GENERAL PRINCIPLES OF PHARMACOLOGY

Part 2 Topics

Anatomy & Physiology Related to Pharmacology

Common Prehospital Medications Common Patient Scenarios Common Patient Medications

Drugs Used to Affect the

Nervous System

Central Nervous System Medications

Analgesics & Antagonists Anesthetics Anti-anxiety & Sedative-Hypnotic Drugs Antiseizure or Anti-epileptic Drugs Central Nervous System Stimulants Psychotherapeutic Medications Parkinson’s Medications

Autonomic Nervous System Medications (1 of 2)

Drugs Affecting the Parasympathetic System: Cholinergics Anticholinergics Ganglionic Blocking Agents Neuromuscular Blocking Agents Ganglionic Stimulating Agents

Autonomic Nervous System Medications (2 of

2) Drugs Affecting the Sympathetic

System: Adrenergic Receptors Adrenergic Agonists Adrenergic Antagonists Skeletal Muscle Relaxants

Distribution of Sympathetic

Post-Ganglionic Fibers

Sympathetic Division of Autonomic Nervous

System

Physiology of an Adrenergic Synapse

Drugs Used to Affect the

Cardiovascular System

Blood Flow Through the Heart

Cardiac Conductive System

Action Potential of Cardiac Contractile Tissue

Action Potential of Cardiac Pacing Cells

Reentrant Pathways

Classifications of Cardiovascular Drugs (1 of

2)

Antidysrhythmics: Used to treat and prevent abnormal

cardiac rhythms.

Antihypertensives: Drugs used to treat hypertension.

Classifications of Cardiovascular Drugs (2 of

2)

Hemostatic Agents: Drugs used to stop bleeding.

Antihyperlipidemic Agents: Drugs used to treat high cholesterol.

Antidysrhythmics

Antihypertensives

Diuretics Adrenergic inhibiting agents Angiotensin converting enzyme

inhibitors Angiotensin II receptor antagonists Calcium channel blockers Direct vasodilators

Hemostatic Agents

Antiplatelets: Drugs that decrease the formation of

platelet plugs.

Anticoagulants: Drugs that disrupt the clotting cascade.

Thrombolytics: Drugs that act directly on thrombi to break

them down.

Antihyperlipidemics

Drugs used to treat high blood

cholesterol. Examples:

Lovastatin (mevacor). Simvastatin (zocor).

Drugs Used to Affect the

Respiratory System

Antiasthmatic Medications

Drugs Used for Rhinitis and Cough

Nasal Decongestants Antihistamines Antitussives Expectorants Mucolytic

Drugs Used to Affect the

Gastrointestinal System

Main Indications for GI Drug Therapy

Peptic Ulcers Constipation Diarrhea and Emesis Digestion

Drugs Used to Treat Peptic Ulcer Disease (1 of 2)

H2 Receptor Antagonists: Cimetidine (Tagamet), ranitidine

(Zantac), famotidine (Pepcid),

nizatidine (Axid).

Proton Pump Inhibitors: Omeprazole (Prilosec),

lansoprazole (Prevacid).

Drugs Used to Treat Peptic Ulcer Disease (2 of 2)

Antacids: Aluminum, magnesium, or sodium

compounds.

Anticholinergics: Pirenzepine (Gastrozepine).

Drugs Used to Treat Constipation

Categories of Laxatives: Bulk–forming

(methylcellulose or Citrucel). Stimulant (phenolphthalein or

Ex-Lax). Osmotic (Milk of Magnesia). Surfactant (Colace).

Drugs Used to Treat Diarrhea

Although a nuisance, diarrhea is often a helpful process.

Specific or non-specific agents may be used.

Drugs Used to Treat Emesis

Antiemetics: Medication used to prevent vomiting.

Serotonin Antagonists: Zofran.

Dopamine Antagonists: Compazine, Phenergan, Inapsine, Reglan.

Cannabinoids: Marinol, Cesamet.

Drugs Used to Aid Digestion

Several drugs are available to aid digestion of carboyhydrates and fats.

Two such drugs are pancreatin (Entozyme) and pancrelipase (Viokase).

Drugs Used to Affect the Eyes

Drugs Used to Affect the Eyes

Opthalmic drugs are used to treat conditions involving the eyes, primarily glaucoma and trauma. Medications used to treat glaucoma are

all aimed at reducing intraocular pressure (IOP). Examples include timolol (Timoptic) and betaxolol (Betoptic).

Tetracaine (Pontocaine) is a local anesthetic of the ester class.

Drugs Used to Affect the Ears

Drugs Used to Affect the Ears

Most drugs used to treat conditions involving the ear are aimed at eliminating underlying bacterial or fungal infections or at breaking up impacted ear wax. Chlorampenicol (Chloromycetin otic). Gentamicin sulfate (Garamycin).

Drugs Used to Affect the

Endocrine System

Drugs Affecting the Pituitary Gland

Anterior Pituitary Drugs—The only conditions treated with these drugs are those associated with abnormal growth such as dwarfism.

Posterior Pituitary Drugs—The two drugs in this category are oxytocin and antidiuretic hormone.

Drugs Affecting the Parathyroid and Thyroid

Glands Parathyroid glands are primarily

responsible for regulating calciumlevels.

Hypothyroidism leads to decreasedlevels of calcium and Vitamin D.

Treatment is therefore throughcalcium and Vitamin D supplements.

Drugs Affecting the Adrenal Cortex

The Adrenal Cortex synthesizes andsecretes 3 classes of hormones:glucocorticoids, mineralocorticoids,and androgens.

Two diseases typify the disordersassociated with the Adrenal Cortex:Cushing’s disease and Addison’sdisease.

Drugs Affecting the Pancreas

Diabetes mellitus is the most important disease involving the pancreas.

Insulin—a substance that decreasesblood glucose level.

Glucagon—a substance that increasesblood glucose level.

Oral Hypoglycemics

Orinase (chlorpropamide) Glucotrol (glipizide) Micronase (glyburide)

Hyperglycemic Agents

D50W is a sugar solution givenintravenously for acute hypoglycemia.

Glucagon is indicated for emergency treatment when an IV is unobtainable.

Drugs Affecting the Female Reproductive

System Estrogens and Progestins Oral contraceptives Uterine stimulants and relaxants:

Brethine, Yutopar.

Infertility agents: Clomid, Metrodin.

Drugs Affecting the Male Reproductive

System Testosterone deficiency: Metandren.

Benign Prostatic Hypertrophy (BPH): Proscare.

Drugs Affecting Sexual Behavior

L-dopa (Levodopa) has demonstrated increased libido as a side effect.

Sildenafil (Viagra) was approved in 1998 for patients suffering erectiledysfunction.

NOTE: If you treat a patient with chest pain

who has taken Viagra recently, do NOT give nitroglycerin or any other nitrate.

Drugs Used to Treat Cancer

Drugs Used to Treat Cancer

Drugs used to treat cancer arecalled antineoplastic agents.

Examples include: fluorouracil (Adrucil) mechlorethamine (Mustargen) vinblastine (Velban) vincristine (Oncovin)

Drugs Used to Treat Infectious

Diseases and Inflammation

Drugs Used to Treat Infectious Diseases and

Inflammation (1 of 3) Antibiotics.

An antibiotic agent mayeither kill the offending bacteria orso decrease the bacteria’s growththat the patient’s immune systemcan effectively fight the infection.

Antifungal Agents. Fungi are parasitic microorganisms that

cannot synthesize their own food.

Antimicrobial and Antiparasitic Drugs. Although most diseases treated with

these drugs are uncommon indeveloped countries, they are leading causes of death in third-world countries.

They include malaria, leprosy, and helminthiasis.

Drugs Used to Treat Infectious Diseases and

Inflammation (2 of 3)

Tuberculosis, caused by bacteria, is increasing in the United States.

NSAIDs (non-steroidal anti-inflammatory drugs)—Commonly used as analgesics and antipyretics.

Uricosuric drugs—Used to treat gout. Serums, vaccines, and other

immunizing agents.

Drugs Used to Treat Infectious Diseases and

Inflammation (3 of 3)

Drugs Used to Affect the Skin

Drugs Used to Affect the Skin

Dermatologic drugs are used to treat skin irritations.

They are common over-the-counter medications.

Drugs Used to Affect the Diet

Many disease processes affect the production, distribution, and

utilization of essential dietary nutrients.

Drugs Used to Treat Poisoning and

Overdoses

Drugs Used to Treat Poisoning and Overdoses

The treatment for poisoning andoverdose depends greatly on the substance involved. Syrup of Ipecac Activated Charcoal Mucomyst Atropine Pralidoxime

Part 2 Summary

Anatomy and Physiology Related to Pharmacology

Common Prehospital Medications

Common Patient Scenarios Common Patient Medications