PharmPrac7e-Chapter4-WLpresentation

[Audio] Welcome to the Pharmacy Practice for Technicians Seventh Edition presentation..

[Audio] Chapter Four: Introducing Pharmacology. Chapter Four Introducing Pharmacology.

[Audio] At the end of this chapter, you will be able to: Define the scope of the field of pharmacology and its areas of scientific study. Discuss the concepts of pharmaceutical and therapeutic equivalency and how they relate to the dispensing of generic and alternative drugs. Discuss the concepts of biosimilars and interchangeable biological drugs..

[Audio] Section four point one: What Is the Scope of Pharmacology?.

[Audio] In its broadest sense, pharmacology includes the study of drugs and how they work. It encompasses specialized scientific disciplines, including the following: Therapeutics, which is the study of appropriate use of drugs for targeted medicinal purposes Pharmacodynamics, the study of biochemical, physiologic, and molecular effects of drugs on the body Toxicology, the study of symptoms, detection and treatment of poisonous effects and side effects.

[Audio] Pharmaceutics, the study of the various dosage forms and routes of administration and their drug-releasing capabilities Pharmacokinetics, the study of the movement of drugs within the body, including absorption, distribution, metabolism, and elimination of drugs from the body, as well as harmful drug interactions And pharmacognosy, the study of the natural sources of drugs and herbs..

[Audio] Section four point two: Essential Knowledge for Technicians.

[Audio] Besides recognizing common drugs and their generic substitutions, technicians should know the primary indications for the drugs, or the common intended uses, to treat specific diseases. Technicians and pharmacists must also be aware of the contraindications of each drug— the specific situations in which a drug should not be used because it will be harmful to a patient. Additionally, one has to remember that, for every intended drug action, there are related unintended reactions, or side effects, that must always be considered..

[Audio] It's also important for technicians to be aware of paradoxical drug, when use of a medication has the opposite effect from what is normally expected. Drug interactions occur when a drug affects the intended indication of another medication or reacts poorly with it. Adverse drug events, or A-D-E, are injuries or harmful responses due to the use of a drug..

[Audio] Section four point three: Prescription Drug Substitutions.

[Audio] Pharmacists or pharmacy technicians in all states are permitted (or in some cases required) to substitute a lower-cost generic drug in place of a higher-cost brand name drug for a specific indication, as long as the generic drug is considered bioequivalent. For a specific generic drug to be considered as a bioequivalent for a brand drug by the Food and Drug Administration, it must be both pharmaceutically and therapeutically equal, though not necessarily identical in appearance. To be considered pharmaceutically equivalent, a generic drug must contain the same amount of active ingredient in the same dosage form as the original, FDA-approved, brand name drug. These generic drug products may differ in characteristics such as shape, scoring configuration, packaging, inert ingredients, and expiration time. Each generic drug also needs to be therapeutically equivalent, or provide the same medicinal benefit at the same dosage rates with the same degree of safety under the conditions specified in the labeling as the name-brand version..

[Audio] Generic drugs are not available for all brand name drugs, as sometimes the patents have not yet expired. In these cases, pharmaceutical drug products may be used. They contain the same active therapeutic ingredients but different salts. Or these products come in different dosage forms, say a tablet rather than a capsule. These pharmaceutical alternatives may be recommended but cannot be substituted without physician approval..

[Audio] Some physicians do not like to substitute generics even if the medications are considered pharmaceutically and therapeutically equivalent. In these cases, the prescriber may indicate on the prescription that the brand name is medically necessary and it cannot be substituted with a generic. Often, prescribers will write D-A-W, meaning dispense as written. They might also write D-A-W-1. Patients may request a brand name drug even if the prescriber did not write "brand medically necessary" or "DAW" on the prescription. The patient's request would be indicated by writing D-A-W-2 on the prescription for insurance processing. This generally results in a higher copay, so the technician must make sure that the patient is aware of this..

[Audio] Biosimilar drugs are deemed by the FDA as biologically comparable or sufficiently like the reference products in therapeutic methods. They have been proven to address the same indications with the same pharmaceutical mechanism of action, or precise ways that the active ingredients exert their influence on the body. They must also have the same administration routes, dosage forms, conditions of use, and levels of quality and strength as the original. Despite being biosimilar, these drugs cannot be substituted without permission of prescriber..

[Audio] Section four point four: 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..

[Audio] Section four point five: 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 four point six: Cardiovascular Agents.

[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 four point seven: 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, HIV.

[Audio] Section four point eight: 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 four point nine: 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 four point ten: 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 four 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 four point twelve: 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 four point thirteen: Biotechnology Drugs.

[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 four point fourteen: Miscellaneous Drugs.

[Audio] Other common prescription drugs fit in less anatomically based areas. Skin conditions such as eczema, psoriasis, and allergic reaction from bug bites or dermatitis from poison ivy are often treated with corticosteroids that can be applied topically Since many diuretics can lower blood potassium levels, prescription-strength levels of potassium are sometimes prescribed. Vitamin D and folic acid are commonly prescribed vitamins. Vitamin D improves the absorption of calcium and folic acid may reduce blood levels of homocysteine, which is thought to be a risk factor for heart disease..

[Audio] Section four point fifteen: Information for Pharmacy Personnel.

[Audio] When studying the wide variety of drugs and indications, there are a number of helpful resources that can be consulted. Package Inserts accompany the stock bottles of medication and provide key information from the drug manufacturer, including indications, contraindications, side effects, warnings, and dosage, along with storage and handling instructions Commonly used references and databases can be found in the Prescribers' Digital Reference ( or P-D-R), the Drug Information Handbook, the AHFS Drug Information, and Thomson Reuters Micromedex. Reference guides that give a bird's eye view of pharmacy practice itself include Remington: The Science and Practice of Pharmacy, and Trissel's Stability of Compounded Formulations.

[Audio] This concludes the Pharmacy Practice for Technicians Seventh Edition presentation for Chapter Four..