GENERAL PRINCIPLES OF PHARMACOLOGY

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GENERAL PRINCIPLES OF PHARMACOLOGY
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Part 2 Topics

• Anatomy Physiology Related to Pharmacology
• Common Prehospital Medications
• Common Patient Scenarios
• Common Patient Medications

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Drugs Used to Affect the Nervous System
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Central Nervous System Medications

• Analgesics Antagonists
• Anesthetics
• Anti-anxiety Sedative-Hypnotic Drugs
• Antiseizure or Anti-epileptic Drugs
• Central Nervous System Stimulants
• Psychotherapeutic Medications
• Parkinsons Medications

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Autonomic Nervous System Medications (1 of 2)

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

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Autonomic Nervous System Medications (2 of 2)

• Drugs Affecting the Sympathetic System
• Adrenergic Receptors
• Adrenergic Agonists
• Adrenergic Antagonists
• Skeletal Muscle Relaxants

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Distribution of Sympathetic Post-Ganglionic
Fibers
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Sympathetic Division of Autonomic Nervous System
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Physiology of an Adrenergic Synapse
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Drugs Used to Affect the Cardiovascular System
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Blood Flow Through the Heart
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Cardiac Conductive System
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Action Potential of Cardiac Contractile Tissue
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Action Potential of Cardiac Pacing Cells
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Reentrant Pathways
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Classifications of Cardiovascular Drugs (1 of 2)

• Antidysrhythmics
• Used to treat and prevent abnormal cardiac
  rhythms.
• Antihypertensives
• Drugs used to treat hypertension.

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Classifications of Cardiovascular Drugs (2 of 2)

• Hemostatic Agents
• Drugs used to stop bleeding.
• Antihyperlipidemic Agents
• Drugs used to treat high cholesterol.

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Antidysrhythmics
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Antihypertensives

• Diuretics
• Adrenergic inhibiting agents
• Angiotensin converting enzyme inhibitors
• Angiotensin II receptor antagonists
• Calcium channel blockers
• Direct vasodilators

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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.

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Antihyperlipidemics

• Drugs used to treat high blood cholesterol.
• Examples
• Lovastatin (mevacor).
• Simvastatin (zocor).

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Drugs Used to Affect the Respiratory System
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Antiasthmatic Medications
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Drugs Used for Rhinitis and Cough

• Nasal Decongestants
• Antihistamines
• Antitussives
• Expectorants
• Mucolytic

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Drugs Used to Affect the Gastrointestinal System
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Main Indications for GI Drug Therapy

• Peptic Ulcers
• Constipation
• Diarrhea and Emesis
• Digestion

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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).

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

• Antacids
• Aluminum, magnesium, or sodium compounds.
• Anticholinergics
• Pirenzepine (Gastrozepine).

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Drugs Used to Treat Constipation

• Categories of Laxatives
• Bulkforming (methylcellulose or Citrucel).
• Stimulant (phenolphthalein or Ex-Lax).
• Osmotic (Milk of Magnesia).
• Surfactant (Colace).

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Drugs Used to Treat Diarrhea

• Although a nuisance, diarrhea is often a
  helpful process.
• Specific or non-specific agents may be used.

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Drugs Used to Treat Emesis

• Antiemetics
• Medication used to prevent vomiting.
• Serotonin Antagonists
• Zofran.
• Dopamine Antagonists
• Compazine, Phenergan, Inapsine, Reglan.
• Cannabinoids
• Marinol, Cesamet.

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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).

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Drugs Used to Affect the Eyes
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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.

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Drugs Used to Affect the Ears
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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).

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Drugs Used to Affect the Endocrine System
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Drugs Affecting the Pituitary Gland

• Anterior Pituitary DrugsThe only conditions
  treated with these drugs are those associated
  with abnormal growth such as dwarfism.
• Posterior Pituitary DrugsThe two drugs in this
  category are oxytocin and antidiuretic hormone.

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Drugs Affecting the Parathyroid and Thyroid Glands

• Parathyroid glands are primarilyresponsible for
  regulating calciumlevels.
• Hypothyroidism leads to decreasedlevels of
  calcium and Vitamin D.
• Treatment is therefore throughcalcium and
  Vitamin D supplements.

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Drugs Affecting the Adrenal Cortex

• The Adrenal Cortex synthesizes andsecretes 3
  classes of hormonesglucocorticoids,
  mineralocorticoids,and androgens.
• Two diseases typify the disordersassociated with
  the Adrenal CortexCushings disease and
  Addisonsdisease.

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Drugs Affecting the Pancreas

• Diabetes mellitus is the most important disease
  involving the pancreas.
• Insulina substance that decreasesblood glucose
  level.
• Glucagona substance that increasesblood glucose
  level.

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Oral Hypoglycemics

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

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Hyperglycemic Agents

• D50W is a sugar solution givenintravenously for
  acute hypoglycemia.
• Glucagon is indicated for emergency treatment
  when an
• IV is unobtainable.

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Drugs Affecting the Female Reproductive System

• Estrogens and Progestins
• Oral contraceptives
• Uterine stimulants and relaxants
• Brethine, Yutopar.
• Infertility agents
• Clomid, Metrodin.

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Drugs Affecting the Male Reproductive System

• Testosterone deficiency
• Metandren.
• Benign Prostatic Hypertrophy (BPH)
• Proscare.

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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.

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Drugs Used to Treat Cancer
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Drugs Used to Treat Cancer

• Drugs used to treat cancer arecalled
  antineoplastic agents.
• Examples include
• fluorouracil (Adrucil)
• mechlorethamine (Mustargen)
• vinblastine (Velban)
• vincristine (Oncovin)

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Drugs Used to Treat Infectious Diseases and
Inflammation
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Drugs Used to Treat Infectious Diseases and
Inflammation (1 of 3)

• Antibiotics.
• An antibiotic agent mayeither kill the offending
  bacteria orso decrease the bacterias
  growththat the patients immune systemcan
  effectively fight the infection.
• Antifungal Agents.
• Fungi are parasitic microorganisms that cannot
  synthesize their own food.

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Drugs Used to Treat Infectious Diseases and
Inflammation (2 of 3)

• Antimicrobial and Antiparasitic Drugs.
• Although most diseases treated withthese drugs
  are uncommon indeveloped countries, they are
  leading causes of death in third-world countries.
  
• They include malaria, leprosy, and helminthiasis.

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Drugs Used to Treat Infectious Diseases and
Inflammation (3 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 drugsUsed to treat gout.
• Serums, vaccines, and other immunizing agents.

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Drugs Used to Affect the Skin
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Drugs Used to Affect the Skin

• Dermatologic drugs are used to treat skin
  irritations.
• They are common over-the-counter medications.

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Drugs Used to Affect the Diet
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Many disease processes affect the production,
distribution, and utilization of essential
dietary nutrients.
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Drugs Used to Treat Poisoning and Overdoses
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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

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Part 2 Summary

• Anatomy and Physiology Related to Pharmacology
• Common Prehospital Medications
• Common Patient Scenarios
• Common Patient Medications