Intro To Pharmacotherapeutics

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Pharmacotherapeutics

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The study of the therapeutic uses and effects of drugs

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Pharmacology

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The study of medicines, the study of the effects of drugs on living organisms

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Number of prescriptions filled annually

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502 million

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Number of drug products on the market

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35, 000

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Average prescriptions/year/person

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15

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Food and Drugs Act

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Standards that drugs must meet, including production, sale, labeling, and advertising.

Drugs must be labeled with the legend Canadian Standard Drug (CSD) on inner and outer labels.

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Health Canada

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Determined which drugs are approved for Canada

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Legislative Bodies

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Canadian narcotic control act

Controlled drugs and substances act

Marijuana Medical Access Act

Natural Health Products Regulations

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Dispensing

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Giving out medicine

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Prescribing

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Written or oral direction for prep and administration of a drug

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New Drugs

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Extensive testing is required that takes 12 years minimum from discovery to prescribing

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Steps for Medicines to get on the market

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Preclinical experiments in the lab

Clinical trial application

New drug submission complete

NDS reviewed by experts

Review by health Canada

Health Canada issues notice of completion and a DIN

Aftermarket monitoring by health Canada

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Therapeutic Classification

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Classification based on the way it is used to treat particular conditions

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Pharmacological Classifications

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The way the drug works at the molecular, tissue, and body system level

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Uses of medications

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Cure (Antibiotic), Elimination or reducing symptoms, stopping or sowing disease process, preventing a disease or unwanted condition, improving quality of life, substitutive (replacing body fluid or substances), and supportive (supports the body function until other treatment or body response takes over

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Non-Parenteral Administration

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Enteral or Tropic

Absorbed slower, uses GI tract, safer than parenteral

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Enteral

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Oral, Buccal, sublingual, rectal, nasogastric, gastrostomy

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Topical

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Transdermal, ophthalmic, optic, nasal, vaginal

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Parenteral

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Intradermal (ID), Subcutaneously (SUBCUT), Intramuscular (IM), Intravenous (IV)

Absorbed faster, picked up by circulation, more dangerous than non-parenteral

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Generic Names

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Name of drug given by Health Canada under the Food and Drugs Act

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Trade Name

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The registered trademark of drug given by manufacturer

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Therapeutic Effect

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Desired or intended effect of med

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Prophylactics

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Any agent that contributes to the prevention of infection and disease

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Side Effects

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Unintended, secondary effects that a med will predictably cause

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Adverse Effects

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Generally considered to be severe, negative responses to medication

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Drug Interaction

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Altered responses of a drug due to presence of other drugs

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Onset

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Time it takes for drug to initiate a therapeutic response

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Peak

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The time it takes the drug to reach its max therapeutic response

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Duration

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The time that a drug concentration is sufficient to elicit a therapeutic response

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Controlled Drugs and Substances Act

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regulates the possession, sale, manufacture, disposal, and distribution of narcotic and controlled drugs

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Regulated Health Professionals Act

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Regulates the practice of various health disciplines in Ontario

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Prescriber

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Physician, Nurse Practitioner, midwife

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Seven Parts of a Drug Order

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Patient; drug name; dosage; route; frequency, time, and special instructions; date and time; signature of the prescriber

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Rights of Medication Administration

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The right patient; the right drug and right amount; the right route, the right time, and the right documentation

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Check the 8-10 rights what 3 times

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When removing medication from the cart/cupboard/computer

When pouring medication into med cup or drawing it up

Prior to returning container to the cupboard

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Medication Administration Record (MAR)

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A legal document that shows what drugs were administered to the patient

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RPN Responsibilities with Label

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Recall rights of Medication administration; check label 3 times (against patient order, before preping meds, after preping meds

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Dividing Oral Dosages

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Only scored tablets can be divided but are preferred to be given whole

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Pediatric and Fragile Adult Dosage

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Standard doses are not always used, body weight significantly affects dosage,

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Pharmacodynamics

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What the drug does to the body

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Pharmacokinetics

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What the body does to the drug (eliminations, metabolism, distribution, absorption, etc.`)

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Factors Affecting Distribution

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Amount of blood flow and body tissues

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Blood-brain Barrier

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A semi-permeable membrane that allows some substances to cross, but prevents others; protects the brain from foreign substances and some hormones; maintains constant environment for the brain

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Blood-brain Barrier Failure

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BBB can be broken down by hypertension, hyperosmolality, microwaves and radiation, infection, trauma, ischemia, inflammation

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Biotransformation

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AKA Metabolism

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Factors affecting metabolism

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Age - young= immature liver; elderly = liver reduced function

Decrease of liver - cirrhosis, hepatitis

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Factors affecting excretion

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renal failure goes up during the duration of drug action and can lead to toxicity

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Drug Action

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Drug binds to receptor causing action (Think lock and key)