drugs Use osmosis and osmotic pressure to: -Attract water from the blood into the intestines -Soften the stool Bulk-producing laxative drugs -Contain indigestible dietary fiber and other substances that absorb and hold water in the intestines to soften the stool -Most natural and safest of all the laxative drugs Bulk-producing laxative drugs -Methylcellulose (Citrucel) -Polycarbophil (FiberCon) -Psyllium (Fiberall, Metamucil, Perdiem)** Stool softener laxative drugs Emulsifiers that allow fat in the stool to mix with water to soften stool -Docusate (commonly given: pregnancy, and elderly)*** -Colace, ex-lax Stool Softener, Surfak -Polyethylene glycol (PEG) -MiraLax Chloride channel laxative drugs -> Stimulate chloride channels in the mucosa of the intestinal wall -> Causes fluid to flow into the intestines to soften the stool -Lubiprostone -Amitiza Irritant/stimulant laxative drugs -> Act directly on the intestinal mucosa to stimulate peristalsis -Bisacodyl -Correctol, Dulcolax, Feen-a-mint -Cascara -Sennosides -Maximum Relief ex-lax, Fletcher's Castoria, Senokot Osmotic laxative drugs -Over-the-counter -Milk of magnesia (MOM, Phillips' Milk of Magnesia) -Prescription-only -Lactulose (Cephulac)

Anesthetic Drugs

Used in mouth and throat to numb the mucous membranes and relieve the pain of cold sores, mouth ulcers, toothaches, braces, dentures, or a sore throat. -Viscous (thick) drug used to coat areas of mouth -Lozenges allowed to dissolve in the mouth -The drug they contain is swallowed continuously to treat a sore throat OTC Benzocaine (Anbesol, Cepacol, Chloraseptic, Orajel) Dyclonine (Sucrets) Rx Lidocaine (Xylocaine)

Antiemetic Drugs

Used to control nausea and vomiting -> associated with many different diseases -> Bacterial or viral illnesses -> Can directly irritate the intestinal mucosa -> Cause nausea and vomiting Irritation of the intestinal mucosa Stimulates the chemoreceptor trigger zone and vomiting center in the brain Some causes -Chemotherapy -Radiation -Drugs Surgery (especially abdominal surgery) Can temporarily stop peristalsis -> Fluids accumulate in the GI tract -> Can cause distention -> Trigger postoperative nausea and vomiting Patients who are actively vomiting and cannot take oral drugs can be given antiemetic drugs in the form of a rectal suppository. Some drugs used to treat nausea and vomiting block dopamine: -> From activating receptors in the wall of the GI tract -> In the chemoreceptor trigger zone -> In the vomiting center in the brain -Aprepitant (Emend) -Chlorpromazine (Thorazine) -Dolasetron (Anzemet) -Haloperidol (Haldol) > antipsychotic for treat schizophrenia. -Ondansetron (Zofran) -Palonosetron (Aloxi) -Promethazine (Phenergan) -Trimethobenzamide (Tigan) Antiemetic drugs for use with chemotherapy drugs Certain antiemetic drugs are used specifically to treat nausea and vomiting caused by chemotherapy drugs. Antiemetic drugs for motion sickness or vertigo -> Motion sickness -> Occurs when repetitive but varying motions of a car, boat, or airplane overstimulate the inner ear -> Activates the vomiting center in the brain

Vaginal Route of Administration

Used to treat vaginal infections Creams, ointments, and suppositories Contraceptive foams are inserted vaginally

Drugs used During the Preoperative Period

Various categories of drugs are given preoperatively to provide sedation as well as to dry up oral secretions to facilitate endotracheal intubation antihistamine drugs. Antihistamine drugs Provide sedation Dry up oral secretions to facilitate endotracheal intubation Hydroxyzine (Vistaril) Promethazine (Phenergan) Anticholinergic drugs Block the action of acetylcholine Decrease oral secretions to facilitate endotracheal intubation Atropine Scopolamine Antianxiety drugs Relieve anxiety and provide sedation Prior to endoscopy, cardiac catheterization, and minor surgical/dental procedures Patient able to respond to commands to facilitate procedure but has little memory afterward Antianxiety drugs Chlordiazepoxide Diazepam (Vistaril) Lorazepam (Ativan) Midazolam Narcotic drugs Relieve pain and provide sedation Schedule II Levorphanol (Levo-Dromoran) Meperidine (Demerol) Morphine (Duramorph) Oxymorphone (Numorphan, Opana) Narcotic drugs Schedule IV Butorphanol (Stadol) Pentazocine (Talwin) Sedative/hypnotic drugs Chloral hydrate (Somnote) Schedule IV Droperidol Dexmedetomidine (Precedex) Barbiturate drugs Produce sedation Schedule II Pentobarbital Secobarbital (Seconal) Antipsychotic drugs Decrease anxiety Chlorpromazine

Periwinkle

Vincristine (used to treat cancer)

rose hips

Vitamin C

Anti-yeast Drugs

Yeasts One-celled organisms that are closely related to fungi Grow easily in the warm, moist, dark environments of the mouth Especially true in patients whose immune systems are compromised by disease Candida albicans yeast infections of the mouth are also known as oral candidiasis (thrush) or monilia. - Topical antiyeast drugs used to treat oral candidiasis Clotrimazole (Mycelex) Nystatin (Mycostatin, Nilstat)

suppository

a cone-shaped, solid drug that is inserted into a body opening; it melts at body temperature prevent vomiting

Drug Enforcement Administration (DEA)

a division of the Department of Justice that enforces the Controlled Substances Act of 1970

*** Food and Drug Administration (FDA)

a federal agency charged with enforcing regulations against selling and distributing adulterated, misbranded, or hazardous food and drug products -weights the inherent risk against the benefits. -completes review process

Federal Trade Commission

a federal agency established in 1914 to investigate and stop unfair business practices

opium poppy

a plant cultivated for centuries, primarily in Eurasia, for opium- a narcotic that acts as a central nervous system depressant. -use a painkiller -recreational drug -narcotic drug

parenteral route

a portal of entry for pathogens by deposition directly into tissues beneath the skin and mucous membranes

desiccant

a substance used to absorb moisture from the air and create a dry atmosphere

enteric coated tablet

a tablet covered in a special coating to protect it from stomach acid, allowing the drug to dissolve in the intestines

sublingual route

administration of medication by placing it under the tongue and allowing it to dissolve slowly

Diuretics drug

also called water pills, are a common treatment for high blood pressure. Find out how they work and when you might need them

**** 1996 indivinavir

another name Crixivan was approved HIV DRUG

Emergency treatment investigational NEW drug (IND)

application to be filed. this is also known as a compassionate use IND application. The first drug for HIV was prescribed for patients before its approval in 1987.

Analgesics drug

are medicines that are used to relieve pain.

willow bark

aspirin

troche or pasille

base of sugar. is like a little lump of bread = french word

cocoa butter

binder or filter ingredient

drug recall

can be done for several different reasons. 1. the drug does not contain the correct amount of active ingredient 2. the does not remain stable unit its expiration date. 3. The drug is contaminated with particulate matter from the manufacturing process.

hot pepper plant

capsaicin (topical pain relief)

compounding

combining two or more substances in definite proportions

gastrostomy

creation of an artificial opening into the stomach

Margin of Safety

difference between your actual or expected profitability and the break-even point - Ex: penicillin, which has a wide margin of safety, has a therapeutic index of more than 100. The therapeutic index of digoxin (Lanoxin) is less than two.

small intestine

duodenum, jejunum, ileum

layers of the skin

epidermis, dermis, subcutaneous hypodermic means below the skin

cialis****

erectile dysfunction

Antibotic drugs

fight against bacteria

GERD (remember***)

gastroesophageal reflux disease

administration means

given

in vitro testing

glass = in Latin phrase that means un glass. is a chemical analysis of a drug done in a laboratory in test tubes.

gtt

glucose tolerance test

scored tablet

has an indented line running across it, from one side to the other, so that it can be easily broken into equal pieces to produce an accurate, but reduced, dose

Components of Prescriptions and Medication Orders

identifying information about the physician Prescription form Preprinted at the top To identify the prescriber Name Office address Phone number Identifying information about the physician Physician's order sheet Physician's signature All other information is on file with the hospital. Identifying information about the patient Prescription form To positively identify the patient First and last name Address Identifying information about the patient Physician's order sheet Patient information already on the order sheet If computerized record, it is preprogrammed to be there. If paper record, hospital card is created and used to imprint order sheet. Patient's age and weight Prescription form Not always included but can be useful Age Child Mandatory for Schedule II Weight The dose may be adjusted for low or high weights.

Food, Drug, and Cosmetic Act of 1938

indicated that mis-branding and adulteration of drug is illegal. It also required manufacturers to provide package inserts and to follow FDA guidelines to present evidence of safety for new drugs before marketing. This law also gives the FDA authority to issue food standards and inspect factories/

intravenous administration

injection of a liquid drug directly into a vein

intravenous route

injection of a solution into the vein

intramuscular route

injection of drugs into a muscle

rDNA technology

inserting genes into cells to produce proteins that the bacteria doesn't normally produce

insulin to treat diabetes Mellitus was ground-up beef or pork pancreas.

insulin

iv stands for

intravenous two types intravenous: IV drip, piggyback, IV port, Helprin port

intranasal route

involves spraying a drug into the nasal cavity

Insulin

is a protein hormone that is used as a medication to treat high blood glucose. (diabetes) (subcutaneously)

drugs

is derived from the Dutch word droog, which means dry and refers to the use of dried herbs and plants as the first medicines.

slow released tablet/ extended release tablet

is manufactured to provide a continuous, sustained release of the drug

effervescent tablet

is one that is dissolved in a glass of water before being swallowed (e.g., Alka-Seltzer for a head cold)

Ephedrine

is present in the leaves of a bushy shrub =Ephedra use to treat respiratory ailments.

intravesical route

is used to treat the pain and burning of inflammation and infection in the bladder. a solution of analgesic drug is instilled into the bladder through a catheter. It is also use to administer chemotherapy drugs to treat bladder cancer.

National Drug code (NDC)

maintained by the Food and Drug Administration (FDA); identifies prescription drugs and some over-the-counter products.

in vivo testing

mean Latin in living testing in animals and humans.

inhalation route

medications absorbed through the nasal passages, oral passage, or endotracheal or tracheostomy tubes. absorbed through the air sacs (alveoli)

The apothecary carry system of measurement

minims drams ounces grains scruples

atropine

muscarinic antagonist

generic name

name assigned by the manufacturer who first develops a drug; it is often derived from the chemical name (generic name is begin with lowercase)

lanolin topical skin drugs

obtained from the purified fat of process sheep's wool.

naloxone

opioid antagonist

OTC

over the counter

lozenges

over the counter tablet, are formed from a hardened based sugar and water containing the drug and other flavorings.

blister packs

packages with preformed plastic molds surrounding individual items arranged on a backing - protect

mold

penicillin (antibiotic drug)

Drug Premarin- female hormone replacement

pregnant mare's urine

***prophylaxis

prevention drug ****-prophylaxis is from a Greek word meaning to keep guard before.

3 major agent

preventive use, diagnostic use and therapeutic use

cinchona bark

quinine (used to treat malaria)

black cohosh

remifemin (use to treat menopause hot flashes)

Kefauver-Harris Amendment of 1962

requires all medications in US to be pure safe and effective

Placebo***

something which has a positive mental effect, but no physical effect "I will please" means in Latin (fake pill= sugar pill or injections of the sterile normal saline)

molecular pharmacology

study of interaction of drugs and their target molecules such as enzymes, or cell surface receptors

liquid

suspension Fine, undissolved particles suspended in a water or oil base Particles gradually settle Important to shake

withdraw

the FDA continually evaluates current reports of adverse event drug effects, especially those that involve death and will withdraw a drug from the market.

expiration date

the date that printed on it /the last day a product is considered fresh

post-marketing surveillance

the drug companies and the FDA continues to monitor the effectiveness and saftey of approved drugs.

capsule: two type of varieties

the first is a soft, one-piece gelatin shell with the liquid drug inside EX.. vitamin A and Eb fat- soluble The second type of capsule is a hard shell manufactured in two pieces that fit together and hold powdered or granular drugs inside.

Inert ingredients

the ingredient of the drug formulation that includes preservatives, stabilizers, and liquid media into which the drug is dissolved or suspended

New Drug Application (NDA)

the process through which drug sponsors formally propose that the FDA approve a new pharmaceutical for sale and marketing in the United States

gene cloning

the production of multiple copies of a single gene

Bioavailability

the rate at and the extent to which a nutrient is absorbed and used

Pharmokinetics

the study of drugs within the body, absorption , distribution, metabolism, excretion

pharmacogenomics

the study of how genetic inheritance affects the body's response to drugs

therapeutic use

the use of pharmaceutical drugs to control, improve, or cure diseases. (treatment)

medicine

the word for drug is medicina, from which we derive the words medicine and medication

*** pharmacopeia

the word pharmacopeia comes from the Greek word pharmakon,*** which means medicine or drug, and poiein which means to make.

Drugs derived from Aninitilis

thyroid supplement drug are composed of dried thyroid gland tissue taken from animals.

Durhan-Humphrey Amendment

to the food, drug and cosmetic act defined prescription drugs as those drugs that could only be given to patients who were under the care of a physician.

Digitalis (foxglove)

to treat heart failure, discovered in 1741. -Digoxin another term Lanoxin is derived from foxglove and still used today.

Gilla monster

treat 2 type diabetes - minerals comes from earth. (trace minerals)

humulin insulin

was the first drug to be created with recombination DNA technology. On the drug box are printed the words. -approved by the FDA