pharm

study of drugs and their actions on living organisms.

tx c meds

tx by manipulation of diet

tx c natural resources (heat, light, h2o)

tx by identifying stressors and stress reduction tech. "talk therapy"

chem substance that has an effect on living tissues

therapeutic drug used in prevention/tx of disease

opiates (morphine, codeine, for pain); from white poppy plant & digitalis (tx of chf/arrythmias) from leaves of purple foxglove flower.

insulin and thyroid hormones from pig/cattle

chem structure of drug - exact molecular makeup; most important to chemist.

simple, common, provided by USAN. Not capitalized

name as listed by FDA. usually same as generic followed by usp

name given by manufacturer. R symbol. registered and only used by owner. Capitalize.

US Food and Drug Administration -- federal agency that tests and determines if drugs are safe for humans. Granted to name drugs.

standards to id, quality, strength, purity, single vol., revised annually

usan name, pronunciation, chem formula, chem name, brand name, manufacturers, reg #, over 1000 drugs. annually.

All meds in US, by Facts and Comparisons, edit yearly, info on gen/brnd/chem names.

most useful for quick comparison of brand/generic name & availability of streghts and dosage forms

official reference for major organization, (public health service, dept of vets, and American Hosp Association.

Most useful for drug interactions

inclusion of most current FDA-approved package insert info and for cross comparison tables of similar drugs

Comprehensice reference for compatibility of inj drugs.

comprehensive book on nonrx otc drugs; 3 major advantages, includes qs to ask pts to determine if tx is needed, product selection guides, pt teaching info

text for info on drugs in current use throughout the world, includes herbs

gold standard reference for over 1000 herbal meds

• 1-g-manufacters index
• 2-w-brand/gen name
• 3-g-product category
• 4-g-product id
• 5-w-product info

medwatch forms (voluntary reporting of drug a/e)

brief comments on newly released drugs and findings

fed law requiring info by approved by FDA before released, insert w ea package, new website all info

articles, dated, not as reliable

growing, cd, mobile, etc, eg: Davis, National Library of Medicine

found most nsg stations, concise, compact and redily available, source used most frequently by nsg

• 3 vol set,
• 1- health professional
• 2-info for pt
• 3- list of fda approved drugs

printouts

current, lay terms

1952 -- tightened control by restricting refills, distinguised rx/otc. tightened drug distribution and mandated licensure to dispense meds

• 1962 -- passed because of thalidomide tragedies (imcompletely tested drug apprived for preg, caused serious birth defects). Increased importance on clinical testing of drugs, control of distribution
• 1- drug proven safe and effective before released
• 2- truth in advertising

1914 -- 1st narcotic control act, regulated import, manufacture, sale and use of all opiates. "narcotics". limited use of these drugs=less drug abuse. Replaced by controlled substances act.

1970 - replaced 50 other laws, 5 schedules, improved reg, man, distr, prevention of drug dependence. DEA enforced. Attorney General has right to shed/resched a drug after public hearings. Manufacturers must register. rx must have..., double lock and key, med count, sgin out

federal bureau of department of justice, enforce acts and train/conduct research related to dangerous drugs/abuse. Manufacturers must register.

high potential for abuse

no acceptable medical use

lack of safety

all illegal drugs

• high potential for abuse
• accepted us med use
• dependence
• no refills, to emergency, written script

morphine, demerol, codeine

high abuse, accepted in us, mod dependency, refills up to 5x 6mo, t/o

tylenol c codeine, vicodin, lortab

less pot. abuse, lower dependency, refill 6x per 6 mo, t/o

min abuse/dependency, no restrictions refill

robitussin, lyrica, lomotil

valium, xanax, ativan

• nsg must:
• 1 be administering to rxed pt
• 2 responsible for supply
• 3 or valid rx

returned to pharmacy, another witness and sign inventory sheet to verify it was discarded

• 1 - preclinical research and development 1.5 yrs
• 2 - clinical research and dev *5 yr
• 3 - new drug application (NDA) review *2 yr
• 4 - post-marketing surveillance

8-15yrs, 1 billion

only 1/10,000 make the cut

1983 -- research money to companies that seek to develop drugs for "health orphans" (rare diseases affecting less that 200,000 persons in us, eg: cystic fibrosis)

risk to fetus. benefits outweigh the risks

fetal abnormalities, not advised for women who are or may become pregnant.

drug that interacts w receptor to stimulate response

stimulates some responses/inhibits others

• attaches to receptor, no stimulate response
• (fill the space---inhibit)

absorption, distribution, metabolism, excretion

directly into gi tract

po, pr, ng, peg, jtube

bypass gi tract

id, sc, im, iv

through skin/mocous membranes

topical, inhale, sl, buccal, opthalmic, otic, nasal

increased absorption

decreased absorption

slows

decreased absorption rate

low o2 level

slower

increased due to increased bloodflow

fastest

• cold-slows
• hot-increases

albumin

liver

gi tract, renal tubes (feces and urine)

amount of time required for 50% of drug to be eliminated from bd

• 200 mg of 2 hrs:  @ 2 hrs 100mg left, @4h=50mg, @6h=25mg, @8h=12.5.
• divide by 2 every 2 hrs

rare, unusual, when drug first given, inability to metabolise drug

hypersensitivity reation; 6-10% of pt; develops antibodies to drug in immune system, reexposed to drug and causes reaction

life threatening stat code blue, occur at any dose

ability of drug to induce mutation of living cells and become cancerous.

ability to cause birth defects, greatest risk in first trimester

undesirable but tolerable

harmful such as shock

• chronic smoking enhances metabolism of some drugs
• smoker may need to up the dose
• r/t increased metabolic effects of nicotine

person requires higher doses to produce same effects that lower doses once provided; dependence or increased metabolism of drug

when drug accumulates in bd when a new dose is administered before old dose excretes. drunken state

combined effect of 2 drugs is greater than effect of ea drug given alone

eg tylenol codeine