Principles of Pharmacology

PowerPoint presentation to accompany:

Medical Assisting
Third Edition

Booth, Whicker, Wyman, Pugh, Thompson

2009 The McGraw-Hill Companies, Inc. All rights reserved

 50-2

Learning Outcomes
50.1 Describe the five categories of pharmacology.

50.2 Differentiate between chemical, generic, and trade

names for drugs.

50.3 Describe the major drug categories.

50.4 List the main sources of drug information.

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 50-3

Learning Outcomes (cont.)

50.5 Contrast over-the-counter and prescription drugs.

50.6 Compare the five schedules of controlled

substances.

50.7 Describe how to register a physician with the

Drug Enforcement Administration (DEA) for
permission to administer, dispense, and prescribe
controlled drugs.

2009 The McGraw-Hill Companies, Inc. All rights reserved

 50-4

Learning Outcomes (cont.)

50.8 Describe how to telephone a medication refill.

50.9 Describe how vaccines work in the

immune system.

50.10 Identify patient education topics related to the use

of nonprescription and prescription drugs.

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 50-5

Introduction
Pharmacology science or study of drugs

Medication errors can result in injury or death

Medical assistant
Knowledge of the foundations of pharmacology
Understand role of drugs in ambulatory medical
facilities

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 50-6

Medical Assistants Role

in Pharmacology
Prescription drugs You should
physicians order Be sure the physician is
required to dispense aware of all medications
and administer the patient is taking

Ask patients about use of

OTC drugs alcohol and recreational
purchased by patient drugs
for self-treatment
Provide patient
education

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 50-7

Medical Assistants Role

in Pharmacology (cont.)
Administration of drugs
Check state regulations scope of practice
Understand pharmacologic principles
Translate prescriptions
Answer basic patient questions
Adhere to legal requirements
Keep accurate records

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 50-8

Drugs and Pharmacology

Drug chemical compound used to prevent,
diagnose, or treat disease
Pharmacognosy study of characteristics of
natural drugs and their sources
Pharmacodynamics study of what drugs do
to the body

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 50-9

Drugs and Pharmacology (cont.)

Pharmacokinetics study of what the body
does to drugs
Pharmacotherapeutics study of how drugs
are used to treat disease
Toxicology study of poisons or poisonous
effects of drugs

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 50-10

Drugs and Pharmacology (cont.)

Prescribe physician gives a patient a
prescription to be filled by a pharmacist
Administer give a drug by injection, mouth,
or other route that introduces it into the body
Dispense health-care professional distributes
the drug, in a properly labeled container, to the
patient for whom it is prescribed

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 50-11

Sources of Drugs
Natural products
Plants
Animals
Minerals
Bacteria and fungi Foxglove is used
to make digitoxin

Chemical development of natural products

Synthesis of chemical makeup of a drug
Manipulation of genetic information

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 50-12

Apply Your Knowledge

1. What is the role of the medical assistant in
pharmacology?
ANSWER: The medical assistant should be sure the
physician is aware of all medications the patient is
taking, including OTC medications; ask patients about
use of alcohol and recreational drugs; and provide
patient education. If the scope of practice permits, the
medical assistant may also be responsible for
administering some medications.

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Apply Your Knowledge

2. Matching: ANSWER:
C Study of poisons
___ A. Pharmacokinetics
A Study of what the body does to drugs
___ B. Pharmacognosy
F Used to prevent, diagnose, or treat disease
___ C. Toxicology
E Study of what drugs do to the body
___ D. Pharmacotherapeutics
D Study of how drugs are used to treat disease
___ E. Pharmacodynamics
B Study of characteristics of natural drug
___ F. Drugs
and their sources

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 50-14

Pharmacodynamics
Mechanism of action of
a drug to produce a
therapeutic effect

Interaction between
drug and target cells
and bodys response to
the interaction

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Pharmacokinetics
What the body does to a drug
Absorption
Conversion of a drug into a form the body can use
Allows the drug to enter the blood and tissues
Rate and extent of absorption depend on
Route of administration
Characteristics of the drug

Distribution
Transportation of a drug from site of administration
to site of action

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Pharmacokinetics (cont.)
Metabolism
Drug molecules are transformed into metabolites
Usually in liver, some in kidneys
Affected by age, genetic makeup, and characteristics
of drug

Excretion
Manner in which a drug is eliminated from the body
Most via urine

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 50-17

Apply Your Knowledge

What is the difference between pharmacodynamics and
pharmacokinetics?
ANSWER: Pharmacodynamics is the way a drug affects the
body to produce its effect. It is the interaction between the
drug and cells and the body's response to the interaction.
Pharmacokinetics is what the body does to the drug and
includes absorption, distribution, metabolism, and excretion
of the drug.

Very Good!
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Pharmacotherapeutics
Clinical pharmacology
Drug names
Generic official name
International nonproprietary name
Chemical name
Trade brand or proprietary name

Generic and trade names used most often

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Pharmacotherapeutics (cont.)
Drug categories Indication and labeling
Action on the body Indication reason(s)
for using a drug
General therapeutic
effect Must be approved by
FDA to be part of
Body system affected labeling

Off-label use

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 50-20

Pharmacotherapeutics (cont.)
Safety
Adverse reaction to drug

Interaction with another medication

Be alert to patient complaints after starting a new drug

Efficacy drug is working as expected

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 50-21

Pharmacotherapeutics (cont.)
If a patient complains a drug is not working
The patient may not understand how the drug
works
Dosage may need to be adjusted
Therapeutic level may not have been reached
Wrong drug may have been prescribed
Some drugs work better for one patient than
another
Some forms of drugs work better
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Pharmacotherapeutics: Kinds of Therapy

Acute improve a life- Prophylactic prevent
threatening or serious disease
condition
Replacement provide
Empiric given before test chemicals a patient lacks
results are available
Supportive for a
Maintenance maintain condition other than the
health primary disease

Palliative reduce severity Supplemental avoid a

of a condition or pain deficiency

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 50-23

Toxicology
Study of poisonous effects of drugs
Adverse effects
Drug interactions

Patient education
Inform physician of any adverse effects
Discuss concerns with physician or pharmacist

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Apply Your Knowledge

1. Mr. Anderson is complaining that the new medication does
not seem to be working. What may be the reason for this?
ANSWER: Mr. Anderson may not understand how the
drug works. His dosage may need to be adjusted, or the
therapeutic level may not have been reached. The wrong
drug may have been prescribed for him, or this
particular drug may not work for as well for him as for
another patient. He may need the medication in a
different form.

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 50-25

Apply Your Knowledge

2. Toxicology includes which of these?
ANSWER:

A. Poisons and poisonous effects of drugs

B. Excretion of drugs
C. Adverse effects of drugs
D. Drug interactions
E. Metabolism of drugs

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 50-26

Sources of Drug Information

Sources must be up-to-date
PDR
Information provided by pharmaceutical
companies
Information closely resembles package insert
Published annually

Drug Evaluations published

annually by the AMA

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Sources of Drug Information

USP/NF
Official source of drug standards
Published about every 5 years

AHFS published by the

American Society of
Hospital Pharmacists

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 50-28

The FDA Regulatory Function

New drugs OTC drugs
Clinical trials
Safety Prescription drugs
Efficacy
Pregnancy categories
Drug manufacturing A
Identity B
Strength C
Purity D
Quality X

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The FDA Regulatory Function (cont.)

Controlled substances
Drugs categorized as potentially dangerous and
addictive
Strictly regulated by federal laws
Comprehensive Drug Abuse Prevention and
Control Act (1970)
Created the DEA
Strengthened drug enforcement authority
Schedules based on abuse potential

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 50-30

The FDA Regulatory Function (cont.)

Schedule Abuse Potential Example
I High Heroin
II High Morphine
III Lower than II Butabarbital
(moderate dependence)
IV Lower than III Diazepam
(limited dependence)
V Lower than IV Antidiarrheals
(very limited dependence)

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The FDA Regulatory Function (cont.)

Comprehensive Drug Abuse Prevention and Control
Act (1970)
Controlled substance Dispensing records
labeling Inventory records
Doctor registration Disposal of drugs
Ordering controlled
substances
Drug security
Record keeping

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 50-32

The FDA Regulatory Function (cont.)

Writing prescriptions parts of a prescription

Superscription Subscription
Patient information directions to the
pharmacist

Inscription Signature patient

Name of the drug instructions
Amount of drug per dose

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The FDA Regulatory Function (cont.)

Prescription for a
Single Medication

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The FDA Regulatory Function (cont.)

Prescription for
Multiple Medications

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 50-35

The FDA Regulatory Function (cont.)

Writing prescriptions
Keep prescription Telephone prescriptions
blanks secure Only at request of the
physician

Follow facility policy

Document carefully

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 50-36

Apply Your Knowledge

1. Which of the following sources of drug information is most like
the package insert? ANSWER:
A. AHFS B. PDR C. USP/NF D. Drug Evaluations

2. Match ANSWER: Correct!

C Contains the patient information
___ A. Subscription
___
D Name of the drug and dosage B. Signature
___
A Instructions to the pharmacist C. Superscription
B Patient instructions
___ D. Inscription

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 50-37

Vaccines
Special preparations made from
microorganisms

Administered to produce reduced

sensitivity to or increased
immunity to an infectious disease

Body creates antibodies in

response to an antigen (vaccine)

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Vaccines: Antibody Formation

1. Antigen enters body
2. White cells produce antibodies
3. Antibodies combine with antigens
to neutralize them
4. This arrests or prevents reaction or disease
5. Vaccines stimulate antibody formation and reduce
symptoms if patient is exposed to disease

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 50-39

Vaccines: Immunizations
Schedule for immunizations for
children up to age 16 years

Pre-exposure immunizations

Post-exposure immunizations
antiserum or antitoxin that
contains antibodies

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 50-40

Vaccines: Immunizations (cont.)

Medical assistant should be familiar with
Indications
Contraindications
Dosages
Administration routes
Potential adverse effects
Methods of storing and
handling

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Apply Your Knowledge

Why are vaccines given to patients?

ANSWER: Vaccines are administered to a person to

produce reduced sensitivity to or increase immunity
to an infectious disease.

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 50-42

Patient Instruction
on Medications
Medical assistant role is important

OTC drugs
Should not be used to avoid medical care
May not produce enough therapeutic benefit
May be dangerous in combination with other
substances or drugs
May mask symptoms or aggravate a problem

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 50-43

Patient Instruction
on Medications (cont.)
Prescription drugs
Inform patient about special
considerations and drug
safety precautions

Encourage patient to
Maintain a complete list
of medications
Report adverse reactions
Patient compliance

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 50-44

Patient Instruction
on Medications (cont.)
To prevent medication errors, be sure patient
understands prescription
How and when to take the medication
Appropriate language
Demonstrate if necessary
Review warnings about
the medication

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 50-45

Apply Your Knowledge

Mrs. Del Rosario tells you she does not take any medication
when you are taking her history. When you question her further,
she says she takes an OTC pain medication occasionally and
routinely take several herbal supplements. What should you tell
her?
ANSWER: You should tell her it is important to report all
medications, including OTC drugs and herbal and other
supplements, to the physician and that they may be
dangerous in combination with other substances or drugs
or may mask symptoms or aggravate a problem.

Nice Job!
2009 The McGraw-Hill Companies, Inc. All rights reserved
 50-46

In Summary
Pharmacology study Medical assistant
of drugs Instruct patients about
Specific drugs
Drug classifications Required safety
precautions
based on action
Promote patient
Immunizations provide compliance
immunity to specific
diseases

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 50-47

End of Chapter

It is easy to get a
thousand
prescriptions but
hard to get one
single remedy.
~Chinese Proverb

2009 The McGraw-Hill Companies, Inc. All rights reserved