CLRS 203 - Ch 3 Pharmacology (Extra Credit)

What is pharmacology?

Study of drugs, their actions, therapeutic uses, and adverse effects and is related to pathophysiology of particular diseases

Where are drugs derived from?

natural and synthetic sources

Reasons for prescribing drugs

1. Promote healing (Antiinflammatory)

2. Cure disease (Antibacterial)

3. Control or slow progress of a disease (cancer chemotherapy)

4. Prevent disease (Vaccine)

5. Alter neurotransmission (Antidepressants)

6. Decrease risk of complications (Anticoagulants)

7. Increase function and comfort (Analgesics)

8. Provide replacement therapy (Insulin)

9. Reduce excessive activity in the body (Proton pump inhibitors)

Pharmacodynamics

Drug-induced responses of physiologic and biochemical systems

Pharmacokinetics

The process by which drugs are absorbed, distributed within the body, metabolized, and excreted. Drug amounts at different sites after administration.

Pharmacotherapeutics

Choice and drug application for disease prevention, treatment, or diagnosis

Toxicology

Study of the body's response to drugs, harmful effects, mechanisms of actions, symptoms, treatment, identification

Pharmacy

Preparation, compounding, dispensing, and record keeping of therapeutic drugs

Therapeutic (desired) action may be?

1. stimulating or inhibiting cell function

2. blocking biochemical actions in tissues

Classification

Grouped by their primary pharmacologic action and effect

Indications

Approved uses or conditions for which the drug has been proved to be effective

Contraindications

Circumstances under which a drug should not be administered

Side effects

Mild, undesirable effects of a drug, even at recommended dose

Adverse or toxic effects

Drug effects that are dangerous, cause significant tissue damage, or are life-threatening

Hypersensitivity―allergic reactions

mild or can result in anaphylaxis (is a medical emergency)

idiosyncratic (or paradoxic) reactions

Unusual responses to a drug

Iatrogenic

Negative effect associated with administration of drug

Teratogenic

Harmful effect on fetus, developmental defects

Interactions

drug effect modified bycombination with another drug

Synergism

Effect of drug combination may be greater than the sum ofthe effects of the individual drugs

Antagonism

Combination greatly decreases the effect of each drug

Potentiation

One drug enhances the effect of a second drug

Dose

Amount of drug required to produce the desired effect in adult; expressed by a weight or measure and time factor

Child's dose is best calculated by what measurement?

child's weight, not age

Loading dose

Larger dose may be administered initially to raise blood levels to an effective level

Why is frequency of dosing important?

to maintain effective blood levels of thedrug without reaching toxic levels

How is optimum dosing schedule established?

Absorption, transport in the blood, half-life of the drug

What factors affect timing of drug administration?

• Timing related to meals

• Daily events

• Sleep

What factors lead to ideal levels of drug in the blood?

Regular intake, normal distribution, and excretion

What factors lead to ineffective or slow onset of a drug?

taking drug at irregular intervals, missing doses

What factors lead to dangerously high blood levels?

double dose or too frequently

Non-medicinal Factors Influencing Blood Levels of a Drug

1. Liver and kidney function➢ Absorption and excretion

2. Circulation and cardiovascular function

3. Age

4. Body weight and proportion of fatty tissue

5. Activity level, exercise

6. Food and fluid intake

7. Genetic factors

8. Health status, presence of other diseases, chronic or acute

Administration and Distribution of Drugs Process

1. Drug enters body by chosen route.

2. Absorbed into blood or acts at local site

3. Travels in the bloodstream

4. Arrives at site of action

5. Exerts its effect

6. Is metabolized into inactive compounds

7. Is excreted from the body

Routes of Drug Administration

1. Oral tablet, capsule, liquid

2. Sublingual

3. Parenteral - injection via subcutaneous, muscular, or venous

4. Inhalation

5. Topical (gel, cream, spray, liquid)

6. Suppository

Oral medication process

1. Absorbed from stomach or intestine

2. Transported to the liver

3. Released into general circulation

Intramuscular injection

1. Gradually absorbed into the blood

2. Blood transports drug

Intravenous route considerations

are designed to attach to plasma proteins; sometimes stored in fat or liver; Blood brain barrier can block drugs for brain tissue

What is required for common pharmacologic action?

Drug-receptor interaction.

How can drugs affect receptors?

Drugs may stimulate receptors directly or block receptor sites for normal chemicals of the body.

What determines the specificity (specific effect) of a drug?

Drug's mode of action.

What is a potential consequence of drugs interacting with several metabolic pathways?

They are likely to have greater side effects.

Agonist

stimulates the same activity as the natural substance when drug binds to cell receptor

Antagonist

block cell receptors so that cells are not stimulated by a natural substance

Drug Administration Responses

1. Dose effects

2. Time effects

3. Variability

4. Toxicity

What must a prescription include?

1. Patient's name, address, and age (if significant)

2. Prescriber's name, address, and identification number

3. Date

4. Name and amount of the drug

5. Dosage

6. Route and directions for using the drug

7. Permission for additional quantities

Drug Nomenclature

generic name, a trade name, and a chemical name

Generic (non-proprietary) name

Unique, official name for a drug (Ex: Ibuprofen)

Trade or Brand (proprietary) Name

Manufacturer's brand name for a drug (Ex: Advil)

Chemical Name

chemical component, usually a long technical numeric and special characters (Ex: 2-(p-isobutyl phenyl) propionic acid)

US Food and Drug Administration

Regulates the production, labeling, distribution, and other aspects of drug control

Scheduled drugs

Drugs considered to have a risk for potential adverse side effects, abuse, or dependency

Over-the-counter (OTC) drugs

Available without prescription

Off-label drug use

Drugs that have been approved for a specific disease/condition but can be used for another disease as well

What is the primary goal of physical therapy?

To assess physical function, reduce pain, restore deficits, and prevent further physical dysfunction.

What type of treatments do physical therapy involve?

Individualized treatment and rehabilitation, appropriate exercise, ultrasound, or Transcutaneous Electrical Nerve Stimulation (TENS)..

Physical therapist

Treats acute injuries as well as chronic conditions

Conditions treated by physical therapists

Pain disorders, Acute neurologic disorders, Musculoskeletal disorders, Cardiopulmonary disorders, Infants with congenital abnormalities, Mobility issues

What is the primary role of an Occupational Therapist?

To provide functional assessment related to normal activities of daily living by providing guidance and practical assistance.

What key areas do Occupational Therapists integrate in their practice?

Remediation of motor control, cognition, and visual-spatial perception.

Why is the integration of motor control, cognition, and visual-spatial perception necessary in occupational therapy?

It is necessary for patient safety.

What do Occupational Therapists teach patients regarding their specific needs?

The use of adaptations for specific needs.

What types of technologies do Occupational Therapists assess for patients?

Technologies available for use in home and workplace.

Speech/Language Pathologist

Assesses and treats those with communication or swallowing problems.

Types of patients for speech language pathologist

1. Child with hearing deficit who is mute

2. Infant with swallowing and feeding problems

3. Adult with aphasia following a stroke

4. Child with delayed speech

5. Individual with dysarthria

Nutritionist-Dietitian Roles

- Expert in nutritional needs of the body in health and illness.

- Supervises food services in hospitals and other health care institutions.

- Advises on nutritional needs and food management suited to a specific diagnosis.

- May consult on the dangers of extreme diets and eating disorders

What are the primary goals of a Registered Massage Therapist?

To increase circulation, reduce pain, and increase flexibility for patients with joint pain or alignment issues.

What techniques may a Registered Massage Therapist use?

Soothing aromatics, acupuncture, and other modalities.

What is an osteopath (D.O.)?

A medically licensed doctor in many jurisdictions that promotes the body's natural healing processes and musculoskeletal manipulations.

What is the primary concept behind chiropractic care?

One's health status is dependent on the state of the nervous system.

What additional therapies may be included in chiropractic care?

Manipulations of the vertebral column via deep tissue massage, acupressure, and/or acupuncture.

What diagnostic tool may be used in chiropractic practice?

Radiology.

What is a key characteristic of chiropractic treatment regarding medications?

It does not involve drugs or surgery.

Complementary or Alternative Therapies

holistic therapies used in conjunction with medically related therapies

What is the primary purpose of Noncontact Therapeutic Touch?

To relieve pain and anxiety and promote healing through energy exchange by lightly touching the skin or moving the hands just above the body surface.

What additional elements may be incorporated into Noncontact Therapeutic Touch?

Imagery, light, or colors.

Naturopathy

- Promoting natural foods

- Massage

- Exercise

- Fresh air

- Acupuncture

- Herbal compounds

- Nutrition

- Physical manipulations

Homeopathy

stimulate the immune system and natural healing powers of the body by using plant, animal, and mineral products

Under homeopathy, what is identified for each disease state?

Offending toxic substance, which is diluted several thousand-fold, then administered to treat the problem.

Herbal medicine

First documented in ancient Egypt, it uses herbs and plants for treatment of acute conditions or prevention of disease

What is Herbal Medicine's focus?

Focuses on providing standardized content, providing efficacy, improving purity

Aromatherapy

- Uses essential oils that have therapeutic effects

- Thought to act on neural pathways through the olfactory system

How are Aromatherapy oils administered?

- inhaled

- absorbed through the skin when bathing or with massage

Qi

- balance or imbalance of life energy

- excess or deficit causes disease

- derived from food, inheritance, or air

- flows along channels called meridians

Acupuncture

➢ Increases energy, function; blocks pain pathways.

➢ Involves Inserting fine needles into the various meridian acupoints (365)

➢ Treatment on average uses 5 to 15 needles

Shiatsu

➢ Japanese―acupuncture without needles

➢ Uses slow, deep, gentle pressure to specific points.

➢ Often used for stress-related illness and back pain; provides relaxation

Yoga

➢ Combines physical activity in the form of stretching postures with meditation.

➢ Improves flexibility, muscle tone, endurance, overall health; reduces stress.

Reflexology

➢ Relates points on feet and hands to 10 longitudinal zones in the body

➢ Practitioner uses varying degrees of pressure

➢ Relieves stress and muscle tension.

Craniosacral therapy

➢ Used by a variety of health care practitioners.

➢ Therapy deals with the pulsing rhythm of cerebrospinal fluid around brain and spinal cord.

➢ Gentle palpation and manipulation of skull and vertebrae

Ayurveda

➢ Special dietary plans, yoga, and herbal remedies are commonly used.

➢ Balance of body factors results in healthy mind and body