Medical assisting Administrative and clinical procedures (5e) Chapter 51 Principles of pharmacology

Pharmacology, which is the science of drugs, is a great responsibility to any allied health professional. Medication mistakes made can injure or even cause the death of a patient. It is important to begin with a good working knowledge of the foundations of pharmacology. This chapter provides an overview of the role of drugs in ambulatory medical facilities.

Principles of Pharmacology

51.1 Identify the medical assistant’s role in

pharmacology.

51.2 Recognize the five categories of

pharmacology and their importance to

medication administration.

51.3 Differentiate the major drug categories,

drugs names, and their actions.

Learning Outcomes

51.4 Classify over-the-counter (OTC),

prescription, and herbal drugs.

51.5 Use credible sources to obtain drug

information.

51.6 Carry out the procedure for registering or

renewing a physician with the Drug Enforcement Administration (DEA) for

permission to administer, dispense, and prescribe

controlled drugs.

Learning Outcomes

51.7 Identify the parts of a prescription, including

commonly used abbreviations and symbols.

51.8 Discuss nonpharmacological treatments for

pain

51.9 Describe how vaccines work in the immune

system.

Learning Outcomes

• Pharmacology – science or study of drugs

• Medication errors can result in injury or

death

• Medical assistant

– Knowledge of the foundations of

pharmacology – Understand role of drugs in ambulatory

medical facilities

• Prescription drugs vs OTC drugs

• The medical assistant should

– Be sure the physician is aware of all

medications the patient is taking

– Ask patients about use of alcohol and

recreational drugs – Provide patient education

Pharmacology (cont.)

• To administer drugs

– Check state regulations / scope of practice

– Understand pharmacologic principles

– Translate prescriptions

– Answer basic patient questions

– Adhere to legal requirements

– Keep accurate records

Apply Your Knowledge

What is the role of the medical assistant in

pharmacology?

ANSWER: The medical assistant should be sure the

physician is aware of all medications the patient is

taking, including OTC medications; ask patients about

use of alcohol and recreational drugs; and provide

patient education If the scope of practice permits, the

medical assistant may also be responsible for

administering some medications.

• Drug – chemical compound used to

prevent, diagnose, or treat disease

• Pharmacology – study of drugs

• Pharmachologist – specialist in

pharmacology

• Pharmacognosy

Pharmacology (cont.)

• A physician prescribes a drug

• Administer a drug by any route that

introduces it into the patient body

• A healthcare professional

dispenses a drug

Sources of Drugs (Pharmacognosy)

• Interaction between drug and their target

cells and the body’s response to the

interaction

• What the body does to a drug

– A bsorption ~ conversion of a drug into a form

the body can use – D istribution ~ transportation of a drug from

site of administration to site of action

• Indication and labeling

– Indication

• Reason for using a drug

• Must be approved by FDA to be part of labeling

– Labeling ~ includes drug form

– Off-label prescribing

Pharmacotherapeutics (cont.)

• Safety

– Determined by adverse effects of a drug

– Be alert to patient complaints after starting a

new drug

• Efficacy – drug is working as expected

– Supplemental

– Inform physician of any adverse effects

– Discuss concerns with physician or

pharmacist

Apply Your Knowledge

Drug Names and Categories

Drug Names and Categories (cont.)

• Prescribed by either generic or trade

name

• Categorized by

– Action on the body

– General therapeutic effect

– Body system affected

Apply Your Knowledge

What is the difference between the trade name

and generic name of a drug?

Very Good!

ANSWER:

Trade name – the brand or proprietary name chosen

by the manufacturer.

The generic name – the drug’s official name selected

by the U.S Adopted Names (USAN) Council It is

nonpropiretary.

FDA Regulation and Drugs

• New drug approval

– Animal trials ~ toxicity

– Clinical trials ~ ratio of benefit to risk

• Regulation of drug manufacturing

– Drugs shipped between states

– Use exact formula approved

– Quality of ingredients

FDA Regulation and Drugs (cont.)

• OTC drugs – nonprescription

• Prescription drugs

• Pregnancy categories

– Available information on risk to fetus

– Most drugs are Category C

• Complementary and alternative therapies

Apply Your Knowledge

What drugs are regulated by the FDA?

ANSWER: All drugs are regulated by the FDA in some

manner This includes prescription, OTC and CAM

therapies.

Sources of Drug Information

• Sources must be up-to-date and credible

– PDR Internet site

Sources of Drug Information (cont.)

• USP/NF

– Official source of drug standards

– Published about every 5 years

• AHFS ® – published by the American

Society of Hospital Pharmacists

• Epocrates ®

Sources of Drug Information (cont.)

• Package insert

– Describes the drug

– Purpose and effects

– Indications and contraindications

– Warning, precautions and adverse reactions

– Drug abuse and dependence

– Overdosage, dosage and administration

– How drug is supplied

Sources of Drug Information (cont.)

• Drug

labels

Apply Your Knowledge

Which of the following sources of drug information

is most like the package insert?

Controlled Substances

• Potentially dangerous and addictive

• Comprehensive Drug Abuse Prevention

and Control Act (1970)

– Created the DEA

– Strengthened drug enforcement authority

– Schedules ~ based on abuse potential

Schedule Abuse Potential Example

Schedule Abuse Potential Example

IV (limited dependence) Lower than III Diazepam Xanax ® ,

V Lower than IV (very limited

dependence)

Antitussives

and antidiarrheals with opioids

Controlled Substances (cont.)

• Labeling – identification

• Doctor registration and drug ordering

– Register with DEA

– Comply with CSA

• Drug security

Controlled Substances (cont.)

• Record keeping

– Dispensing records

• Schedule II drugs – separate from patient record

• Schedule III through V – with patient record

– Inventory records ~ every two years

– Disposing of drugs ~ follow DEA regulations

Apply Your Knowledge

What does the Controlled Substances Act

regulate?

ANSWER:

Controlled substance labeling Doctor registration

Drug ordering Drug security

Record keeping Dispensing records

Inventory records Disposing of drugs

Nice Job!

• Signa

• Signature

• DEA number

– New or renewals may be called to pharmacy

– Only the physician may call for Schedule II

drugs

Apply Your Knowledge

Nonpharmacologic Pain Management

Nonpharmacologic Pain Management

Apply Your Knowledge

Why do patient’s consider complementary and

alternative medicine?

ANSWER: It is generally less expensive, has fewer

side effects and more accessible than traditional

medical treatments

• Preparations

– Produce reduced

sensitivity – Increase immunity

• Immunity – formation

of antibodies

Antibody Formation

• Response to an antigen

• Lymphocytes produce antibodies to

neutralize antigen

– Antibodies are antigen specific

– Prevents the reaction or disease

Apply Your Knowledge

ANSWER: Vaccines are administered to a person to

produce reduced sensitivity to or increase immunity to

an infectious disease.

Why are vaccines given to patients?

In Summary

51.1 The role of the medical assistant in pharmacology

includes being attentive to ensure the physician is aware of all medications, both prescription and OTC, that a patient is taking; asking each patient about

alcohol and recreational drug use (both past and present), as well as herbal remedies; assisting in managing and renewing medication prescriptions; and educating the patient, using guidelines provided by the licensed practitioner, about the purpose of a drug and how to take the drug for maximum effectiveness and minimum adverse effects.

In Summary (cont.)

51.2 The five categories of pharmacology include:

pharmacognosy, pharmacokinetics, pharmacodynamics, pharmacotherapeutics, and toxicology It is important to understand each of these

in order to carry out the medical assistant’s role in pharmacology.

51.3 Drug categories are sometimes named based on their

action The major drug categories and their actions

In Summary (cont.)

51.4 Nonprescription drugs, including herbal and OTC

drugs, can be obtained without a physician’s order

For prescription drugs, patients must have a physician’s written (or oral) order.

51.5 Credible sources for drug information are the

Physicians’ Desk Reference ® (PDR), United States

Hospital Formulary Service (AHFS ® )

You may also access medication information from package inserts, drug labels, and other reliable

In Summary (cont.)

51.6 The medical assistant should assist the physician

with registration, renewal, and ordering of controlled substances, as outlined in the Controlled Substance Act of 1970 and Procedure 51-1.

51.7 A prescription must be complete to be filled

The medical assistant must be able to interpret a prescription in order to manage new and refilled medications

Procedure 51-2 and Table 51-4 will assist the medical assistant in performing these tasks.

In Summary (cont.)

51.8 Multiple nonpharmacologic methods are used to

treat pain, including CAM therapies such as massage, yoga, biofeedback, chiropractic,

acupuncture, magnetic therapy, hypnotism, and

glucosamine chondroitin.

51.9 Immunizations usually contain killed or weakened

organisms When given, they stimulate the body to build up

a resistance to the organism They are used to provide

immunity against specific diseases.

End of Chapter 51

It is easy to get a thousand

prescriptions but hard to get one single remedy. 

~Chinese Proverb