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pharmacology

pharmacology

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

pharmacologist

either an MD or a PhD who specializes in pharmacology

subdivisions of pharmacology

*Medicinal chemistry
-new drug synthesis
*Pharmacodynamics
-Drug effects on the body
*Pharmacokinetics
-Drug [ ] in tissues and blood measured over a
period of time
*Molecular pharmacology
-interaction of drugs and components inside
the cell or on the cell surface
*Chemotherapy
-use of drugs in treatment of cancer and
infectious diseases
*Toxicology
-studies of harmful effects of drugs on the body

Antidotes

substances given to neutralize unwanted effects of drugs

Chemical name

specifies the chemical makeup of the drug

Generic name

shorter and less complicated than chemical name
-identifies the drug legally and scientifically
-generic name becomes public property after 17 years of use by the original manufacturer

brand name

the private property of the individual drug manufacturer, and no competitor may use it
-drugs can have several brand anmes, because each manufacturer producing the drug gives a different name
-when prescribing a brand name on a Rx, the pharmacist must give out that particular brand.
-Brand names are capitalized

Who sets the standards?

Food and Drug administration (FDA)

United States Pharmacopeia (USP)

FDA

has the legal responsibility for deciding whether a drug may be disseminated and sold

united states pharmacopeia (USP)

reviews the available commercial drugs and continually reappraises their effectiveness

Two large reference listings of drugs

available at libraries and hospitals

1) hospital formulary: gives info about the characteristics of drugs and their clinical usage

2) Physicians Desk Reference (PDR): published by a private firm and drug manufacturers pay to have their products listed.
-its useful with several different indices to identify drugs, along with precautions, warnings about side effects and info about the recommended dosage and administration of each drug

oral administration

drugs given by mouth, slowly absorbed into the bloodstream

sublingual administration

drugs placed under the tongue dissolve in the saliva
-absorption may be rapid (bayer under tongue, nitroglycerin for angina)

rectal administration

suppositories (cone shaped objects containing drugs) and aqueous solutions are inserted into the rectum
-drugs are given by rectum when oral administration presents difficulties (nauseated and vomiting)

parenteral administration

injection of drug from a syringe thru a hallow needle placed under the skin, into a muscle, vein, or body cavity
Multiple types:
1) Intracavitary instillation
2) Intradermal injection
3) Subcutaneous (hypodermic) injection (SC)
4) Intramuscular injection (IM)
5) Intrathecal instillation
6) Intravenous injection (IV)
7) Pumps

1) intracranial instillation

an injection made into a body cavity, such as the peritoneal or pleural cavity
-this drug causes the pleural surfaces to adhere, thereby obliterating the pleural space and preventing the accumulation of fluid
- known as Pleurodesis

2) intradermal injection

shallow injection is made into the upper layers of the skin and is used chiefly in skin testing for allergic rxns

3) subcutaneous (hypodermic) injection (SC)

a small hypodermic needle is introduced into the subcutaneous tissue under the skin, usually on the upper arm, thigh, or abdomen
-insulin is injected daily via this route

4) intramuscular injection (IM)

the butt or upper arm is the usual site for this injection into muscle
-used when drugs are irritating to the skin or when a large volume of solution must be administered

5) intrathecal instillation

occurs in the space under the membranes (meninges) surrounding the spinal cord and brain
-Methotrexate (chemotherapeutic drug) in troduced intrathecally for treatment of leukemia (spinal cord)

6) intravenous injection (IV)

injection is given directly into a vein
-used when an immediate effect from the drug is desired or when the drug cannot be safely introduced into other tissues
-needs good technical skill b/c leakage into surrounding tissues may result in irritation and inflammation

7) Pumps

battery-powered pumps may be used for continuous administration of drugs by the subcutaneous of intravenous route

Inhalation

vapors or gases taken in the nose or the mouth are absorbed into the bloodstream thru alveoli
-type: Aerosols

Topical application

drugs that are applied locally on the skin or mucous membranes of the body
-Anticeptics (against infection) and Antipruritics (against itching) are creams, ointments and lotions
-Transdermal patches are used to deliver drugs continuously thru the skin

receptor

target substance with which a drug interacts in the body
- a drug may cross the cell membrane to reach its receptor or may react with a receptor on the cells surface

additive action

if the combination of two similar drugs is equal to the sum of the effects of each

ex: Drug A gives 10% tumor kill and drug B gives 20%, but when taken together they have 30% killing

antagonistic action

if two drugs give less than an additive effect

synergistic, synergism

a combination of two drugs sometimes can cause an effect thats greater than the sum of the individual effects of each drug alone

Response

a desired and beneficial effect of a drug
-lowering BP by antihypertenisive drugs

Tolerance

the effects of a given dose diminish as treatment continues, and increasing amounts are needed to produce the same effect
-tolerance is a feature of addiction to drugs

controlled substances

drugs that produce tolerance and dependence and have potential for abuse or addiction

idiosyncratic reaction

unexpected effect produced in a particularly sensitive patient but not seen in most people
-an example of an unpredictable type of drug toxicity

Iatrogenic

predicted condition caused by treatment (drugs or procedures) given by physicians or medical personnel

contraindications

dangerous factors that prevent the use of a drug or treatment

resistance

a lack of beneficial response, and it is seen when drugs that used to be effective and unable to control the disease process in a particular patient

Classes of Drugs

*Analgesics
*Anesthetics
*Antibiotics and Antivirals
*Anticoagulants and antiplatelet drugs
*Anticonvulsants
*Antidepressants and Anti-Alzheimer Drugs
*Antidiabetics
*Antihistamines
*Antiosteoporosis
*Cardiovascular Drugs
*Endocrine drugs
*Gastrointestinal Drugs
*Respiratory Drugs
*Sedative-hypnotics
*Stiulants
*Tranquilizers

Analgesics

a drug that lessens pain
*Mild analgesics relieve mild to moderate pain for myalgias, headaches, and toothaches (ACETAMINOPHEN)

*Narcotics or Opioids, which contain or are derived from opium (morphine, codiene, oxycodone, tramadol, vicodin)
---induce a stupor and are only used to relieve sever pain b/c they are addictive
THN)

Anesthetics

reduces or eliminates sensation

GENERAL ANESTHETIC: effects all tissues in the body. Used in surgeries.
-depress the activity of the CNS, producing loss of consciousness, and block the perception of pain

LOCAL ANESTHETIC: limited to a particular region.
-inhibit the conduction of pain impulses in sensory nerves in the region in which they are injected or applied

Antibiotics

its a chemical substance produced by a microorganism (bacterium, yeast, or mold) that inhibits (BACTERIOSTATIC) or kills (BACTERICIDIAL) bacteria, fungi, or parasites (penicillin)
-made is possible to cute UTIs, pneumonia, and steptococcal pharyngitis (strep throat)

Antivirals

treat funal infections commonly found on the skin (ringworm), vagina (Moniliasis or candidiasis), mouth, bloodstream, and other organs
-used against infections due to viruses (Herpesvirus, Epstein-Barr virus, Cytomelalovirus, human immunodeficiency virus (HIV))

Antitubercular drugs treat tuberculosis

Anticoagulants

prevent clotting of blood
-the prevent formation of clots or break up clots in blood vessels in conditions such as thrombosis and embolism. They are also used to prevent coagulation in preserved blood used for transfusions
*HEPARIN is a natural anticoagulant purified pig intestine. its found in our WBCs
*Warfarin (Coumadin) blocks the formation of a number of clot-forming factors in the blood and its action is reversed from Vit.K
*Tissue-type plasminogen activator (tPA) dissolves clots and is used to open vessels after myocardial infarction

Antiplatelets

reduce the tendency of platelets to stick together
*ASPIRIN is recommended for paitents with coronary artery disease
*Plavix inhibits clumping of platelets and is used to prevent clotting after heart attacks and blood vessel procedures (angioplasty)

Anticonvulsants

they prevent or reduce the fequency of convulsions in various types of epilepsy

Antidepressants

treat symptoms of depressions
-they elevate mood, increase physical activity and mental altertness, and improve appetite and sleep patterns
-the largest class of antidepressants increases the action of neurotransmitters by blocking their removal from the synpases
-Tricyclic antidepressants (TCAs)
-Selective serotonin reuptake inhibitors (SSRIs)
-the other antidepressants increase the length of time neurotransmitters work by blocking monoamine oxidase (enzyme that inactivates NTs)
-Monoamine oxidase inhibitors (MAOIs)

Anti-Alzheimer drugs

used to treat symptoms of Alzheimer disease
-they aid brain neurotransmitters or shielding brain cells from glutamate (a NT which at high levels, kill brain cells)

Anti-Diabetics

used to treat diabetes mellitus
-patients with type 1 (body cant make insulin) receive daily injections of insulin
-patients with type 2 (resistant to insulin) are given oral antidiabetic drugs:
-sulfonylureas
-biguanideas
-alpha-glucosidase inhibitors
-meglitinides
-may need an insulin pump

Antihistamines

block the action of histomines, which are increased during an allergic reaction
-histomine causes anaphylactic shock (dyspnea, hypotension, and loss of consciousness)

-antihistamines have strong antiemietic (prevention of nausea) activity and are used to prevent motion sickness

Antiosteoporosis drugs

Osteoporsis = abnormal loss of bone density
-calcium, vit D, and estrogen are Rx to increase calcium absorption
-Biphosphonates are used to treat osteoporsis by
preventing bone loss
-SERMs, selective estrogen receptor modulators

Cardiovascular drugs (B4 serious Rx are used)

act on the heart or the blood vessels to treat hypertension, angina, myocardial infarction (heart attack), congestive heart failure, and arrhythmias
-before Rx cardiovascular drugs are used, aspirin (dilates BVs) and sublingual nitroglycerin (dilates coronary BVs)
-Digoxin (Lanoxin) helps heart pump more forcefully in heart failure

Serious Rx Cardiovascular drugs:

-Angiotensin-converting enzyme (ACE) inhibitors
-Angiotensin II receptor blockers (ARBs)
-Antiarrhythmics
-Beta- blockers
-Calcium channel blockers
-cardiac glycosides
-Cholesterol-binding drugs
-Cholesterol-lowering drugs (statins)
-Diuretics

Angiotensin-converting enzyme (ACE) inhibitors

dilate BVs to lower BP, improve the performance of the ehart, adn reduce its workload
-they prevent the conversion of angiotensin I to angiotensin II, which is a powerful vasopressor (vasocontrictor)
-ACE inhibitors reduce risk of heart attack, stoke, and death

Angiotensin II receptor blockers (ARBs)

lower BP by preventing angiotensin from acting on receptors in BVs
-used in patients who do not tolerate ACE inhibitors because cough or angioedema (swelling of tissues)

Antiarrhythmics

reverse abnormal heart rhythms
-they slow the response of heart muscle to NS stimulation or slow the rate at which NS impulses are carried thru the heart

Beta-blockers

decrease muscular tone in BVs (leading to vasodilation), decrease output of the heart, and reduce BP by blocking the action of epinephrine at receptor sites in the heart muscle and in BVs

Calcium channel blockers

dilate BVs and lower BP and are used to treat angina and arrhythmias
-they inhibit the entry of calcium (constrict BVs) into mm of the heart and BVs

Cardiac glycosides

made from digitalis (foxglove plant)
-they drugs increase the force of contraction of the heart and are used to treat heart failure, certain arrhythmias, and atrial fibrillation

Choesterol-lowering drugs (statins)

Control hypercholesterolemia (which causes heart failure)
-they reduce cholesterols production in the liver

Choesterol-binding drugs

bind to dietary cholesterol and precent its uptake from gastrointestinal tract

Diuretics

reduce volume of blood in the body by promoting the kidney to remove water and salt thru urine.
-they treat hypertension (high BP) and congestive heart failure

Endocrine drugs

act in the same way as natural body hormones do
-Androgens
-Antiandrogens
-Estrogen (usually associated with menopause)
-Aromatase Inhibitors reduce amt of estrogen
-Selective estrogen receptor moldulator (SERM)
-Progestins Rxed for abnormal uterine bleeding
-Thyroid hormone for low output thru thyroid
-Calcitonin treats osteoporosis
-Glucocorticoids (reduce inflammation)
-Parathyroid hormone (PTH)
-Growth hormone release-inhibiting factor
(somatomstatin)

Gastrointestinal drugs

Used to relieve symtpoms versus cure
-Antacids
-Antiulcer
-Ranitidine (zantec) and cimetidine (tagamet) turn on histamine and promote secretion of stomach acid
-omeprazole (prilosec) stops stomach acid
-Antidiarrheal
-Cathartics (relieve constipation)
-Laxitives (mild cathatics)
-Purgatives (strong Cathartics)
-Antinauseants (antiemetics) prevent nausea
-Anti-TNF (tumor necrosis factor) used to treat auto immune diseases like Chrons

Respiratory drugs

treat asthma, emphysema, chronic bronchitis, and bronchospasm
-Bronchodilators
-Steroid drugs (reduce chronic inflammation)
-Leukotriene modifiers (anti-inflammatory therapy for asthma

Sedative-hypnotics

meds that depress the CNS and promote drowsiness (sedatives) and sleep (hypnotics). Used for insomniacs
-Barbiturates
-Benzodiazepines

Stimulants

drugs that act on the brain to speed up vital processess (heart and respiration) in cases of shock and collapse
-they also increase altertness and inhbit hyperactive behavior in children

-Amphetamines, used to prevent narcolepsy (seizures of sleep), to suppress appetite, and calm hyperkinetic children
-Caffeine also is a cerebral stimulant

Tanquilizers

used for controlling anxiety
-Benzodiazepines (minor tranq) controls minor anxiety
-Phenothiazines (major tranq) control more severe disturbances of behavior

aer/o

air

*aerosol

alges/o

sensitivity to pain

*analgesic

Bronch/o

bronchial tube

Chem/o

drug

Cras/o

mixture

*idiosyncrasy (idi/o = individual, syn- = together) means an abnormal, unexpected effect of a drug that is peculiar to an indivual)

cutane/o

skin

*hypodermic

derm/o

skin

*hypodermic

erg/o

work

*synergism

esthes/o

feeling, sensation

*anesthesia

hist/o

tissue

*antihistamine

hypn/o

sleep

*hypnotic

iatr/o

treatment

*iatrogenic

lingu/o

tongue

*sublingual

Myc/o

mold, fungus

*eythromycin

narc/o

stupor

*narcotic

or/o

mouth

*oral

Pharmac/o

drug

*pharmacology

prurit/o

itching

*antipruritic

pyret/o

fever

*antipyretic

thec/o

sheath (of brain and spinal cord)

tox/o

poison

*toxic

toxic/o

poison

*toxicology

vas/o

vessel

vasodilator

ven/o

vein

*intravenous

Vit/o

life

*vitamin

ana-

upward, excessive, again

anaphylaxis (phylaxis means protection)

anti-

against

*antidote
*antibiotic

contra-

against, opposite

*contraindication (ex, a bacterial infection while on a antibiotic, may be an indication to switch to a different antibiotic)

Par-

other than, apart from

*parenteral

syn-

together, with

*synergistic

ac, a.c.

before meals

ACE

angiotensin-converting enzyme

ad lib

freely, as desired

APAP

acetaminophen (tyenol)

ARB

Angiotensin II receptor blocker

b.i.d., bid

two times a day (bi-day)

c (with a line about it)

with

Caps

capsules

cc

cubic centimeters

FDA

U.S. Food and Drug Administration

gm, g

gram

gtt

drops (guttae)

h.s., hs

at bedtime (hora somni)

H2 blocker

histamine H2 receptor antagonist

HRT

hormone replacement therapy

IM

hormone replacement therapy

INH

isoniazid - antituberculosis agent

IV

intravenous

MAOI

monoamine oxidase inhibitor - an antidepressant

mg

milligram

ml, mL

milliliter

NPO

nothing by mouth

NSAID

nonsteroidal anti-inflammatory drug

p (with a line about it)

after (post)

pc, p.c.

after meals (post cibum)

PCA

patient-controlled analgesia

PDR

physicians desk reference

PO, p.o., po

by mouth (per os)

prn, p.r.n.

as needed (pro re nata) per request

Pt

patient

q

every (quaque)

q.h., qh

every hour (quaque hora)

q2h

every 2 hours

qid, q.i.d.

four times a day (quater in die)

q.s., qs

sufficient quantity (quantun satis)

qAM

every morning

qPM

every evening

s (with line above)

without (sine)

SERM

selective estrogen receptor modulator

Sig.

directions - how to take medication

s.o.s.

if it is necessary (si opus sit)

SSRI

selective serotonin reuptake inhibitor - an antidepressant)

SQ

subcutaneous

tab

tablet

TCA

tricyclic antidepressant

t.i.d., tid

three times a day (ter in die)

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