Pharmacy technician training- Unit 2, lessons 22-34

Pharmacodynamics

Study of how drugs produce effects on body, desired or not

Pharmacokinetics

Study of what body does to the drug, including how it handles, changes the drug into a usable form, secretes metabolized drugs, how body affects drugs

Receptors

Some drugs only affects specific receptors to produce desired effects, but some affect unintended receptors, producing side effects

Mechanism of action

Mechanisms by which the chemicals produces a response in the body, such as what biological processes are affected and its effects

Drug absorption

Movement of drug into the bloodstream, affects how much and how fast a drug reaches intended site of action

Affected by:

Drug product design and manufacturing process

Physical and chemical processes

Physical state or illness of the patient

Length of time it takes for stomach to empty, speed drug moves through digestive tract

Stomach pH

Drug metabolism

Process by which body breaks down and converts medication into active chemical substances

Primary site is the liver, whose enzymes chemically change drug components into substances called metabolites, which bind to other substances to be excreted

Excretion

Kidneys are the primary mode of excretion

Drugs are usually small particles dissolved in blood

Filtered into kidneys, then reabsorbed back into bloodstream

Kidneys filter blood multiple times until drug is fully eliminated

Water soluble drugs

Usually only partially soluble

Does not absorb too quickly

Fat soluble drugs

Dissolve into lipids

Enter very quickly into body

Bioavailability

The degree to which a drug is made available to body after administration

Affected by:

Processes such as digestion

Solubility

Manufacturing process

Buffers

Salt vs nonsalt

Rate and volume of distribution

Excretion from body

Symptoms of addiction

Preoccupation with drug

Increased tolerance
Denial of dependency

Interference with daily life

Painful or symptomatic withdrawal

Alcohol interactions-alprazolam, diazepam

Drowsiness, dizziness, and increased risk for overdose

Alcohol interactions-Aspirin, Advil, Tylenol

Stomach upset, bleeding ulcers, liver damage, increased heart rate

Alcohol interactions-clonazepam, phenytoin

Drowsiness, increased risk of seizures

Alcohol interactions-cimetidine, nizatidine

Rapid heart rate, sudden changes in blood pressure

Alcohol interactions-diphenhydramine, temazepam

Drowsiness, dizziness, increased risk of overdose

Alcohol interactions-glyburide, metformin

Rapid heart rate, sudden changes in blood pressure, convulsions, and possibly comas

Alcohol interactions-griseofulvin, Flagyl

Rapid heart rate, sudden changes in blood pressure, liver damage

Alcohol interactions-herbal preparations

Increased drowsiness

Alcohol interactions-hydrocodone, oxycodone

Drowsiness, dizziness, risk of overdose

Alcohol interactions-isosorbide, nitroglycerine (NTG)

Rapid heartbeat, sudden changes in blood pressure

Alcohol interactions-warfarin

Occasional drinking may lead to internal bleeding

Heavier drinking may cause clots

Suspected addiction protocol

Notify pharmacist, who may escalate to physican if needed

Sebaceous glands

Oil glands in dermis secreting sebum made of fat and the debris of dead fat producing cells

Protects skin and hair and makes it more waterproof

Sudoriferous glands

Sweat glands in dermis or subcutaneous layers

Cools body

Hair papilla

Tiny capillary at base of the hair follicle

Pilomotor muscle

Attached to side of each hair follicle, makes hair stand erect when stimulated

Increase insulation

Skin rash

Treated by antihistamines and topical corticosteroids

Eczema

Treated by topical immunomodulators

Psoriasis

Chronic immune system overactivity causing inflammation and painful, disfiguring lesions on skin

Treated by topical steroids, oral antibiotics, and immunosuppressants

Can be treated with penicillin, tetracycline, hydrocodone, cyclosporine

Viral skin infections

Treated by anti-inflammatory steroidsBacterial and antihistamines

Bacterial skin infections

Can cause systematic infections, treated by oral antibiotics

Fungal skin infection

Treated by topical antifungals

Cellulitis

Inflammation of connective tissue in skin, treated by oral or IV antibiotics, including cefazolin, dicloxacillin, or nafcillin

Parasites

Treated by topical anti-parasitic agents, Lindane solution or shampoo, pyrethrins gel

Basal cell carcinoma

Epidermis, usually face and scalp, often due to sun exposure

Squamous cell cancer

Second most common skin cancer, usually in outer layer of skin but deeper than basal cell

Malignant melanoma

Deadliest skin cancer

Actinic keratosis

Crusty or scaley bump on skin, can develop slowly, 5% develop into squamous cell carcinoma, precancerous and can spread into other body tissues

Rosacea

Chronic disorder, reddening of skin and development of lesions, inflammation enlarges small blood vessels

Symptoms can be controlled by topical medications or anti inflammatory agents, such as sodium sulfacetamide or oral antibiotics

No cure

Spider veins

Small broken blood vessels enlarge and become visible, can be caused by obesity prolonged standing, sun exposure, or hormonal changes in women

First degree burn

Superficial, only affect epidermis

Second degree burn

Affect dermis and epidermis, may blister

Third degree burn

Destruction of epidermis, dermis, and subcutaneous tissue, nerve endings destroyed, no pain, but can be life threatening

Fourth degree burn

Destruction of all skin layers and underlying tissue, life-threatening and requires skin graft

Stage I Decubitus Ulcer

Earliest stage, reddened, but unbroken skin, treated by frequently moving positions or padding affected area

Stage II Decubitus Ulcer

Abrasions, blistering, or broken areas of skin

Treated by lotions to hydrate skin, frequent position changes and padding

Stage III Decubitus Ulcer

Deep ulceration exposing subcutaneous tissue, medical attention required, infection becomes common

Stage IV Decubitus Ulcer

Ulcer extending into muscle, bone, and deep tissues, internal structures are exposed, medical emergency requiring immediate treatment, can cause systematic infections

Anti infectives/antibiotic

Specific to each microorganism

Amebicides

Antibiotic for intestinal infections for amoeba like organisms

Aminoglycosides

Antibiotic for gram negative organisms

Anthelmintics

Antibiotic for parasitic infections

Antifungals

Antibiotic for fungal infections

Antimalarial agents

Antibiotic used to treat mmalarial infections

Antiprotozoals

Antibiotic for infections caused by protozoa

Antituberculosis agents

Antibiotic for tuberculosis, must be taken for extended periods of time

Antiviral

Antibiotic used to treat viral infections, cannot kill viruses, but render them unable to reproduce

Cephalosporins

Antibiotics related to penicillin used to treat generalized infections, oral, IV or IM treatment

Fluoroquinolones

Broad spectrum antibiotics used to treat variety of infections by preventing bacteria from reproducing

Macrolides

Antibiotic commonly used in patients with penicillin allergies, inhibit bacterial reproduction

Penicillin

Antibiotic that works by directly killing bacteria

Tetracyclines

Antibiotics that inhibit bacterial growth and reproduction, broad spectrum

Acne

Treated by topical antiseptic, retinoic acid, Accutane, or antibiotic

Eczema

Treated by tacrolimus (Protopic) or pimecrolimus (Elidel)

Impetigo

May be treated by antibiotics, including azithromycin or cephalexin

Burns

Treated by Silvadene or mafenide acetate depending on burn severity

Skin cancer treatment

Depends on type and stage, can include fluorouracil cream or imiquimod cream

Rods

Low light images, peripheral, night, and detail vision, such as shape, size and brightness

Cones

Absorb and process bright lights, enhance detail and color

Stye

Inflammation of sebaceous gland, redness, swelling, and eyelid pain, treated by anti biotic eyedrops, warm and cold compresses manage discomfort and reduce swelling

Blepharitis

Inflammation or infection of margins of eyelids, redness, pain, thickening, formation of crust and scales, treated by antibiotic eye ointment

Allergic conjunctivitis

Environmental, occurs in both eyes and causes itching and excessive tearing

Bacterial conjunctivitis

Highly contagious conjunctivitis caused by bacteria

Viral conjunctivitis

Self limiting, caused by virus, usually after upper respiratory infection or contact with an infected person, symptoms managed with cold compress and lubricating eyedrops

Conjunctivitis caused by chlamydia

Usually in newborns acquiring through birth canal, routine treatment with erythromycin eye ointment shortly after birth due to this

Open angle glaucoma

Increased ocular pressure caused by abnormal outflow of aqueous humor, causing pressure to build, 90% of glaucoma

Closed angle glaucoma

Anterior chamber fills with aqueous humor and distorts iris, which blocks outflow, and pressure builds

Emergency since irreversible damage can be done in days

Glaucoma treatments

Betopic

Lumigan

Alphagan P

Azopt

Miostat

Octupress

Propine

Trusopt

Xalatan

Neptazane

Cataracts

Lens become opaque, due to aging, alcoholism, diabetes

Treated by inserting clear plastic lens to replace clouded lens, Miochol-E (acetylcholine) and Voltaren (diclofenac 1%)

Retinopathy

Often due to diabetes an cut blood flow to retina, can be treated by laser treatments

General guidelines for ophthalmic products

Wash hands thoroughly, remove contact lenses and wait for 15 minutes after applying to replace them if at all

Do not let anything touch medication tube tip, remove excess from eyelids and lashes with tissue

Immediately wash hands after applying

Wait 5-10 minutes to apply another medications

Medication may blur vision, do not operate vehicle or machinery until vision clears

Drug induced hearing loss

Caused by loop diuretics (Bumex, Demadex, Edecrin, Lasix), anticancer drugs, and drugs with Quinine, antibiotics (Amikin, Garamycin, Nebcin), as well as large doses of NSAIDs

Cerumen buildup treatment

Debrox (carbamide peroxide) and Crumenex (triethanolamine)

Treatments for otitis media

Some eye medications, such as:

Amoxil, Ciprodex, Cipro HC, Bactrim, Septra, amoxicillin

Carbohydrates

Most readily available source of energy, immediate energy, broken into monosaccharides, 45-65% of caloric intake

Protein

Break down into amino acids, used to repair and make body tissues, cells, and muscles, 10-35% of caloric intake

Fats/lipids

Broken into fatty acids and glycerol, provides lubrication, helps metabolize carbohydrates and proteins more efficiently, carry fat soluble vitamins (A,E, D,K)

Energy reserve, insulation, cushion and shock absorber to protect organs

20-35% of caloric intake, not more than 10% from saturated

Vitamins

Help prevent diseases, maintain health, water or fat soluble, best obtained from balanced diet

Fat soluble vitamins

Vitamins A, D, E, K

Water soluble vitamins

Vitamins B1, B2, B6, B12, and C

Minerals

Inorganic compounds, smaller and simpler than vitamins

Amino acids

Metabolic function, requires 20 amino acids, 9 essential, 11 non essential

Essential amino acids

Histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine

Nonessential amino acids

Alanine, arginine, asparagine, aspartic acid, cysteine, glutamic acid, glutamine, glycine, proline, serine, tyrosine

Histamine H2 Antagonists

Treats ulcers, gastroesophageal reflux disease, bleeding in gastrointestinal tract

Proton pump inhibitors

Inhibits proton pumps that secretes stomach acid, used to treat ulcers and GERD

GI anticholinergic/antispasmodics

Decrease gastrointestinal mobility and painful cramping in GI tract

Laxatives

Treats constipation, used to clear colon before medical procedures or for diagnostic testing

Antidiarrheals

Treats nonspecific diarrhea