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Pharmacology
DENTALELLE TUTORING
WWW.DENTALELLE.COM
CHAPTER ONE
INFORMATION, SOURCES AND AGENCIES
PRESCRIPTION WRITING
INTRODUCTION
Definition of Pharmacology
Defined as the production, preparation and
dispensing of a drug
•Pharmaco-: drugs
•-ology: the study of
Pharmacology:
the study of drugs
Definitions of DRUG
• “a therapeutic agent; any substance,
other than food, used in the
prevention, diagnosis,
alleviation, treatment, or cure of
disease.”
OR
• any chemical substance that affects
biological systems
DEFINITIONS
• Over-the-Counter (OTC): drug available to
the general public (without a prescription)
• Prescription (Rx): usually a controlled
substance and requires a written authorization
for its use
Pharmacology & The Oral Health Care
Providers
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Obtaining a medical/health history
Administering drugs in the office (e.g Fl, *anesthetics)
Handling emergency situations (epi. For allergy)
Planning appointments (diabetic ct in am vs pm)
Choosing self-medication (OTC meds – eg. Advil & Vitamins –
Herbals).
Discussing drugs (use correct terminology; make sure ct. is aware of
drugs and certain oral side effects).
Life-long learning (be current – up to date with new drugs)
DRUG NAMES – DEFINITIONS
CHEMICAL NAME:
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•
•
determined by the drugs’ chemical structure
used during the investigative & developmental
stage by a company
shows the exact chemical composition of the
drug
DRUG NAMES – DEFINITIONS
GENERIC NAME:
official name the drug is known globally & in scientific
publications
drugs listed by the Food & Drug Administration
(FDA) by this name – only one name per drug
first letter of name is NOT capitalized
DRUG NAMES – DEFINITIONS
TRADE OR BRAND NAME:
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assigned to a drug by a pharmaceutical company which
manufactures it commercially
usually followed by ® - registered trademark & can only be
used by one company – patented for “x” # of years; once
expired, generic can be available
can have several names
first letter of name ALWAYS Capitalized
Drug Names –
Example #1
Chemical Name:
•
4-dimethylaminmo – 1,4,
4a,5,5a,6,11,12a –
octahydro -3,6,10,12,12a
– pentahydroxy- 6 –
methyl – 1,11, dioxo -2 –
naphthacenecarboxamide
Generic Name:
•
tetracycline
Trade or Brand Name:
•
Achromycin,
Apo-Tetra,
Novo-Tetra,
Nu-Tetra,
Tetracyn
Drug Names –
Example #2
Chemical Name:
•
2-diethylamino-2,6
acetoxylidide
Generic Name:
•
lidocaine
Trade or Brand
Name:
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Xylocaine, Dolicaine,
Octocaine
Figure 1-1:
A COMPARISON BETWEEN THE TRADE AND
GENERIC DRUG NAMES OF LIDOCAINE.
DRUG SUBSTITUTION
•
Similar drugs can sometimes substitute each other
Drugs can be similar:
• Chemically
• Biologically
• Therapeutically
Drug Substitution
•
Chemically Equivalent – Two formulations of a drug meet established chemical
and physical standards
•
Biologically Equivalent – Two formulations produce similar concentrations in
blood and tissues
•
Therapeutically Equivalent – Equal therapeutic effects during a clinical trial
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IF oversees:
•
The Food and Drug Act
•
The Proprietary or Patient Medicine Act
•
The Narcotic Control Act
•
These acts are designed to protect the consumer from fraud, deception, and health hazards
due to the use of foods, drugs, cosmetics, and medical devices.
•
The Department of National Health and Welfare also authorizes substance abuse treatment,
including the use of methadone, for narcotic addicts
CLINICAL EVALUATION OF A NEW DRUG
•
A discovered or synthesized compound must pass through
many steps before it is approved to become a marketed drug
–
Animal studies begin by measuring both acute and chronic
toxicity
–
The median lethal dose is determined for several
species of animals
CLINICAL EVALUATION OF A NEW DRUG
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Long-term animal studies continue, including a search for teratogenic
effects
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Toxicity and pharmacokinetic properties are also noted
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An investigational new drug application (INDA) must be filed
before any clinical trials are performed
Human studies involve four phases
Clinical Evaluation of a New Drug
• PHASE I
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Small and then increasing doses are administered to a
limited number of healthy human volunteers
• Primarily to determine safety
Determines biologic effects, metabolism, safe dose range in
humans, and toxic effects of the drug
Clinical Evaluation of a New Drug
•
PHASE 2
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Larger groups of humans are given the drug and any
adverse reactions are reported to the FDA
•
Primarily to test effectiveness
Clinical Evaluation of a New Drug
•
PHASE 3
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More clinical evaluation takes place involving a large
number of patients who have the condition for which the drug
is indicated
•
Both safety and efficacy must be demonstrated
•
Dosage is determined
Clinical Evaluation of a New Drug
•
PHASE 4
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Postmarketing surveillance
•
Toxicity that occurs in clients taking the drug after it is
released is recorded
•
Several drugs in recent years have been removed from
the market only after phase 4 has shown serious
toxicity
ROLE OF THE DENTAL HYGIENIST IN PHARMACOLOGY
• Drugs used should be entered into the treatment record,
including drug, dose, and route of administration
• Any drug recommended or given as a sample to a client
should be recorded in the treatment record with the client’s
instructions
• Drug or herbal supplement history review should include
investigation of potential drug effects and modifications of
the treatment plan
CONTROLLED SUBSTANCE
ACT OF 1970
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Requirements of the Act
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Prescriptions for a controlled substance require a
Drug Enforcement Agency (DEA) number.
Schedules II-V require a written prescription.
Schedule II prescriptions must be signed in ink, no refills,
phone-ins are emergency only.
Schedules III-V can be telephoned in and can have 5 refills
over 6 months.
Several states require “duplicate” or “triplicate” prescription
blanks for Schedule II drugs.
10
PRESCRIPTION WRITING
PRESCRIPTION WRITING
A prescription is an order for a specific
medication for a specific patient at a particular
time, with appropriate instructions for how the
patient is to use the prescribed medication.
PRESCRIPTION FORMAT
Parts of a Prescription:
In the Past, Latin was used.
• Superscription*
• Inscription*
• Subscription*
• Signature*
* Required by law to make valid prescription
PRESCRIPTIONS - FORMAT
Superscription:
Includes the patient’s name, address, and
age, date, and the symbol (Rx) (Latin for
recipe,”{you} take” or “take thou of”)
Inscription:
Includes the name of the drug, dose
(amount needed), and dose form
PRESCRIPTIONS - FORMAT
Subscription:
Includes the directions to the pharmacist.
Transcription: or Signature
Includes the directions to the patient
PRESCRIPTIONS
- FORMAT
Fig 1-3, p.10 - A typical
prescription form
1.
2.
3.
4.
Superscription
Inscription
Subscription
Transcription
CURRENT PRESCRIPTIONS FORMAT
HEADING:
• Contains M.D.’s info. & client’s info.
Date of the prescription (most commonly
missed)*
– Name, address & phone # of dental office*
– Name, address, age of client*
– Weight for children
–
*(not a legal prescription unless the date is filled
in)
CURRENT PRESCRIPTIONS FORMAT
BODY
• Includes the symbol (Rx)*
• Name and dose size or concentration
(liquids) of the drug*
• Amount to be dispensed*
• Directions to the patient
CURRENT PRESCRIPTIONS FORMAT
• Rx symbol is the name of the
drug being prescribed
• Size – if tablet (milligrams); if
liquid (milligrams per
millilitre mg/ml)
• Quantity to be dispensed is the
number of capsules or tablets
or millilitres of liquid; the
number is written in roman
numerals
CURRENT PRESCRIPTIONS FORMAT
• “Sig.” are the directions to the patient.
• Directions must be completely clear
and explicit and should include the
amount of medication and the time,
frequency and route of administration.
• The pharmacist will transcribe Latin
abbreviations into English on the label
when the prescription is filled.
CURRENT PRESCRIPTIONS FORMAT
CLOSING
• Refill information*
• Drug enforcement administration number if
required
• Generic substitution instructions
• Signature of Prescriber*
*Required by law to make valid prescription
The DIN (Drug Identification Number is
included in this section if it is a controlled
substance (Canada)
Example of a Prescription Label
CURRENT
PRESCRIPTIONS
FORMAT
**You may see some of these on
your tests
•
ABBREVIATIONS
Used to save time but also makes alteration of the prescription by a
patient more difficult
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ac: before meals
d: day
h: hour
hs: at bedtime
pc: after meals
prn: as needed
sig: write (label)
stat: immediately
bid: twice per day
tid: three times per day
qid: four times per day
PRESCRIPTIONS - RECORDS
• Record all prescriptions in chart
• Record reason for prescription & date written
• If photocopy taken - put into client chart,
stroke through the photocopy or write “COPY”
to prevent the copy from being used for
fraudulent purposes