Cert Exam 5e Chapter 1 Presentation

[Audio] Welcome to the Certification Exam Review for Pharmacy Technicians Fifth Edition presentation for Chapter 1..

[Audio] Chapter One: Medications. Chapter 1. Medications.

[Audio] At the end of this chapter, you will be able to: Define pharmacology and related terminology pertaining to medications. Identify strengths, doses, dosage forms, and routes of administration of commonly used medications. Classify drugs into therapeutic classes. List common drug interactions, adverse reactions, and contraindications. Match brand and generic names of commonly used medications and vaccines. Match common prescription and over-the-counter medications with their indications. Identify biotechnology and other miscellaneous medications..

[Audio] Match common prescription and over-the-counter medications with their indications. Identify common alternative medicines and dietary supplements. Describe proper storage of medications and vaccines. Identify principles of drug stability, including physical and chemical incompatibilities related to compounding and reconstitution. Identify principles of drug stability, including physical and chemical incompatibilities related to compounding and reconstitution. Identify common drug suffixes and prefixes. Identify common auxiliary labels and the common drugs that require these labels..

[Audio] Section one point one Essential Pharmacology Knowledge for Technicians.

[Audio] There are numerous drugs on the market for many indications. This chapter reviews and discusses the basic pharmacology of commonly dispensed drugs in community and hospital pharmacies. Pharmacy technicians should have a clear understanding of generic and brand names of the most common medications, their primary indications, and common side effects. Technicians also need to know the common auxiliary warning labels that accompany these drugs and which commonly prescribed drugs are controlled substances or are on lists of high-risk drugs. It is important for technicians to have this knowledge to function effectively in the pharmacy and it is also covered on certification exams. Essential pharmacological information is necessary to help technicians better understand Drug Utilization Review alerts and enhance patient education and compliance with prescribed medications..

[Audio] Pharmacology is defined as the scientific study of drugs and how they work (their mechanisms of action) along with side effects, adverse reactions, and drug interactions. In its broadest sense, pharmacology encompasses specialized scientific disciplines about drugs, including: · therapeutics—appropriate uses of drugs for targeted medicinal purposes · pharmacodynamics—mechanisms of drugs and their biochemical and physiological effects · toxicology—symptoms, mechanisms, detection, and treatment of poisonous effects and side effects of drugs · pharmaceutics—various dosage forms and routes of administration of drugs, and their drug-releasing capabilities · pharmacokinetics—movement of drugs within the body: absorption, distribution, metabolism, and elimination (ADME) of drugs from the body, and harmful drug interactions · pharmacognosy—natural sources of drugs and herbs. It takes pharmacists many years of studying these basic and applied elements of pharmacology for thousands of drugs before they begin to practice, which is why patient questions about drugs must always be directed to the pharmacist..

[Audio] Most prescriptions are written for brand-name drugs, though a generic drug that is bioequivalent is often dispensed. To be bioequivalent, a generic drug must be both pharmaceutically and therapeutically equivalent to the brand-name drug. To be pharmaceutically equivalent, the generic drug must have the same amount of active ingredient in the same dosage form. For two drugs to have therapeutic equivalence, they must have the same clinical effect and safety profile. Pharmacy technicians must be aware of the correct substitutions and situations when generic drugs can be legally substituted for brand-name drugs and when they cannot. Technicians also need to know each drug's primary indications, or the common intended uses to treat specific diseases, and each drug's contraindications, or the specific situations in which the drug should not be used because it will be harmful to a patient For every intended drug action, there are related unintended reactions, or side effects, that must always be considered. They can be mild or severe, such as varying intensities of nausea, constipation, diarrhea, itchiness and other skin reactions, drowsiness, pain, muscle aches, headaches, shakiness, and numbness. Drug interactions occur when a drug affects the intended indication of another agent or reacts poorly with it. Interactions can happen between a prescribed drug and another prescribed or nonprescribed, or over-the-counter drug, food, or multiple drugs. The mechanism, or primary means by which the interaction occurs, varies widely depending on the interacting agents. Drugs in combination with other agents can cause many difficulties as they react with each other, and their side effects build up. Even vitamins, nutrients, or herbal and other dietary supplements can enhance or interfere with a drug's potency or cause intense reactions; so, the vitamins and supplements a patient is taking must be added to the patient profile and also considered..

[Audio] The Institute for Safe Medication Practices (or I-S-M-P) has created lists of high-alert medications for community and ambulatory healthcare settings, long-term care settings, and acute care settings. There are also lists designed to address medication concerns for vulnerable populations, such as the elderly and pregnant individuals Formerly known as black box warnings, boxed warnings are mandated by the F-D-A for drugs that have serious, life threatening risks. Boxed warnings highlight dangerous side effects, interactions, and cautions for use..

[Audio] Section one point two Dosage Forms, Routes of Administration, and Drug Delivery.

[Audio] It is important for technicians to understand the different dosage forms and routes of administration for the medications they dispense. The route of administration is the path by which the drug enters the body. Drugs are aimed at two kinds of therapeutic effects: a systemic effect, where the drug gets into the bloodstream to affect the whole body or a bodily system or a localized effect, where the drug is meant to exert its therapeutic action at or near the site of administration (for example, an ear drop in the ear). A dosage form is the physical manifestation of a drug—such as a tablet, capsule, suspension, ointment, cream, patch, or injection—that is designed to deliver the medication by a specific route of administration..

[Audio] A dosage form is the physical manifestation of a drug—such as a tablet, capsule, suspension, ointment, cream, patch, or injection—that is designed to deliver the medication by a specific route of administration. The dosage form selected is the one best suited to produce the desired systemic or localized effect in either an immediate or time-delayed manner. The routes of administration for drugs intended to have a systemic effect are: Oral enteral, which means into mouth and swallowed. Dosage forms include Tablets, capsules, syrups, and suspensions Transmucosal, or through mucous of inner linings. Dosage forms include Lozenges, sprays, troche tablets, and effervescent tablets. Topical transdermal, or absorbed through the skin. Dosage forms include Creams, ointments, pastes, patches, plasters..

[Audio] Inhalation/intrarespiratory, or breathed in. Dosage forms include Dry powder inhalers, metered-dose inhalers, and nebulizer solutions. Parenteral/injection, or injected into muscle, skin, or under the skin. Dosage forms include Injection shots, injectable pen solutions, and IV solutions. Rectal and vaginal, which may be transdermal and/or transmucosal. Dosage forms include Rings, suppositories, and solutions. And implants. Dosage forms include Pumps, radiation seeds, stents, and wound dressings..

[Audio] The routes of administration for drugs intended to have a localized effect are: Topical dermal, which means on or in the skin. Dosage forms include Creams, lotions, ointments, powders, and solutions. Inhalation, or breathed in. Dosage forms include Dry powder inhalers, metered-dose inhalers, and nebulizer solutions. Transmucosal, or through mucous membranes which may be through the nose, eyes, or ears. Dosage forms include Sprays, solutions, and suspensions And vaginal and rectal, which may be transdermal and/or transmucosal. Dosage forms include: Suppositories, solutions, creams, gels, and ointments..

[Audio] Oral dosage forms with specialized drug delivery systems include the disintegrating tablet, the sublingual tablet, and the buccal lozenge. These products have modified absorption and distribution phases in order to enhance their therapeutic effects. Other tablets and capsules have been formulated with an enteric coating to delay their release and protect the stomach or extend their release over a 12- to 24-hour period. A drug has a calculated delivery system when a pair of letters follow the name of the drug. These abbreviations are: CD, which stands for Controlled delivery CR, which stands for Controlled release DR, which stands for Delayed release LA, which stands for Long acting SR, which stands for Sustained release TR, which stands for Timed release XL, which stands for Extended length/release XT, which stands for Extended time release Because these delivery systems distribute the drugs in a therapeutic manner, patients are advised not to split one of these tablets in two unless directed by their prescriber..

[Audio] Section one point three Anatomical Classification of Drugs.

[Audio] To study and remember some of the generic and brand name drugs you will encounter, it is often easiest to consider them according to their classification by anatomical system or organ and/or by their pharmaceutical action. Drug Facts and Comparisons ( or F&C) is a primary reference for considering drugs by their anatomical classifications and finding the generic substitutions. It provides factual, up-to-date information on drug product availability, indications, administration and dose, pharmacological actions, contraindications, warnings, precautions, adverse reactions, overdoses, and patient instructions. For the hospital setting, the American Hospital Formulary Service (AHFS) serves as a primary reference for drug information. Although community and hospital pharmacies dispense some of the same drugs, drugs used in hospital settings also include injectable antibiotic and biotechnology drugs..

[Audio] Section one point four Central Nervous System Agents.

[Audio] Central Nervous System Agents are drugs that alter the neurotransmitter activity at the neuron level to produce medicinal effects. These include: Analgesic and Anti-Inflammatory Agents. Analgesic medications are used to relieve or reduce pain, whereas anti-inflammatory drugs work to reduce swelling. Antianxiety and Hypnotic Agents. These are psychoactive drugs, medications targeted to modify the brain functions to influence mood, perception, and consciousness. Hypnotic drugs are those that induce sleep. Miscellaneous CNS Agents, which treat a variety of neural disorders such as seizures, attention-deficit hyperactive disorder, and muscle strain..

[Audio] Section one point five Cardiovascular Medications.

[Audio] Cardiovascular Agents are drugs that treat heart disease in many forms. These include: Antihypertensive Agents, that work to lower blood pressure by dilating blood vessels, slowing heart rate, and increasing the elimination of fluids from the body; Antihyperlipidemic drugs are drugs that treat hyperlipidemia, a condition marked by elevated cholesterol, phospholipids, and/or triglycerides (discussed later) in the blood. Miscellaneous CNS Agents, which are used in addition to or instead of drugs that control high blood pressure and cholesterol. These other agents teat abnormal heartbeats, heart failure, and angina pectoris..

[Audio] Section one point six Systemic Anti-Infective Agents.

[Audio] Systemic Anti-Infective Agents are drugs used to slow the spread of an infectious organism or kill the infectious organism outright. Antibiotic agents kill or weaken bacteria and commonly cause gastrointestinal side effects, such as diarrhea, as well as yeast infections. Antifungal agents are used to treat fungal infections, such as yeast infections. Antiviral agents are used to treat viral infections, such as influenza, herpes, and HIV..

[Audio] Section one point seven Endocrine and Metabolic Agents.

[Audio] The endocrine system is the network of glands that secrete hormones into the circulatory system to regulate bodily functions, including metabolism. Various endocrine and metabolic agents are frequently prescribed in the community pharmacy. These include: Estrogens and Contraceptive Agents, where estrogen is often used in hormone replacement therapy to reduce the symptoms in menopausal and postmenopausal patients and contraceptives are used to prevent pregnancy Antidiabetic Agents are used to compensate for the insufficient secretion of the hormone insulin by the pancreas for processing sugar; And Miscellaneous Endocrine Agents that can be used to treat such conditions as osteoporosis, hypothyroidism, and various inflammatory ailments..

[Audio] Section one point eight Respiratory Agents.

[Audio] Respiratory agents work to provide relief by opening the airways in times of respiratory distress. These include: Asthma, a condition in which the airways narrow and swell and make breathing difficult chronic obstructive pulmonary disease, or C-O-P-D, a chronic inflammatory lung disease that causes obstructed airflow from the lungs. And allergies, an immune system response to a foreign substance that can often be treated with antihistamines..

[Audio] Section one point nine Gastrointestinal Agents.

[Audio] Gastrointestinal Agents are used to treat ailments in the esophagus, stomach, and intestines. Such conditions include: Heartburn, that state where stomach acid backs up into the esophagus. Ulcers, which are sores on the lining of the stomach, small intestine or esophagus. And gastroesophageal reflux disease, a chronic digestive disorder that occurs when acidic stomach juices or food and fluids back up from the stomach into the esophagus..

[Audio] Section one point ten Musculoskeletal Medications.

[Audio] Musculoskeletal agents include medications to treat pain and inflammation, muscle spasms, osteoporosis, and gout. Analgesic medications are used to relieve or reduce pain. Anti-inflammatory drugs work to reduce pain, inflammation, and swelling. Some of the most commonly prescribed medications are nonsteroidal anti-inflammatory drugs or en-sads. Muscle relaxants work to reduce muscle strain and pain..

[Audio] Section one point eleven Renal and Genitourinary Agents.

[Audio] The renal system, or urinary system, includes the kidneys, bladder, ureters, and urethra. The genitourinary system includes both the genital reproductive system and the urinary tract. Common conditions that can be treated with medication are: Hypertension, another word for high blood pressure, which is often treated with diuretics that work with the kidneys to eliminate excess salt and water from the body by dilating blood vessels; Enlarged prostrate, a prostate gland enlargement often associated with aging that can cause urination difficulty; And erectile dysfunction, the inability to get or keep an erection firm enough to have sexual intercourse..

[Audio] Section one point twelve Reproductive System Medications.

[Audio] The reproductive system is a collection of internal and external organs that work together for the purpose of sexual reproduction. In menopausal and postmenopausal patients or in patients who have had a hysterectomy, reproductive hormone production drops dramatically. Hormone-replacement therapy or H-R-T with estrogen is often used to reduce the symptoms. There are many prescription birth control medications on the market. Most hormonal contraceptives contain reproductive hormone combinations of estrogen and a progestin to simulate pregnancy and, thereby, prevent ovulation..

[Audio] Section one point thirteen Hematologic Agents.

[Audio] The hematologic system is made up of the Blood, the Spleen, Bone Marrow, and the Liver. Conditions that may require medication include: Abnormal blood cell production, where drugs may be used to stimulate production of red or white blood cells Blood quality, which must be monitored when blood thinners are prescribed to treat another condition And blood clotting, where drugs are administered to assist with the clotting of blood..

[Audio] Section one point fourteen Biotechnology Medications.

[Audio] Numerous drugs developed through biotechnology are used in the hospital for a variety of medical conditions: to treat anemia from chronic kidney disease or cancer chemotherapy to boost white and red blood cell count for patients at risk of an infection or experiencing severe fatigue or to treat inflammatory diseases..

[Audio] Section one point fifteen Miscellaneous Drugs.

[Audio] There are a number of other commonly used drugs that are used for a variety of conditions. These include corticosteroids, used to treat inflammatory diseases and conditions. Emergency medications, such as those used for opioid overdose or anaphylaxis. And drugs used to help patients stop smoking..

[Audio] Section one point sixteen Over-the-Counter Medications.

[Audio] Customers often seek counsel from pharmacy personnel to select the appropriate O-T-C product for a specific condition. Technicians should direct them to a pharmacist's counsel. Pharmacists are the only pharmacy personnel who can legally direct people to the right medication for a medical purpose or indication, the right dosage and administration, expected therapeutic effects, side effects, contraindications, and interactions—even for O-T-C drugs and vitamins. However, pharmacy technicians can help customers find the brands and types of medications they are looking for. Technicians can also help customers understand the O-T-C product labels, which include product name and therapeutic purpose, directions for dosage and frequency of administration for different age groups, active and inactive ingredients, expiration dates, precautions or warnings, and special storage requirements..

[Audio] Section one point seventeen Alternative Medicine and Dietary Supplements.

[Audio] The act of using prescribed conventional treatments and alternative medicine is called integrative medicine and may involve, for example, a physician recommending acupuncture to a cancer patient receiving chemotherapy. The term alternative medicine applies to non-western medical practices, sometimes considered "nonconventional" treatments, such as specialized diets, acupuncture, deep breathing and relaxation techniques, yoga and Pilates, meditation, massage therapy, and chiropractic manipulations. Alternative medicine also includes using natural products as medications, including homeopathic remedies and dietary supplements, like vitamins and minerals, herbals, nutritional supplements, and probiotics. It is important to realize that natural products could have side effects or problematic interactions with prescription drugs, even when used appropriately..

[Audio] Section one point eighteen Vaccines and Immunization.

[Audio] Immunization is the process whereby a person acquires immunity or resistance to an infectious disease through vaccination. Vaccination is the treatment with a vaccine to provide immunity against a disease. Vaccination is a proven tool for the prevention and elimination of infectious diseases.. Live attenuated vaccines use living but weakened pathogens to induce an immune response. Inactivated vaccines use pathogens that have been killed with chemicals, heat, or radiation. Common side effects of vaccines include fever, headache, injection-site irritation, mild skin rash, and irritability. Severely immunocompromised individuals should not receive live vaccines, and live vaccines are typically contraindicated in pregnancy..

[Audio] Section one point nineteen Drug Stability and Storage.

[Audio] Drug stability refers to the extent to which a dosage form retains its properties and characteristics over time. Drug stability directly affects the safety and efficacy of drug products. Degradation of a dosage form may cause loss of efficacy and adverse effects. Manufactured drug products will have an expiration date, which is the date beyond which a drug's stability and potency cannot be guaranteed. Compounded and reconstituted drug products will have a beyond-use date (BUD), which is determined based on the date that the product is compounded. Proper storage of medications is important to drug stability. All medications have specific storage conditions as determined by the manufacturer. These conditions include the temperature at which the drug is to be stored, whether the drug is to be protected from light, and whether the drug must be dispensed in the original container. Medications stored outside of recommended temperature ranges may experience a loss of physical integrity or effectiveness. Drugs may lose potency if exposed to light or moisture. For this reason, drug products that are particularly sensitive to light or moisture should always be stored and dispensed in their original containers..

[Audio] Section one point twenty Final Thoughts on Medications.

[Audio] This chapter has introduced many different types of medications. The suffixes and some prefixes in generic names relate to medication classifications. To learn the many drug families and their similarities, it is helpful to memorize drug suffixes and prefixes for quick recognition. Please see Table 1.44 in the textbook for a list of many common drug suffixes and prefixes to help with memorization..

[Audio] This concludes the Certification Exam Review for Pharmacy Technicians Fifth Edition presentation for chapter one..