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Chapter 51: Principles of Pharmacology

Learning Outcomes

• 51.1 Identify the medical assistant’s role in pharmacology.

• 51.2 Recognize the five categories of pharmacology and their importance to medication administration.

• 51.3 Differentiate the major drug categories, drug names, and their actions.

• 51.4 Classify over-the-counter (OTC), prescription, and herbal drugs.

• 51.5 Use credible sources to obtain drug information.

• 51.6 Carry out the procedure for registering or renewing a physician with the Drug Enforcement Administration (DEA) for permission to administer, dispense, and prescribe controlled drugs.

• 51.7 Identify the parts of a prescription, including commonly used abbreviations and symbols.

• 51.8 Discuss nonpharmacologic treatments for pain.

• 51.9 Describe how vaccines work in the immune system.

Medical Assistant’s Role in Pharmacology

• Ensure Licensed Practitioner Awareness: It is critical for medical assistants to make sure that licensed practitioners are informed of all medications that the patient is taking.

• Inquire about Substance Use: Medical assistants should ask patients about the use of alcohol and recreational drugs to understand interactions and health history better.

• Assist with Prescriptions: They play a role in managing and renewing prescriptions (in collaboration with the healthcare provider).

• Educate Patients: Medical assistants should educate patients about the purpose and effects of their medications, enhancing patient understanding and compliance.

Categories of Pharmacology

• Pharmacology: The study of drugs and their effects on the body, encompassing several sub-disciplines, including:

  • Pharmacognosy: The study of natural products that are drugs or may become drugs in the future.

  • Pharmacodynamics: The study of how drugs affect the body, focusing on mechanisms of action and effects on biological systems.

  • Pharmacokinetics: The study of the absorption, distribution, metabolism, and excretion (ADME) of drugs. Each phase is crucial:

  • Absorption: How a drug enters the bloodstream.

  • Distribution: How it spreads throughout the body.

  • Metabolism: How the body breaks down the drug.

  • Excretion: How it is eliminated from the body.

  • Pharmacotherapeutics: The branch of pharmacology that focuses on the therapeutic use of drugs and their effects.

  • Toxicology: The study of the harmful effects of substances, including drugs.

• DEA Guidelines: Medical assistants must adhere to Drug Enforcement Administration (DEA) guidelines when prescribing, administering, and dispensing drugs.

Drug Names and Categories

• Drug Names: These include three primary types:

  • Generic Name: The name given to the drug that is derived from the chemical name, typically lower case (e.g., ibuprofen).

  • Chemical Name: The scientific name that represents the chemical structure of the drug.

  • Trade Name: The brand name under which a drug is marketed, usually capitalized (e.g., Advil for ibuprofen).

• Categorization by Action: Drugs are categorized based on their effects on the body and the general therapeutic effects they provide.

• Body System Affected: Drugs can also be classified by the specific body system they impact (e.g., cardiovascular, nervous systems).

FDA Regulations and Drug Categories

• Over-the-Counter (OTC) Drugs: Medications that can be purchased without a prescription.

• Prescription Drugs: Medications that require a prescription from a licensed healthcare provider.

• Pregnancy Categories: Drugs are classified into categories based on their safety during pregnancy and lactation, assessing risks for males and females of reproductive potential.

Sources of Drug Information

• Credible Sources: Various resources are available for obtaining reliable drug information:

  • Physician’s Digital Reference (PDR): An online reference for healthcare professionals.

  • United States Pharmacopeia/National Formulary (USP/NF): Provides standards for medicines and their quality.

  • American Hospital Formulary Service (AHFS): A compilation of drug information used by hospitals.

  • Online Resources: Websites like Drug.com and Medline Plus offer accessible drug information.

  • Epocrates: A mobile application and online resource used by healthcare professionals.

  • Package Insert: Important drug labels containing essential information about medications.

Controlled Substances

• Regulatory Framework: Governed by the Comprehensive Drug Abuse Prevention and Control Act, which addresses the prescription and medical use of drugs to prevent abuse.

• Controlled Substance Scheduling: Defined categories based on the potential for abuse, including:

  • Schedule 1: High abuse potential; no accepted medical use.

  • Schedule 2: High abuse potential with strict regulations—must be prescribed by a DEA licensed physician.

  • Schedule 3: Moderate abuse potential; limited refills allowed (five refills in six months) with a handwritten prescription.

  • Schedule 4: Lower abuse potential; five refills allowed in six months, requiring a physician's signature.

  • Schedule 5: Lowest abuse potential; same refills and signature requirements as Schedule 4.

• Regulation Essentials: Includes doctor registration, drug ordering, security measures, recordkeeping for dispensing and inventory records, and proper drug disposal practices.

Prescriptions

• Parts of a Prescription: Essential information must be included in prescriptions:

  • Prescriber Information: Includes the prescriber’s name, contact information, and DEA number if applicable.

  • Patient Information: Patient's full name, address, and date of birth.

  • Medication Prescribed: Specific drug name and dosage information.

  • Subscription: Directions for the pharmacist.

  • Sig: Instructions for the patient on how to take the medication.

  • Signature: The prescriber’s signature indicating authorization to dispense the medication.

• Prescription Management: Includes e-prescribing and procedures for managing telephone prescriptions.

Nonpharmacologic Pain Management

• Alternative Treatments: Various techniques used to manage pain without medications, including:

  • Chiropractic Care: Focus on spinal manipulation and joint health.

  • Massage Therapy: Soft tissue manipulation to relieve tension and pain.

  • Acupuncture: Insertion of needles to stimulate specific body points.

  • Yoga and Meditation: Practices focusing on mental wellness and physical flexibility that can alleviate pain.

  • Hypnotism: A therapeutic technique leveraging suggestibility to manage pain perception.

  • Glucosamine Chondroitin: Supplements thought to help with joint health and pain relief.

  • Magnetic Therapy and Biofeedback: Techniques to harness the body's natural healing abilities.

Understanding Vaccines

• Mechanism of Action: Vaccines work by stimulating the immune system to recognize and fight pathogens.

• Immunizations: Typically consist of killed or weakened forms of pathogens, which help build immunity against specific diseases.

Chapter Summary

• Role of Medical Assistant: Medical assistants are crucial in reviewing patient medications (both prescription and OTC), as well as any illicit drug use or herbal treatments.

• Pharmacology Categories: Understanding pharmacognosy, pharmacokinetics, pharmacodynamics, pharmacotherapeutics, and toxicology.

• Drug Categories: Drugs are categorized based on their actions and whether they require prescriptions; OTC and herbal drugs do not require prescriptions.

• Drug Information: Awareness of numerous credible resources for drug information.

• Controlled Substances: Proper procedures for registration, renewals, and ordering must align with DEA regulations.

• Prescriptions: A prescription must be complete with all necessary information to be effectively filled.

• Alternative Pain Treatments: Emphasis on nonpharmacologic therapies such as complementary and alternative medicine (CAM) techniques.

• Role of Vaccines: Understanding the general purpose and methodology behind immunization as it relates to public health.