Core Ethical Principles In Pharmacology PDF

CORE ETHICAL PRINCIPLES IN PHARMACOLOGY Respect for Beneficence Justice person Respect for Person It is the recognition of a person as a autonomous, unique, and free individual. Beneficence The principle of beneficence is the obligation of physician to act for the benefit of the patient...

CORE ETHICAL PRINCIPLES IN PHARMACOLOGY Respect for Beneficence Justice person Respect for Person It is the recognition of a person as a autonomous, unique, and free individual. Beneficence The principle of beneficence is the obligation of physician to act for the benefit of the patient and supports a number of moral rules to protect and defend the right of others, prevent harm, remove conditions that will cause harm, help persons with disabilities, and rescue persons in danger. JUSTICE This principle refers to the obligation to treat people fairly and equitably.  DRUG ADMINISTRATION  PRESCRIPTION It is written instruction for medicine from a physician or a registered medical practitioner.  PARTS OF PRESCRIPTION Date Patient’s Data (Name, Age, Sex, Address) Superscription Inscription Subscription Signatura Signature Registration Number SOURCE OF ERRORS IN PRESCRIPTION Checking: No one persons are available to recheck the full medications. Too many patients: Due to too many customers, the dispenser needs more time to properly handle. But customers have no time to wait that's why errors occur. Lack of concentrations: Every dispenser should properly concentrate on prescription if they not. Error occurs. Too many phone calls and social media: This is also very important to stay out of mobiles or keep it switched off at the time of working. Lack of experience: Experience is very important in this field.  MEDICAL ABBREVIATIONS These are some common Latin prescription abbreviations and their meanings: ac (ante cibum) g before meals gram" ad (auris dextra) gr right ear grain" gtt(s) (gutta) ad lib (ad libitum) drop(s)" use as much as desired IM aI, as (auris laeva, auris sinistra) intramuscular" with respect to left ear injections au (auris utraque) IV both ears intravenous" bid (bis in die) od (oculus dexter) twice a day right eye" cap, caps (capsula) os (oculus sinister) capsule left eye" MEDICAL ABBREVIATIONS ou (oculus uterque) qh (quaque hora) both eyes" every hour" pc (post cibum) qhs (quaque hora somni) after meals" every night at bedtime" po (per os) q3h (quaque 3 hora) by mouth" every three hours" pr (per rectus) qid (quater in die) by rectum" four times a day" prn (pro re nata) qwk as needed" every week" qad (quoque alternis die) sc, subc, subcut, subq, sq every other day" subcutaneous" qd (quaque die) sig (signa) every day" write" MEDICAL ABBREVIATIONS tab (tabella) supp tablet suppository tbsp mEq tablespoon milliequivalent tsp stat teaspoon immediately tid (ter in die) NPO three times a day nothing by mouth top KVO topical keep vein open ud, ut dict (ut dictum) IVPB as directed intravenous piggyback x oz times ounce PHARMACEUTICAL DOSAGE FORMS TABLETS Tablets are solid dosage form to be taken orally into the body. PHARMACEUTICAL DOSAGE FORMS CAPSULE An edible preparation inside a small casing, usually made of gelatin, that can be filled with medicines to produce a unit dose for oral use.  PHARMACEUTICAL DOSAGE FORMS POWDER Medicated powder for oral use is usually dissolved in water for the patient to drink for its therapeutic action.  PHARMACEUTICAL DOSAGE FORMS LOZENGES Lozenges are medicated solid preparations that need to be sucked inside the mouth until dissolved.  PHARMACEUTICAL DOSAGE FORMS MIXTURES Mixtures are liquid preparations containing medicated active ingredients dissolved in a suitable solvent medium and to be taken according to the dose prescribed.  PHARMACEUTICAL DOSAGE FORMS IMPLANT Implant is a medicine delivery device planted in the body (most commonly under the skin) to enable the administration of medicine slowly and steadily over a period of time.  PHARMACEUTICAL DOSAGE FORMS IRRIGATION SOLUTION is a sterile germ-free solution, which is used to clean body cavity, operation sites, wound or the urogenital system.  PHARMACEUTICAL DOSAGE FORMS LOTION Lotion cannot be taken orally and is for external use only by rubbing it on the skin surface. PHARMACEUTICAL DOSAGE FORMS GARGLE Gargle is used to rinse and treat infections of the mouth. PHARMACEUTICAL DOSAGE FORMS DROPS Drops are liquids containing certain medications and placed into the cavity of the body such as the eyes, nostrils and ears to provide the desired therapeutic effect. PHARMACEUTICAL DOSAGE FORMS OINTMENT Ointment is an oil-based preparation and contains certain medications. PHARMACEUTICAL DOSAGE FORMS CREAM Cream is a semi-solid dosage form containing one or more medicines for external use. PHARMACEUTICAL DOSAGE FORMS INJECTIONS Injections are sterile solutions containing medicines inserted into the blood vessels, tissues and organs of the body using a needle and a syringe. PHARMACEUTICAL DOSAGE FORMS SUPPOSITORY Suppository is a type of dosage form introduced into the body through the anus. PHARMACEUTICAL DOSAGE FORMS TRANSDERMAL PATCH Transdermal patch is a medicine formulation that is glued to the skin surface so that the medicine is absorbed through the skin into the blood to produce local effects. PHARMACEUTICAL DOSAGE FORMS INHALER INHALER USUALLY CONSISTS OF TWO TYPES : AEROSOL OR POWDER. PHARMACEUTICAL DOSAGE FORMS PESSARY Pessary is an oblong tablet inserted into the vagina using a special tool to treat infections of the vagina.  PHARMACEUTICAL DOSAGE FORMS ENEMA Medicated liquid inserted into the anus for the purpose of cleaning the colon or to facilitate defecation. ROUTES OF DRUG ADMINISTRATION ENTERAL ROUTES OF MEDICATION 1.ORAL This is convenient and indicated for patients who can ingest and tolerate oral medication. Advantages: Ease of administration Widespread acceptance by the patients. Disadvantages: Variable absorption rates Degradation of some drugs before reaching the site of absorption into the bloodstream The inability of many compounds to effectively traverse the intestinal epithelial membrane cells to reach the bloodstream. The insolubility of many drugs at low pH levels is prevalent in the digestive tract. The inactivation of the drug in the liver on its way to the systemic circulation Irritation of the mucous lining of the gastrointestinal tract. This can be prevented to some extent by coating. 2. Sublingual and Buccal Routes These are indicated for medications with high first-pass metabolism that need to avoid clearance by the liver. Advantages: Rapid absorption is due to the abundant mucosal network of systemic veins and lymphatics, thereby leading to a rapid onset of action. If there is any untoward event, the tablet can be removed. Avoids first-pass hepatic metabolism. A tablet can be kept for a long time in the buccal cavity, which helps develop formulations with a sustained-release effect. This route is useful in patients having swallowing difficulties. Low risk of infection Convenience Disadvantages: The tablet must be kept in the buccal cavity and neither chewed nor swallowed. Excessive salivation may cause quick dissolution and absorption of the tablet. Patients may find it difficult to accept an unpalatable tablet. Hence some drugs are applied as a patch or a spray. 3. Rectal Route This route is useful for patients with gastrointestinal motility problems such as dysphagia or ileus that can interfere with delivering the drug to the intestinal tract. Advantages: A relatively large amount of the drug can be administered. Those drugs destroyed by the acidic medium in the stomach and those metabolized by pancreatic enzymes can be administered effectively. Safe and convenient for infants and the elderly. It can be used in emergency situations, such as in infants having seizures when the intravenous route is unavailable. The rate of absorption is uninfluenced by the ingestion of food or the rate of gastric emptying. Bypasses hepatic metabolism Less degradation of drugs compared to that in the upper gastrointestinal tract. Disadvantages: Some hydrophilic drugs like antibiotics and peptide drugs are unsuitable for rectal administration as they are not readily absorbed. Some drugs can cause rectal irritation and proctitis, leading to ulceration and bleeding. PARENTERAL ROUTES OF MEDICATION 1. Intravenous Route This directly administers the medications to the systemic circulation. Advantages: Rapid onset of action Predictable way of action and almost complete bioavailability The problems of oral drug administration can be eliminated by avoiding the gastrointestinal tract The best way of administration in very ill and comatose patients who cannot ingest anything orally. Disadvantages: Causes pain Chance of infection The delivery of protein products that require sustained levels can be difficult. 2. Intramuscular Route This can be utilized when oral drug absorption occurs in an erratic or incomplete pattern, the drug has high first- pass metabolism, or the patient is not compliant. Disadvantages: Injection site pain The amount of drug administered has to be adjusted according to the mass of the muscle available. Peptides get degraded locally. Complications - hematoma, abscess, peripheral nerve injury, puncture of a blood vessel leading to inadvertent intravascular administration. 3. Subcutaneous Route This is used when the drug's molecular size is too large to be effectively absorbed in the intestinal tract or when better bioavailability or a faster absorption rate is needed than the oral route. Disadvantages: The rate of absorption is difficult to control. Local complications - irritation and pain. Injection sites must be changed frequently to prevent the buildup of unabsorbed medication, which could lead to tissue injury. 4. Intradermal injections (ID) Are injections administered into the dermis, just below the epidermis. The ID injection route has the longest absorption time of all parenteral routes. Advantages Improve vaccine efficacy Dose-sparing strategy during shortage Reduced cos Overcome poor-response (e.g. elderly or immunocompromised Disadvantages Skin holds limited volume--optimal dose is not know ID injection technique requires skill and tim Injection site reactions--discolouration swelling, itching It is painful Only a small amount of the drug can be administered OTHER ROUTES OF MEDICATION Intranasal Route This can be utilized in administering nasal decongestants for cold or allergy treatment. Factors that affect the rate of absorption of drugs via the nasal route are: The rate of nasal secretion Ciliary movement Vascularity of the nose Metabolism of drugs in the nasal cavity Diseases affecting nasal mucous membrane. Intranasal Route This can be utilized in administering nasal decongestants for cold or allergy treatment. Factors that affect the rate of absorption of drugs via the nasal route are: The rate of nasal secretion Ciliary movement Vascularity of the nose Metabolism of drugs in the nasal cavity Diseases affecting nasal mucous membrane. Advantages: Increased permeability of the nasal mucosa compared to the gastrointestinal mucosa. Highly vascularized subepithelial tissue. Quick absorption, usually within thirty minutes Avoids the first-pass effect. Avoids the effects of gastric stasis and vomiting. Ease of administration. Higher bioavailability of the drugs than in the case of the enteral route or inhalational route. Disadvantages: Nasal cavity diseases and conditions may result in impaired absorption. The dose is limited due to the small area available for absorption. The time available for absorption is limited. This route does not apply to all drugs.  Inhalational Route This provides a greater surface area for absorption of the inhaled substances. Advantages: Large surface area Proximity to blood flow Avoids first-pass hepatic metabolism Only smaller doses are enough to achieve equivalent therapeutic effects as the oral route Disadvantages: The aerodynamic filter of the lungs has to be overcome. Clearance of particles by the mucus lining the airways. Only 10–40% of the drug from a conventional inhalation device is actually deposited in the lungs. Vaginal Route This is not commonly used but can deliver low, continuous dosing of medications which can help achieve stable drug levels. Transdermal Route Iontophoresis and microneedles are playing an increasing role in transdermal drug delivery.