Pharmacology Reviewer PDF

**PHARMACOLOGY** - The study of chemical drugs on living tissue and how those chemicals help diagnose and prevent disease - Study of the mechanisms of action of drugs - What drugs does to the body - Study drug actions as they move through the body - What the body does to drugs 1....

**PHARMACOLOGY** - The study of chemical drugs on living tissue and how those chemicals help diagnose and prevent disease - Study of the mechanisms of action of drugs - What drugs does to the body - Study drug actions as they move through the body - What the body does to drugs 1. **PROPHYLACTIC/PREVENTIVE-** Prevent a disease from occurring 2. **DIAGNOSTIC-** Detects the nature of diseases 3. **THERAPEUTIC** a. **CURATIVE**- treats disease b. **PALLATIVE**- does not affect the disease itself c. **SUPPORTIVE**- sustains patient d. **SUBSTITUTIVE**- take as replacement e. **RESTORATIVE**- help the drug return to its normal healing 4. **PRESCRIPTION DRUGS-** Ordered by the physician 5. **NON-PRESCRIPTION DRUGS/ OVER THE COUNTER DRUGS** - Can be purchased from a pharmacy without prescription 6. **INVESTIGATIONAL DRUGS-** Drugs under study, not yet approved 7. **ILLICIT DRUGS/ ILLEGAL DRUGS-** Drugs that are abused 1. **OFFICIAL NAME-** Listed on official publication as a drug reference 2. **CHEMICAL NAME** - Describes the drugs chemical structure on - Complex for general use 3. **GENERIC NAME-** Not owned by any drug company 4. **PROPRIETY NAME/ BRAND NAME-** Usually a trademark owned by the specific manufacturer - It validates the need for research on how drugs work - It undergoes 3.5 years of laboratory a. **PRE**-**CLINICAL** **TRIALS**- drug tested on animals b. **PHASE** **1**- uses 20-80 volunteers takes about 1 year c. **PHASE** **II**- 100-300 and takes about 2 years d. **PHASE** **III**- 1000-3000 in clinics and hospitals and takes about 3 years - Applies for FDA approval and takes about 2.5 years **PREGNANCY CATEGORIES** **PRE**-**CATEGORIES**- 1979 to indicate the potential risk birth defects of drugs a. **CATEGORY** **A**- adequate and well controlled, no evidence of risk and safe during pregnancy b. **CATEGORY** **B-** Animal used in study, no adverse effect in animals but no study in human c. **CATEGORY** **C**- has an adverse effect on animals and well controlled studies in humans d. **CATEGORY** **D**- adverse effect in humans and the benefit outweighs the risk e. **CATEGORY** **X**- the risk in pregnancy outweighs the benefits and causes abortion **PREGNANCY AND LACTATION LABELLING FINAL RULE (PLLR)** - June 30, 2015 and removed by June 29, 2018 **RELEVANT DRUG LAWS** 1. **GENERIC ACT OF 1988 (RA 6675)** - Ensure production of an adequate supply 2. **ADMINISTRATIVE ORDER NO. 62 S. 1989** - Rules and regulations to implement prescribing requirements - Use of generic names in all prescriptions **PARTS OF THE MEDICAL PRESCRITION** a. **SUPRERSCRITION**- Consists of the heading where the symbol Rx b. **INSCRIPTION**- body of prescription c. **SUBSCRIPTION**- special description for the pharmacists d. **SIGNATURE****SINGLE** **ORDER**- given once c. **PRN** **ORDER**- necessary d. **STAT ORDER-** immediately 3. **RIGHT** **DOSE****stable**- occurs with predictable stress **Unstable****Prinzmetal** **ANTIARRHYTHMIC** **DRUGS** \- restore the cardiac rhythm to normal.\ **CARDIAC** **DYSRHYTHMIA****NIACIN** (**VITAMIN** **B3**)- very effective at lowering cholesterol levels\ 6. **ANTICOAGULANTS**- used to inhibit clot formation.\ ○ **venous** **problems** - DVT (deep vein thrombosis ○ **arterial** **problems** - coronary thrombosis or MI **CLASSIFICATIONS**\ 1. **HEPARIN** (heparin sodium)- Introduced in 1938,is a natural substance in the liver that prevents clot\ - First used in blood transfusions to prevent clotting and used in open heart surgery to prevent blood from clotting 2.**LOW**- **MOLECULAR** - **WEIGHT** **HEPARINS**- introduced to prevent venous thromboembolism.\ - Inactivates the Xa factor, but it is less able to inactivate thrombin. Ex. Enoxaparin sodium Dalteparin sodium\ - **FONDAPARINUX**- designed to be effective as a once-daily SQ injection.\ 3. **DIRECT** **THROMBIN** **INHIBITORS**- directly inhibit thrombin from converting fibrinogen to fibrin.\ - More expensive than the other aanticoagulants.\ Ex. Argatroban Bivalirudin Lepirudin\ Desirudin Dabigatran\ 4. **ORAL** **ANTICOAGULANTS**\ a. **WARFARIN**- oral anticoagulant from the coumarin drug family.\ - Inhibits hepatic synthesis of Vitamin K, thus affecting the clotting actors II, VII, IX and X. b\. **FACTOR** **Xa** **INHIBITORS**- Block activity of clotting factor Xa to prevent clot formation.\ - It activates prothrombin to thrombin Ex. Rivaroxaban Apixaban Edoxaban **THROMBOLYTICS****HISTAMINE** **ANTAGONISTS**\ - They compete with histamine for receptor sites, preventing a histamine response.\ - Decrease nasopharyngeal secretions by blocking the H1 (histamine 1)receptor.\ a. **FIRST-GENERATION** **ANTIHISTAMINES**.\ - They have anticholinergic properties that can cause dryness of\ the mouth and decrease secretions.\ Ex. Brompheniramine maleate Chlorpheniramine maleate Clemastine fumarate Diphenhydramine Cyproheptadine HCl Levocitirizine (Xyzal)\ Chlorcyclizine b\. **SECOND**-**GENERATION** **ANTIHISTAMINES**- Frequently called nonsedating antihistamines- they have little to no effect on sedation.\ Ex. Azelastine Cetirizine Fexofenadine Loratadine Desloratadine 2. **NASAL & SYSTEMIC DECONGESTANTS**\ a. **NASAL** **DECONGESTANT**- stimulate the alpha- adrenergic receptors, thus producing vascular constriction of the capillaries within the nasal mucosa.\ b. **SYSTEMIC** **DECONGESTANT** (alpha adrenergic agonists)- Primarily used for allergic rhinitis\ - They relieve nasal congestion for a longer period than nasal decongestants.\ Ex. Ephedrine Phenylephrine Phenylpropanolamine\ Pseudoephedrine Oxymetazoline Naphazoline\ Tetrahydrozoline 3. **INTRANASAL GLUCOCORTICOIDS**\ - Are effective for treating allergic rhinitis/hay fever Ex. Beclomethasone Budesonide Flunisolide\ Fluticasone Triamcinolone\ 4. **ANTITUSSIVES**- Act on the cough control center in the medulla to suppress the cough reflex.\ - Given if the cough is non productive and irritating.\ **TYPES**:\ a. **NARCOTIC** **ANTITUSSIVES**\ Ex. Codeine Dextromethorpan\ Homatropine and Hydrocodone Guaifenesin and codeine b\. **NON** **NARCOTIC** **ANTITUSSIVES**- does not depress respiration\ Ex. Benzonatate 5\. **EXPECTORANTS**- Loosen bronchial secretions so they can be eliminated with coughing.\ Ex. Guaifenesin **B. DRUGS FOR ACUTE AND CHRONIC LOWER RESPIRATORY DISORDERS**\ 1. **BRONCHODILATORS**\ a. **SYMPATHOMIMETICS**- Increase cAMP, causing dilation of the bronchioles.\ - **cAMP**- cyclic adenosine monophosphate- activates target enzymes in the\ cells\ Ex. Albuterol- newer beta adrenergic drug Metaproterenol- first marketed in 1961\ Isoproterenol- introduced in 1941 Levalbuterol\ Salmeterol Terbutaline Sulfate\ Arformoterol Indacaterol\ Olodaterol b\. **METHYLXANTINE**- Used in the treatment of asthma.\ Ex. Aminophylline-theophylline- for maintenance Doxophylline c\. **ANTICHOLINERGICS**- Dilates the bronchi and decreases bronchial secretions.\ Ex. Ipratropium bromide- used to treat asthmatic conditions by dilating the bronchioles Glycopyrrolate Aclidinium\ Tiotropium- used for maintenance treatment of bronchospasms 2\. **LEUKOTRIENE** **MODIFIERS**\ - Are effective in reducing the inflammatory symptoms of asthma triggered by allergic and environmental stimuli thus decreasing bronchoconstriction.\ - not recommended for treatment of acute asthmatic attacks **LEUKOTRIENE** (LT)- a chemical mediator that can cause inflammatory changes in the lungs.\ **Cysteinyl** leukotrienes- promote an increase in eosinophil migration, mucous production, and airway wall edema that results in bronchoconstriction.\ Ex. Zafirlukast- first drug in this class. Zileuton Montelukast sodium- new LT receptor\ 3. **GLUCOCORTICOIDS** (STEROIDS)\ - Used to treat respiratory disorders, particularly asthma.\ 4. **MAST CELL STABILIZER**\ - **CROMOLYN SODIUM**- Used for prophylactic treatment of bronchial asthma and not used for\ acute asthmatic attacks.\ 5. **MUCOLYTICS**- Act like detergents to liquefy and loosen thick mucous secretions so they\ can be expectorated.\ Ex. Acetylcisteine\ o Antidote also for Acetaminophen overdose\ Acetylcisteine Carbocisteine Ambroxol