ALU 201: Intermediate Medical Life Insurance Writing PDF

PHARMACOLOGY Introduction this includes pharmaceutical drugs, street drugs, and ethanol alcohol). The pharmacology industry addition, while medications listed are described based on their originally intended and Food and ® Further, a situation in which a client reports having asthma but does not rev...

PHARMACOLOGY Introduction this includes pharmaceutical drugs, street drugs, and ethanol alcohol). The pharmacology industry addition, while medications listed are described based on their originally intended and Food and ® Further, a situation in which a client reports having asthma but does not reveal any prescription going unmedicated. A medication is any substance that can produce biological changes in the body, whether therapeutic in nature, it can be considered a medication. medications on a limited basis are physician assistants (PA), nurse practitioners, and psychiatrists. Chiropractors are not allowed to write prescriptions. Page 437 ALU 201: Intermediate Medical Life Insurance Writing Supplements are considered products that are not sold as therapeutic medications. The FDA does medications in each category. Schedule Example morphine, methadone ® Valium® ® chemical name generic acetaminophen, which is more easily recognized as Tylenol®, the trade name. In ®. It is important to realize that new Two processes describe how a medication is utilized in the body – pharmacokinetics and pharmacodynamics. Pharmacokinetics including how the medication is metabolized and then excreted by the body. Administration route Pharmacodynamics describes how the medication changes the body. The nature and intensity Page 438 Medication metabolism varies in individuals. Age, gender, body mass, and genetic makeup are the kidneys and liver. Medications are administered or introduced into the body by several routes. Table 2 describes Administration Intravenous (IV) Intramuscular (IM) Subcutaneous (SC) Description Into the vein Into the muscle Example IV drips Immunizations Insulin By mouth Pills, capsules, tablets Inhalation Breathing the medication into the Inhalers, oxygen, anesthesia nose or mouth Buccal or sublingual In the cheek or under the tongue (nitroglycerin) Breathing or placing the medication into the nose Anal, vaginal, colonic By anal cavity, vagina, or into the Suppositories colon Topical application Medicated creams Intrathecal Into the spinal canal Pain medication, anesthesia Intraperitoneal Into the peritoneum Chemotherapy, antibiotics Into the joint Into the artery Vasodilators Transdermal Through the skin Birth control and nicotine patches Page 439 ALU 201: Intermediate Medical Life Insurance Writing 1. 2. 3. 4. becomes addicted to a medication, such as morphine. 5. 6. ® and aspirin) protects the stomach and reduces the gastric irritation produced by aspirin when it is 1. depressed. This interaction can be quite dangerous. 2. stomach. 3. medications. For example, the interaction between monoamine oxidase inhibitors (a type When a proposed insureds report a medication on an application, it is assumed they are taking Page 440 The heart is assisted by pressure gradients within the vascular system, which are dependent Angiotensin II is the chemical that causes the muscles surrounding blood vessels to contract, blood pressure but can also help to regulate blood volume. For this reason, these medications are Angiotensin-converting enzyme inhibitors, or ACE inhibitors as they are more commonly and enalapril. Angiotensin receptor blockers Beta Blockers Page 441 ALU 201: Intermediate Medical Life Insurance Writing and supraventricular tachycardia. In addition, beta blockers are used to treat migraines, glaucoma, benign tremor, and anxiety disorders. Commonly used medications in this class include atenolol and metoprolol. Calcium Channel Blockers As their name suggests, calcium channel blockers block calcium channels in the heart and blood vessels. This reduces cardiac muscle contraction, which results in lower cardiac output. The examples include diltiazem and verapamil. arrhythmias. Potassium channel blockers arrhythmias. Examples include amiodarone and sotalol. Sodium channel blockers work very similarly to calcium channel blockers by slowing the electrical impulse in the heart and are used to treat various atrial and ventricular arrhythmias. Cardiac glycosides medications. Vasodilators Organic nitrates venous dilation predominates and reduces preload (venous resistance). They are most used to treat Page 442 angina pectoris but can be combined with other agents, like hydralazine, to treat congestive heart Diuretics encourage the kidneys to decrease blood volume by increasing urinary output, which ® ). ® Potassium-sparing diuretics tumors. Examples include spironolactone and triamterene. Blood Thinners thrombus, which adheres to the artery wall, and an embolus, which travels to another site, are Anticoagulants ) and ® those taking dabigatran do not. Anti-platelet medications ). ® Thrombolytics acute arterial thrombosis. Examples include tissue plasminogen activators (tPAs), such as alteplase. Page 443 ALU 201: Intermediate Medical Life Insurance Writing Statins and myalgias (muscle aches). Common statins prescribed are atorvastatin, rosuvastatin, and simvastatin. Nicotinic acid, or vitamin B Bile-acid binding resins Ezetimibe Fibrates Acid Blockers The most common problem seen with the digestive system is an increase in acid production. This Antacids ® and Mylanta®. Proton pump inhibitors (PPIs) reduction in acid prevents ulceration and helps heal existing ulcers in the esophagus, stomach, and histamine -receptor antagonists (H antagonists) Page 444 Intestinal Agents Poor diet or disease processes can contribute to abnormal bowel habits. Constipation represents A laxative matter through the colon. Psyllium husks and methylcellulose are bulking agents, which cause electrolyte secretion and stimulate peristaltic action and can be dangerous with overuse. Antidiarrheal agents are. These medications are thought to have an Glucocorticoids, such as Antibiotics are used to treat any Bismuth antacid and an antidiarrheal agent. Cytoprotective medications, or mucosal protectants, can work either by coating the gastric Prokinetic medications suppress vomiting and increase gastrointestinal vomiting. Examples include metoclopramide and prochlorperazine. Page 445 ALU 201: Intermediate Medical Life Insurance Writing Anticholinergics receptors. These prevent involuntary muscle contracting within the gastrointestinal system, making Antineoplastics Ursodeoxycholic acid pancrease. supplementing hormones or suppressing them, depending on the individual’s need. remaining two are produced by the posterior pituitary gland. Table 3 summarizes these hormones, HORMONE Corticotropin (adrenocorticotropic FUNCTION Stimulates growth in tissues and organs Acts on the adrenal cortex to Acts on the thyroid gland to release hormones Page 446 MEDICATION somatrem See adrenal glands See thyroid gland Acts on the ovaries to promote promote sperm growth Prolactin Antidiuretic hormone ovulation and men to promote androgen production Stimulates milk production in Promotes uterine contractions Acts on the kidneys to retain water bromocriptine oxytocin vasopressin 1. Cortisol (hydrocortisone) is the most important glucocorticoid naturally produced by the adrenal cortex. Typically, glucocorticoids are not the sole medication being prescribed, but disorders, asthma, and gastrointestinal disorders. The most commonly used glucocorticoid is prednisone. 2. Aldosterone is the most important mineralocorticoid naturally produced by the adrenal 3. treated with replacement therapy, such as hydrocortisone and cortisone. hormone (i.e., hypothyroidism), supplementation with a synthetic version, such as levothyroxine, is required. Page 447 ALU 201: Intermediate Medical Life Insurance Writing toxic nodular goiter (Plummer’s disease). When the thyroid overproduces its hormone, surgical option. A third option is antithyroid medications, such as methimazole. Sex hormones Gonadotropin-releasing hormone (GnRH) agonists overstimulate the pituitary gland to release Female reproductive agents Bromocriptine is a dopamine agonist that works to correct amenorrhea and excess prolactin secretion. Phosphodiesterase type 5 (PDE5) inhibitors work in conjunction with sexual arousal to increase Prostate 5-alpha-reductase inhibitors block the enzyme that promotes prostate growth. A commonly Alpha blockers Pancreas sugar. Type 1 diabetes mellitus results when the pancreas can no longer produce its own insulin, which must then be replaced by injection. In addition to insulin supplementation, regular Page 448 to avoid microvascular and macrovascular complications. Insulin injections or insulin pumps are 1. 2. 3. long acting (ultralente insulin). to the body. Immune Support When the immune system is weak, opportunistic diseases overcome the body and one is Antibiotics antiviral medications do exist. ® is a combination Antifungal medications Page 449 ALU 201: Intermediate Medical Life Insurance Writing most serious being malaria. The prototype anti-malarial medication is chloroquine hydrochloride. Anthelmintics are medications that destroy helminths, which are parasitic worms that are Immune Control therapeutic transplantation, the immune system can mobilize to destroy it. When the immune system acts inappropriately in these ways, pharmacologics can be employed to save the healthy tissue. Glucocorticoids used is prednisone. Calcineurin inhibitors other ailments as a threat to the body. These medications can also be used in conjunction with other immunosuppressants to treat other autoimmune disorders such as rheumatoid arthritis, lupus, and psoriasis. An example is cyclosporine. many connective tissue diseases (e.g., lupus, Sjogren’s), psoriasis, and Crohn’s disease. The most tumor necrosis factor (TNF) inhibitors which are administered by injection. They work by neutralizing the immune system’s signals that nonsteroidal antisymptoms. Page 450 Pain Medications COX-2 inhibitors have mostly been with common musculoskeletal disorders, such as tendonitis and arthritis. When pain is severe, narcotic, or opioid analgesics hyaluronate) to reduce knee pain caused by osteoarthritis. Muscles Antispasmodics Page 451 ALU 201: Intermediate Medical Life Insurance Writing disorders that generate spasticity. Both muscle relaxants and antispasmodics can be used to Benzodiazepines can also be used as a muscle relaxant and antispasmodic. They will be addressed later in this chapter. Bone Density Bisphosphonates bone loss. These can be used prophylactically or to treat osteopenia or osteoporosis. Examples be given as treatment. This medication is also used to treat other bone disorders, such as Paget’s disease. Hormone replacement therapy (HRT) is used to prevent many menopausal symptoms, including Antiepileptics used to treat epilepsy and control seizure activity. They work by suppressing the rapid and neuropathic pain. Examples include carbamazepine, topiramate, and phenytoin. Valproates Page 452 GABA analogues Barbiturates with phenobarbital. Benzodiazepines have predominantly replaced barbiturates in pharmacology. These medications amnesic action. While these uses are widespread, the most common conditions benzodiazepines Common examples include alprazolam and clonazepam. Hypnotics, also known as sedatives or , are medications that induce sleep. While many zolpidem and eszopiclone. Antidepressants such as depression and anxiety. Depression is the most common psychiatric illness. While Selective serotonin reuptake inhibitors (SSRIs) are the most prescribed antidepressants. They Both serotonin and norepinephrine have been highly implicated in depression and anxiety, and it Serotonin-norepinephrine reuptake inhibitors (SNRIs) Page 453 ALU 201: Intermediate Medical Life Insurance Writing Bupropion is an antidepressant medication that is in its own class. It is thought to work as depression. Examples include isocarboxazid and phenelzine. Antimanic Agents schizophrenia. Antipsychotics Antipsychotic medications, or neuroleptics, are primarily used to manage psychosis and are atypical antipsychotics. Both tend to block receptors in the dopamine pathways in the brain but There is now a third generation that is thought to reduce the susceptibility to metabolic symptoms aripiprazole. understood and do not always respond to normal pain control. Page 454 Triptans treat them when they occur. They work by narrowing blood vessels in the head that become dilated during a migraine. Examples include sumatriptan and rizatriptan. Ergot alkaloids ergotamine and dihydroergotamine. Parkinson’s Disease Treatment Dopamine agonists essentially supplement reduced dopamine in the brain to treat Parkinson’s bromocriptine. Opioid antagonists physical dependence this medication creates in the body, withdrawal symptoms can be severe balance in the brain that is disrupted in an individual who is addicted to alcohol, once alcohol alcohol or opioid dependence. Dementia Treatment Cholinesterase inhibitors Page 455 ALU 201: Intermediate Medical Life Insurance Writing treatments available can help in certain cases, but tend to have mixed results. risk. Oral antihistamines Leukotriene inhibitors block the chemicals that are released in the body when an allergen symptoms as well as asthma attacks. A common example is montelukast. Sympathomimetics (adrenaline), norepinephrine (noradrenaline), and dopamine. These are used to decrease nasal congestion as well as to treat sinusitis and the common cold. An intranasal example is mometasone Antitussives cough medicine. When a cough is productive (i.e., produces phlegm or mucus), an expectorant or mucokinetic Bronchodilators Bronchodilators, as their name suggests, are any agent that will dilate the bronchial tree, Short-acting beta agonists examples include albuterol and pirbuterol. Page 456 Long-acting beta2 agonists ® Anticholinergics suddenly cause the bronchial tree to become narrower (bronchospasm). In addition, they can also Glucocorticoids The three major strategies in treating cancer are surgery, radiation therapy, and medication. Solid tumors, such as breast cancer, are most treated with radiation and/or surgery. Disseminated cancers, such as leukemia, some lymphomas, and metastasized cancers, are treated with medications. and reduce symptoms. Cytotoxic agents are medications that kill the cells directly. Examples are the alkylating agents, as cisplatin. Hormones and hormone antagonists glucocorticoids, aromatase inhibitors, and progestins. medicine, which means they are not sold as therapeutic medications. The FDA does not regulate Page 457 ALU 201: Intermediate Medical Life Insurance Writing Turmeric is a spice commonly used in cooking, but its active ingredient curcumin helps support Garcinia Cambogia production. CoQ10 and improve circulation. Probiotics Ginkgo biloba is used to improve memory, increase concentration, and reduce dizziness. It is Ginseng is used to support digestion, relieve stress, enhance the immune system, and reduce Saw palmetto fruit gland. St. John’s wort Glucosamine and chondroitin cartilage retain water. Fish oil (omega-3 fatty acids) cardiovascular disease. Similarly, red yeast rice Black cohosh Evening primrose oil Page 458 cancer or diabetes. cancer to slow tumor growth by limiting cell division and reducing the blood supply to the tumor. Echinacea Medical Marijuana over. Medical marijuana has been available in Canada since 2001. then taken to an accredited marijuana dispensary or individual distributor where the patient can decriminalization. Page 459 ALU 201: Intermediate Medical Life Insurance Writing 1. 2. possibly only those that cannot be controlled by other medications. Studies have shown 3. enteric nerves and can be activated pharmacologically to provide gastroprotection and reduce gastric and intestinal motility as well as intestinal secretions. Marijuana has been 4. 5. bladder control, and other movement disorders. psychiatric conditions – Marijuana has been noted to provide sedative, hypnotic, anxiolytic, in many mental health conditions including anxiety, depression, insomnia, stress, bipolar 6. 7. bronchodilator medications), pruritus and allergies through immunomodulatory action, neurogenerative diseases (e.g., Parkinson’s, Tourette’s, dementia), obesity, osteoporosis, Page 460 and actual clinical trials are needed not only to determine appropriate administration methods and Page 461 ALU 201: Intermediate Medical Life Insurance Writing APPENDIX (For students’ information only; this material will not be tested.) Generic Medication acamprosate albuterol alendronate Campral® Proventil® Fosamax® ® allopurinol alprazolam alteplase amantadine aminoglutethimide amiodarone amitriptyline amoxicillin amphotericin B aripiprazole atenolol atorvastatin azithromycin ® ® Activase® Symmetrel® Cytadren® Cordarone® Elavil® Amoxil® Fungizone® ® Tenormin® ® ® ® benzonatate bisacodyl bismuth boceprevir bromocriptine bupropion candesartan carbamazepine carbidopa celecoxib cephalexin cetirizine chloroquine hydrochloride cholestyramine cisplatin Page 462 Tessalon® Dulcolax® ® Victrelis® Parlodel® Wellbutrin® Atacand® Tegretol® Sinemet® Celebrex® ® ® Aralen® Questran® Platinol® Generic Medication citalopram clomiphene clonazepam Celexa® Clomid® ® Plavix® codeine colchicine colestipol cyclobenzaprine cyclophosphamide cyclosporine dabigatran dantrolene desipramine dihydroergotamine diltiazem diphenhydramine docusate donepezil drospirenone duloxetine enalapril enoxaparin ergotamine escitalopram oxalate estradiol eszopiclone etanercept ezetimibe ® Colcyrs® Colestid® Flexeril® Cytoxan® Sandimmune® Pradaxa® Dantrium® ® Voltaren® Migranal® Cardizem® Benadryl® Antabuse® Colace® Aricept® ® Cymbalta® Vasotec® Fuzeon® ® ® ® Premarin® ® Enbrel ® ® Pepcid® Tricor® Allegra® Proscar® Tambocor® ® ® Page 463 ALU 201: Intermediate Medical Life Insurance Writing Generic Medication Prozac® Symbicort® ® gabapentin ® ® glipizide gonadorelin ® ® Mucinex® haloperidol hydralazine hydrocodone hydrocortisone hydroxychloroquine hyoscyamine ® Apresoline® ® , Vicodin® Cortenema® Plaquenil® ® Motrin®, Advil® ® ® Intron A® , ® ribavirin ipratropium isocarboxazid isosorbide lamivudine lansoprazole leuprolide levodopa levothyroxine lisinopril lithium loperamide losartan lovastatin mebendazole medroxyprogesterone acetate menotropins mesalamine metaxalone Page 464 ® Atrovent® Marplan® Isosordil® Epivir® Prevacid® ® Dopar® Synthroid® Prinivil® Eskalith® Immodium® Cozaar® Mevacor® Vermox® Provera® Menopur®, Pergonal ® ® Skelaxin® Generic Medication ® methadone methimazole methotrexate methylcellulose metoclopramide metoprolol misoprostol Dolophine® Tapazole® ® Citrucel® ® ® Cytotec® ® montelukast naloxone naltrexone naproxen naproxen sodium niacin nitrogen mustards nortriptyline nystatin olanzapine omeprazole oxytocin pantoprazole paroxetine phenelzine phenobarbital phenytoin pirbuterol pregabalin prochlorperazine pseudoephedrine psyllium husks ranitidine risendronate risperidone rivastigmine rizatriptan rosuvastatin Singulair® Synarel® ® Depade® ® Aleve® ® Mustargen® Pamelor® ® ® Prilosec® Pitocin® Protonix® Paxil® ® ® Dilantin® Maxair® ® Compazine® ® Metamucil® Evista® ® Actonel® ® Exelon® Maxalt® Crestor® Page 465 ALU 201: Intermediate Medical Life Insurance Writing Generic Medication salmeterol saquinavir simvastatin sodium hyaluronate sodium valproate somatrem sotalol spironolactone succinylcholine Serevent® Fortovase® Viagra® ® ® Depakote® Protropin® Betapace® Aldactone® Anectine® ® ® sumatriptan Imitrex® Cialis® ® tamsulosin testosterone tiotropium topiramate ursodeoxycholic acid valacyclovir vasopressin Flomax® Androgel® Spiriva® Topamax® Fertinex® ® , Actigall® Valtrex® Pitressin® ® , Verelan PM , Calan® Coumadin® ® verapamil zoledronic acid zolpidem Page 466 ® ® Ambien®