Chapter 3 - Pharmacology Flashcards
Food and Drug Administration (FDA)
responsible for regulating the safety and effectiveness of over the counter and prescription drugs
- include the approval of new drugs as well as the manufacturing and labeling, advertising and marketing, and efficacy and safety of all drugs
- approval for new drug could take 17.5 years
Food and Drug Administration (FDA):
Removing Unsafe Medications
also, responsible for removing unsafe medications from the market
- a drug manufacturer may contact the FDA after discovering a problem with one of their drugs
- the FDA may identify an unsafe drug while inspecting a manufacturers facility
- the FDA may receive reports of health problems associated with a specific drug
- the Centers for Disease Control and Prevention (CDC) may alert the FDA about a specific drug
Drug Enforcement Agency (DEA)
responsible for enforcing the laws and regulations of controlled substances
- federal law requires that all facilities that store, dispense, or administer controlled substances have a DEA certificate
Storage and Packaging
kept in locked cabinet or closet
- controlled substances must be kept separately from prescription medications, which should also be kept separate from over the counter medications
- when possible, medications should be purchased in individual dose packs
FDA Drug Recall Classes
Most serious (Class I) - potential for serious health problems (Class II) - potential for temporary or slight health problem (Class III) - not likely to cause a health problem Least serious
Dispensing
refers to the act of providing multiple doses of a medication to a patient
- athletic trainers are not legally able to dispense medications to their patients
Administering
refers to the direct application of a single dose
- athletic trainers are able to administer OTC medications to their patients
Documentation and Inventory Control
medication log includes:
- patient’s name, date of service, reason for medication, prescription number (if given), physician name, medication name, strength, dosage form, quantity, expiration date, lot number, initials of AT, and initials of physician
an inventory audit of all medications should be performed at least once a year
Expired Medication
all expired OTC and prescription medications should be removed from the current inventory, recorded in the medication log, and disposed of properly
- dispose through biohazard waste bag and waste removal procedure
- written log should be attached to the bag or container including the drug name, strength, dosage form, quantity,lot number, expiration date, and initials of person who completed the log
Nomenclature:
Chemical
chemical name rather long and refers to the chemical structure of the drug
Nomenclature:
Generic Name
nonproprietary, usually shorter and is derived from the chemical name
- only one generic name for each drug
ex: ibuprofen = generic name
Nomenclature:
Trade
the recognized brand name that is assigned to a drug by the manufacturer
- proprietary, therefore cannot be used by other manufacturers
- may be multiple trade names if more than one company markets the drug
ex: Motrin and Advil = trade name
Nomenclature:
Generic Drugs
every drug has a generic name but not every drug is available in a generic form
- copies of brand name drugs whose patents have expired
- usually cheaper
- must be therapeutically equivalent, meaning they must have the same chemical makeup and active ingredients as the original drug and produce the same medical effect
Classification of Drugs:
Over the Counter (OTC)
do not require a prescription and also referred to as no prescription drugs
- many were prescription drugs that were approved by the FDA as nonprescription drugs
- typically contain less drug per dose compared to prescription drug
Classification of Drugs:
Prescription
requires a written prescription from a physician or nurse practitioner and must be filled by a pharmacist
- typically associated with a greater potential for adverse reactions and generally prescribed for a restricted time period
Classification of Drugs:
Controlled Substances
have a greater potential for abuse than prescription drugs
- divided into 5 schedules (I = highest potential for abuse like heroin, IV = least potential for abuse like fought suppressants)
- schedule III = narcotic pain medications and anabolic steroids
Pharmacokinetics
the physiological processes of how the body acts on a drug and can be divided into four distinct phases: absorption, distribution, metabolism, and elimination
Absorption
for a drug to produce a therapeutic effect, it must be absorbed into the bloodstream and distributed throughout the circulation to reach its site of action
- drug molecule must move across one or more membranes through simple diffusion, active transport, or passive diffusion
Bioavailability
the amount of drug that is actually available in the body’s tissues
- usually only a fraction of the original dosage amount (varies among drugs)
- ex: bioavailability of 50%, then the body will absorb only 250 mg of a 500mg dose
The “first-pass effect”
occurs if the drug is absorbed from the intestine into the liver before entering the systemic circulation
- liver is the main site for drug metabolism and may cause further inactivation of a portion of a drug
- influences the bioavailability and only factor when drug is taken orally
Absorption: Passive Diffusion
the most common mechanism for moving medications across membranes
- the lipid solubility of a drug will affect its ability to diffuse across membranes
- lipid-soluble drugs will diffuse more quickly and easily and are capable of passing through the blood-brain barrier to affect the CNS
- greatest concentration to lowest concentration until equal on both sides
Absorption: Active Transport
requires a protein to move the drug across a membrane
- the protein binds to the drug molecule and transports it through the membrane
- allows selective diffusion of drug molecules in a specific direction, regardless of the concentrations on either side of membrane
- requires energy
Absorption: Facilitated Diffusion
combines the process of passive diffusion and active transport
- allows for drug selectively through the binding of a protein, however, the drug molecule will move only from areas of high concentration to low concentration
Distribution
once absorption is complete, the drug is transported to its site of action via the circulatory system
- also affected by lipid solubility
- drugs with higher lipid solubility will be able to pass through more membranes providing a wider distribution, with respect to blood-brain barrier and fat cells
