Medical Review Doses + Terminology

•Process where a drug is taken up from the site of administration and is transported to the blood stream
•Occurs:
oOrally
oTopically
oRectally
oBy inhalation
oParenteral
Examples:
•ASA goes to stomach - absorbed in stomach
•Enteric Coated ASA goes to intestine
•SQ Insulin absorbed under skin
•IV goes directly into blood stream

•Process where a drug, once in the bloodstream, is delivered to specific organs and tissues in the body to exert its pharmacological effects
Example:
•Aspirin goes to the stomach, then to the blood, then to the organ needing relief. Headache

•Disappearance of a drug, when it changes chemically into another compound
•Takes place in many body organs - Primarily in the liver
•Usually enhances excretion and inactivation of a drug

•Process by which the drug is eliminated from the body - Primarily by the kidney
•Drugs can be excreted via the urine, feces, lungs, skin, etc.

This is a percentage or fraction of the administered dose of a drug that actually reaches systemic circulation. Factors affecting oral route of administration include age, body weight and time of administration.

•When the effectiveness of two drugs is decreased when given together.
Example:
•Ampicillin and Gentamicin therapeutic incompatibility.

•When two drugs from the same class are given together.
Example:
•Cephalexin and Cefaclor are both Cephalsporins. This is an example of therapeutic duplication.

•Effects other than the desired ones.
--
•A severe adverse reaction to the administration of a drug.
•This can cause anaphylaxis or anaphylactic shock.
Example:
•If a patient has a severe adverse reaction after prior administration of Penicillin.

•Effects that are predictable and widely reported
•Undesired pharmacological effects of a drug seen when therapeutic doses of the drug are used.
•Often unavoidable, part of the drug's action.
Example:
•Nausea,
•Drowsiness
•Upset stomach
•Addiction

•Effects that are harmful and destructive to the body.
Causes:
•Drug dosage exceeds recommended dosage
•Drug is used for longer periods of time than is recommended
•Drug is not properly monitored
Example:
•Chemotherapy kills good cells

•Allergy to drugs that are chemically similar
Example:
•(Penicillin & Ceflasporin)
--
•A change in the magnitude or duration of the pharmacological response of one drug because of the presence of another drug

•Increased risk of side effects
•Increased risk of toxicities
•Decreased pharmacological response desired
--
Additive Response:
•Occurs when two or more drugs combined together yield a response when the drugs by themselves are not enough

•Occurs when the effect of two or more drugs is greater than the sum of the drugs
Examples:
•Bactrim,
•Septra,
•Trimethoprim
•Sulfamethoxazole
--
A Theoretical Ratio
•Weigh risks vs. benefits
•Must be done on an individual basis
Example:
•Asthma patient should not be on a B blocker
•Inderal.

•When a drug used for one indication cause an increase in severity of another indication.
Example:
Pseudoephedrine contraindicated in hypertension

Pharmacology is the study of drugs and their interactions with the human body to produce therapeutic effects.
--
A drug is a substance intended for use in the diagnosis, cure, mitigation (decrease in severity), treatment, or prevention of disease in human beings or animals.
--
A Legend Drug is a drug that requires a prescription.

Non-prescription drugs are also referred to as over the counter (OTC) drugs. These are medications that the FDA has determined to be safe and effective for consumers to self-medicate when used as directed by the product labeling. An OTC (over the counter) Drug is a drug that does not require any form of prescription. Often times, OTC Drugs are prescribed by a physician.

•Colace
•Metamucil
•Dulcolax
•Bisacodyl tablets
•Senokot
•Milk of Magnesia ( OTC laxatives)
•Imodium brand for Loperamide, (OTC treatment diarrhea)
•Cerumenex (OTC ear drop to remove ear wax. Patient information should include how to instill in ear.)
•Selenium shampoo (OTC used to treat dandruff)

•Prescription or Legend Drugs must be taken with the supervision of a physician and may be harmful if not monitored.
•These drugs also require a physician's drug order.
•A pharmacist cannot dispense these drugs without a prescription.
--
Some legend drugs are also available OTC.
Examples:
•Antivert (Meclizine) - Legend
•Bonine (Meclizine) - OTC

•Medications which warrant more restrictive regulation because of their potential for addiction and abuse
Example:
•Schedules I, II, III, IV & V

Dietary Supplements are not regulated by the FDA because the suppliers do not make therapeutic claims.
Example:
•St. John's Wort
These products are not reviewed for content and have not been proven effective.