INTRODUCTION TO PHARMACOLOGY

Mrs. Opland

James Valley Career & Technology Center

Careers in Pharmacy

• Pharmacy Aide• Pharmacy Technician• Pharmacist

Pharmacy Aide• Job Description

– Helps pharmacists with clerical duties answers phoneshandles billing and paymentsstock shelvesclean equipmentmanage cash register

• Education:– informal on the job training– need a high school diploma

• Earnings:Pay Period Low Median High

  Hourly $6.92 $9.35 $14.64

  Annual $14,400 $19,400 $30,400

“High” indicates 90% of workers earn less and 10% earn more.“Median” indicates 50% of workers earn less and 50% earn more.“Low” indicates 10% of workers earn less and 90% earn more.

Pharmacy Technician• Job Description

– Receive prescriptions or refill requests– Prepare prescriptions– Prepare prescription labels– Complete insurance forms– Prepare IV & Chemo medications– Order medications

• Education– Technical or College training – 2 years of education… Associate Degree– Certification through Pharmacy Technician

Certification Board– Faster than average growth

• Earnings

Percentile 10% 25% 50%

(Median) 75% 90%

Hourly

Wage $9.36 $11.07 $13.49 $16.26 $19.31

Annual

Wage (2)

$19,480 $23,020 $28,070 $33,820 $40,160

Pharmacist• Job Description

– Advise physicians and other medical personnel as to selection, dosages, interactions, and side effects of medications

– Counsel clients– Provides information about over-the-counter

medications– Give advice about medical equipment– Hire and supervise personnel and oversee the

operation of the pharmacy

– Assess, plan, and monitor drug programs– Fill prescriptions

• Education– 5 to 7 years at an accredited school of

pharmacy to earn a master’s degree or doctorate• 4 years of college: Bachelors degree• Acceptance into Pharmacy program• 2 years of pharmacy• Internship

• Earnings• Median annual wages of wage and

salary pharmacists in May 2008 were $106,410.

• The middle 50 percent earned between $92,670 and $121,310 a year.

• The lowest 10 percent earned less than $77,390

• The highest 10 percent earned more than $131,440 a year.

Work Locations Employees in the Field of Pharmacy

• Community or Retail Pharmacists• Hospital Pharmacies• Pharmaceutical Researchers• Pharmaceutical Representatives

History of Pharmacology

• Charting from 16th century BC lists medicine as:– beer, turpentine, myrrh, juniper berries,

poppy, lead, salt and crushed precious stones

– products derived from animals including lizard's blood, swine teeth, goose grease, ass hooves and the excreta from various animals.

Sources of Drugs

• Pharmacology: study of drugs– How drugs work– Show to administer them safely & effectively

• Natural Sources:– Pharmacognosy: study of drugs that are naturally

derived from plants or animals

– Plants: main source of medicine until the early 1900’s

– 1921: insulin extracted from a pancreas– Problems with naturally occurring drugs

• Some poorly absorbed• Some broken down very quickly by the body• Isolating drugs from a plant or animal is often a

slow and expensive process• May result in a product containing impurities that

cause harmful effects• Some are extremely scarce

Drugs Obtained From Plants and Animals

Source Drug(s) Use

Poppies Codiene & Morphine Pain

Foxgloves Digitalis To treat congestive heart failure (CHF)

Yew Taxol To treat cancer (CA)

Thyroid glands Thyroid As hormone replacement

Stomachs Pepsin As digestive enzyme

• Microscopic Organisms:– Penicillin

• Produced by a mold• Flemming in 1928

– All antibiotics are made from microorganisms such as bacteria, fungi, or molds

Pharmacotherapeutics• Key term:

– Mechanism of Action (MOA)• Chemicals that affect the function of living organisms. They

produce their effects by interacting with other chemicals in the body.

• Pharmacotherapeutics– Examines the MOA of drugs– Describes the effects produced by a drug– Determines what dose of a drug is needed to produce a

desired effect– Determines what dose of a drug produced toxic effects

• Mechanisms of Action– Therapeutic class

• Drugs with the same MOA produce their effect in exactly the same way

• Have many of the same uses, advantages, and disadvantages.

• Each drug within a therapeutic class is a different chemical

• Example: Benadryl & Claritin

• Side Effects– Any effect produced by a drug that is not the

desired effect• Local

– Side effects that occur before a drug is absorbed into the bloodstream

» Example: ASA – irritates the lining of the stomach» Inhalers – can cause a dry throat or cough» Antibiotics – can cause diarrhea, yeast infection,

• Systemic– Side effects that take place after a drug is absorbed into

the bloodstream» Example: allergic reaction» Bronchodilators: dilate the bronchial but also

increases the heart rate and can cause insomnia

Routes of Administration

• Oral Administration– Drug swallowed– Tablet, capsule, or a liquid– Usually takes 30 to 60 seconds before taking

effect– Onset of action

• Time needed before a drug takes effect

• Patenteral Administration– All other routes other than oral administration– Examples

• Inhaler– Deliver medication directly to the lungs– Rapid in action– Systemic side effects minimal

• Eye Drops

Parenteral Routes of Administration

Route Description Onset of action Indications Examples

Sublingual Tablet placed under the tongue

Several minutes When rapid effects are needed

Nitroglycerin

Buccal Tablet placed in cheek

Several minutes When effects of digestion must be avoided

Androgenic drugs

Rectal Suppository, cream, or ointment

15 to 30 minutes For local effect or when client cannot take oral medication

Laxatives, nausea medications

Sublingual Buccal

Rectal

Route Description Onset of action

Indications Examples

Transdermal patch

Adhesive patch applied to skin

30 to 60 min. When cont. absorption and systemic effeccts over many hours are needed

NirtoglycerinEstrogenBirthcontrol

Subcutaneous (SC)

Drug injected into the fatty layer beneath skin

Several min. When a drug would be inactivate by the GI tract

Insulin

Intramuscular (IM)

Drug injected into a muscle

Several min. When a drug is absorbed poorly & when high levels are desired

Narcotic analgesics, antibiotics, immunizations

• Transdermal patch– Deliver a constant amount of drug over an extended

period of time, usually 24 hours– Guidelines

» Remove old patch» Select site for new patch

- site must be hairless

- site must be intact, no cuts, rash or irritation» Apply new patch

• Injections– Given when rapid effect is needed– Given when a drug would be destroyed by the digestive

system if taken orally– When a local effect (numbing) is desired– Two types

» Subcutaneous = injection into the fatty layer just beneath the skin

- most often given in the upper arm, front of the thigh, or in the abdomen

- needle ½ inch long, 25 guage (measurement of thickness of needle)

» Intramuscular = injection into a muscle

- given in shoulder, buttock, outer portion of thigh

- needle 1 - 1½ inches long, 23 guage or larger

Transdermal Patch

Subcutaneous

Intramuscular

Route Description Onset of action

Indications Examples

Intravenous (IV)

Drug injected into the blood in a vein

Within one min.

For emergency situations requiring immediate effects or for drugs that are rapidly destroyed in the body

Antiarrhythmics, antibiotics

Inhalation Drug inhaled into the nasal cavity or lungs

Within 1 min.

For local effects within resp. tract

Decongestants antiasthmatics

» Intravenous (IV) = injection inserted directly into a vein

- delivered this route for a rapid effect

- If the medication is to irritating to the SC or IM tissue

- administration of fluids

IntravenousInhalation

Topical

Vaginal

Key Terms

• Absorption• Distribution• Dosage • Elimination

• Loading dose• Maintenance dose• Therapeutic range • Transformation

Pharmacokinetics

• Pharmacokinetics – Study of four processes that affect the plasma

concentration of drugs• Absorption• Distribution• Transformation• Elimination

– Intensity of a drug’s effect• Determined by the concentration of the drug in the

plasma• Goal of tx is to get the correct plasma concentration• High enough to provide therapeutic effect but not so

high as to cause serious harmful effects• Therapeutic range:

– Minimum and maximum concentrations of a drug that achieve this objective

• Absorption – Process by which a drug enters the plasma

• Example: Oral – Dissolved in fluid of stomach or intestines– Drug must pass through the membranes of GI tract and

blood vessels to reach the plasma– Drugs cross membranes by a process called diffusion

– Diffusion: movement of molecules from an area where they are concentrated toward area of less concentration

• Distribution– Where the drug goes after entering the plasma

• Some binds to proteins in the plasma• Some diffuses out of the bloodstream into other

tissues• Chemical properties of a drug determine what other

tissues the drug will enter• Only a small % of drug absorbed will reach the site

where it is intended

• Transformation– Chemical change that takes place in a drug after

absorbed by the body• Most transformation occurs in the liver

• Elimination – Process that removes a drug from the body

• Most eliminated in the urine• Smaller amounts in feces, sweat, tears, saliva, and

breast milk

Dosages

• Therapeutic range must be found• Dosing interval

– Loading dose: initial large dose– Smaller doses are then taken at regular intervals – Maintenance doses: smaller doses to keep the

plasma concentration in the therapeutic range

• Effects of Individual Differences on Maintenance doses– Determinants of dosage

• Body weight• Age• Disease• Percentage of body fat• Malnutrition• Dehydration

Key Terms: Systems of Measurement

• Avoirdupois systemUsed in U.S.

• Metric systemUsed in medicine, other countries of

the world

Systems of Measure

• Metric System– Most widely used in pharmacy– Drugs usually in milligrams– Liquid medications usually in milliliters– Weight is usually in kilograms

• Basic units of measure – Gram (g)

• Used for weight or mass

– Liter (L) • Used to measure volume                                 

• Prefixes– Used to show how large or small a unit is

kilo- hecto- deka- No prefix

deci- centi- milli-

Meaning x1000 x100 x10 10 100 1000

Abb: k h da d c m

weight kg hg dag g dg cg mg

volume kL hL daL L dL cL mL

Kate had dates who didn’t call much

• Other systems of measurement– Household

• Measurements used in the kitchen

– Avoirdupois system• Measures units such as the fluid ounce and pound

1 tbsp = 3 tsp

1 tsp = 5 ml

1 tbsp = 15 ml

1 fl oz = 2 tbsp

1 fl oz = 30 ml

1 lb = 454 g

1 kg = 2.2 lb

• Basic Dosage Calculations– In order to administer medication you have to

have a physicians order– Order includes

• Name of drug• Amount of drug to be given• Frequency• Route of administration

– Known unit on hand• Amount of grams or milligrams in a drug for which

the dosage is known

Drug Labels• Drug name

– Trade name:• Registered with a specific company• Spelled with a capital letter

– Brand name:• Usually named due to ingredients

• Form of the Drug– Tablets– Capsules– Liquid

• Total number or Volume in container– Total number of tablets or amount of liquid

• Route of administration– Way the medication is to be taken

• Mouth, eye drops, IV

• Warnings– Statements of caution

• “may be habit forming”• “may cause drowsyness”• “take with food”

• Storage information– Where and how to store medicine

• May need to be refrigerated• May need to be kept out of sunlight

• Manufacturing information– Name of manufacture– Expiration date

• Lot number– Number assigned to the batch of medication

made at a certain time and location

Over-the-Counter (OTC)

• Medication that can be dispensed without a prescription

• Caution– May be a lower dose – Need to know side effects– Need to know if there is interference with other

medication

Prescription Drugs

• Can only be dispensed with a order from a medical personnel with prescription privileges

Controlled Substances

• Drugs that have addictive traits• Controlled to combat and control drug

abuse

Abbreviations to Know

• Refer to abbreviation sheet