Basics Of Pharmacology

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pharmacology

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the study of the preparation, properties, uses and actions of drugs

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toxicology

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the study of the harmful effects of drugs and chemicals on the body

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drugs (medications)

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substances used to prevent or treat a condition or disease - obtained from plants, animals, or synthesized in a laboratory

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prescription drug

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drugs that require a written or verbal order from or under the direction of a licensed physician prior to dispensing

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legend drug

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prescription drug

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over the counter drugs (OTC)

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drugs that can be purchased without a written order

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controlled substance drugs

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substances that are addictive and have a potential to be abused

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narcotics

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common name for controlled substance drugs

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CI-CV

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the five major classes or schedules of controlled substance drugs

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schedule-I (CI)

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not stocked in a pharmacy
no medicinal use (US)
ex: heroin, lysergic acid diethylamide (LSD), marijuana

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schedule I (CI)

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highest potential for abuse

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schedule II (CII)

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high possibility of abuse, which can lead to severe psychological or physical dependence

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schedule II (CII)

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dispensing is severely restricted, cannot be prescribed by phone unless in an emergency (72 hr), no refills
ex: morphine, oxycodone, meperidine, hydromorphone, fentanyl

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schedule III (CIII)

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moderate potential for abuse and addiction

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schedule III (CIII)

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prescriptions can be refilled up to 5 times in 6 months if authorized by a physician (written, phone, or fax), transferred to another pharmacy once ONLY
ex: codeine/ASA, codeine/APAP, anabolic steroids

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schedule IV (CIV)

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low abuse potential, associated with limited physical or psychological dependence

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schedule IV (CIV)

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prescriptions can be refilled up to 5 times in 6 months if authorized by a physician (written, phone, or fax), transferred to another pharmacy once ONLY
ex: benzodiazepines, meprobamate, phenobarbital

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schedule V (CV)

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lowest abuse potential

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schedule V (CV)

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some sold without a prescription based on state law, must be over 18 years and required to sign a log and show identification, prescriptions can be refilled up to 5 times in 6 months if authorized by a physician (written, phone, or fax), transferred to another pharmacy once ONLY
ex: liquid codeine preparations

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dose

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exact amount of drug that is administered in order to achieve the desired effect

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minimum dose

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smallest amount of the drug that will produce a desired effect

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maximum dose

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largest amount of the drug that will produce a desired effect without producing signs of toxicity

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loading dose

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initial high dose used to quickly elevate the level of drug in the body

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maintenance dose

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dose required to keep the drug level at a steady amount

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duration of action

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the length of time that a particular drug is effective

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mechanism of action (MOA)

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explanation of how the drug works in the body

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site of action

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location within the body where a drug exerts it therapeutic effect, often a receptor site

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receptor site

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specific location on the cell membrane or in the cell where the drug attaches to produce its intended effect

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agonist

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drug that binds to specific sites and produces a drug action

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antagonist

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drug that binds to specific sites but does not produce a drug action, prevents the effect of other drugs or natural body substances from producing an effect

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blocker or blocking agent

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antagonist

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indication

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disease, condition, or symptom for which a drug is used

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contraindication

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any situation where the drug should not be used ex
ex: factors in a patient's condition that make the use of a drug dangerous and ill advised

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systemic effect

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an action of a drug that has a generalized, all-inclusive effect on the body
ex: oral and most parenteral drugs

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local effect

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an action of a drug that works on a specific area in/of the body
ex: topicals, opthalmic, otic...

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therapeutic effect

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desired action of a drug

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side effect

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toxic effects that routinely result from the use of a drug, unintended effect but more of an irritation then harmful, usually patients become tolerant of the effect

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adverse effect

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toxic effect that result from the use of a drug, unintended effect that can become harmful

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toxic effect

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toxic effect that result from the use of a drug, extremely harmful, possibily fatal

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allergic hypersensitivity

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an over-response of the body to a specific substance

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severe reaction

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severe allergic response to a drug resulting in immediate, life-threatening respiratory distress, usually followed by vascular collapse and shock, accompanied by hives

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anaphylactic reaction

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severe reaction
treated promptly with epinephrine

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teratogenicity

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the effect on a fetus from maternal drug administration that causes the development of physical defects
6 categories: A, B, C, D, X, NR

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category A

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teratogenicity category
studies have demonstrated little risk to the fetus

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category B

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teratogenicity category
only animal studies have been conducted and have shown little or no fetal risk

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category C

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teratogenicity category
have not been studied, benefit of drug use must clearly justify potential fetal risk

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category D

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teratogenicity category
studies show risk to fetus in humans

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category X

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teratogenicity category
fetal risk outweighs the benefit to the mother and should not be used

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category NR

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teratogenicity category
drugs that have not been rated

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idiosyncrasy

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an unpredictable type of drug toxicity, unique, unusual response to a drug
ex: tranquilizer causing agitation

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tolerance

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decreased response to a drug, once developed- the dose must be increased to achieve the same effect

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dependence

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patient requires the drug to 'function normally', characterized by a physical and/or psychological dependence

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addiction

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the condition of drug abuse and dependency that is characterized by compulsive behavior

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withdrawal

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occurs when a drug is no longer administered to a dependent patient

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pharmacokinetics

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the study of drug effects in the body over time, includes absorption, distribution, metabolism, excretion

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absorption

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process whereby a drug enters the circulatory system (mucosa of the stomach, mouth, small intestines or rectum)

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distribution

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the ability of a drug to pass into the bloodstream
(after absorption, the medication is distributed throughout the body from the bloodstream into tissues, membranes, and ultimately organs of the body)

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metabolism

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chemical alteration of drugs or other compounds of the body
main organ: liver
altered by age, gender, genetics, diet and other chemicals ingested

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excretion

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elimination of waste, last phase of drug life in the body, via urination and bowel movements (most common), exhalation, sweat glands and breast milk

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bioavailability

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the proportion of the drug that makes it to the destination and is available to the site of action for which it was intended

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half-life

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the measurement of time the body takes to break down and excrete one half of the drug, important in determining the frequency of drug administration

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bioequivalence

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the comparison between drugs either from manufacturers or in the same company but from different batches of drug

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route of administration

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the path by which a substance is taken into the body
ex: by mouth, injection, inhalation, rectum, or by application

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dosage

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the determination and regulation of the size, frequency and number of doses

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placebo

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an inactive substance with no pharmacological action that is administered to some patients in clinical trials to determine the relative effectiveness of another drug administered to a second group of patients.

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clinical trial

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a trial based upon the scientific method in which a control group and a test group are compared over time in order to study a single, differing factor.

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inscription

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part of a prescription that identifies the name of the drug, the dose, and the quantities of the ingredients

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peroral (PO)

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administration of a medication by mouth, easiest route of administration (self-administered), systemic
disadvantage: slow (30-60 min)

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sublingual (SL)

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under the tongue
bypasses the long GI system and are absorbed readily into the bloodstream
most common ex: nitroglycerin

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buccal

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dissolved between the cheek and gum
bypasses the long GI system and are absorbed readily into the bloodstream

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topical

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work at site of action, systemic or localized, absorbed through pores into the bloodstream

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per rectum (PR)

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actual amount of drug absorbed is not as predictable as oral
forms: ointment, cream, suppository, solution...

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parenteral

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outside the GI tract, may involve puncture of the skin, increasing risk of infection

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intravenous (IV)

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parenteral route of administration, rapid onset of action because the medication is injected directly into the bloodstream

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intramuscular (IM)

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parenteral route of administration, injected into the muscle where the drug passes through capillary walls to enter the bloodstream

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subcutaneous (SQ)

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parenteral route of administration, injected under the skin and commonly used for the injection of insulin in diabetics

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ophthalmic

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eye (sterile) preparations

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otic

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ear (non-sterile) preparations

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nasal

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nose

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inhalation (INH)
metered dose inhaler (MDI)
small volume nebulizer (SVN)

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onset of action relatively quick, persons that suffer from lung diseases