Essential pharmacotherapy concepts and terminology applied ... · Essential pharmacotherapy...

Essential pharmacotherapy concepts

and terminology applied to medication

reconciliation for Medical/Healthcare

Interpreters.

Instructor:

Dr. Lizbeth N Mendoza, MD-FMG-Mexico, CMI-Spanish

Contact: [email protected]

2

Objectives At the end of the workshop the participant will be able to:

• Identify, define, exemplify and interpret key concepts in medication

reconciliation such as generic and brand names, dosage form, route of

administration, dosage regimen, contraindications, and drug reactions.

• Identify, define, exemplify and interpret key concepts in pharmacotherapy

such as: pharmacokinetics, pharmacodynamics, bioavailability, mechanism

of action, receptors, drug efficacy and safety, and drug interactions.

• Identify 20 frequently mentioned medications, both prescription drugs

and OTC’s, including their therapeutic category and pharmacologic class.

5/6/2016 © LNMM - BVCMI

Medication reconciliation

Formal process for creating the most complete and

accurate list possible of a patient’s current medications and

comparing the list to those in the patient record or

medication orders.

High-risk clinical situation for LEP patients

Includes the transmission of specific information about

medications such as name, dosage, frequency, and route.

3 5/6/2016 © LNMM - BVCMI

Examples of interpreter errors of potential

clinical consequence

• Omitting questions about drug allergies.

• Omitting instructions about antibiotic dose, frequency, and duration.

• Instructing a mother to give an antibiotic for 2 instead of 10 days.

• Erroneously adding that hydrocortisone cream must be applied to an infant’s entire body, instead of solely to a facial rash.

• Explaining that an antibiotic was being prescribed for the flu.

• Instructing a mother to put oral amoxicillin into her child’s ears to treat otitis media.

Ref: Flores, G., Laws, M.B., Mayo, S.J. et al, Errors in medical interpretation and their potential clinical consequences in pediatric encounters. Pediatrics. 2003;111:614

4 5/6/2016 © LNMM - BVCMI

5

Ideas?

5/6/2016 © LNMM - BVCMI

6

Tools

5/6/2016 © LNMM - BVCMI

20 + frequently mentioned medications

7 5/6/2016 © LNMM - BVCMI

Pharmacology

8

Definitions

5/6/2016 © LNMM - BVCMI

Pharmacotherapy

9

Definitions

5/6/2016 © LNMM - BVCMI

Chemotherapy

10

Definitions

5/6/2016 © LNMM - BVCMI

Pharmacogenomics (or pharmacogenetics)

11

Definitions

5/6/2016 © LNMM - BVCMI

Chronopharmacology

12

Definitions

5/6/2016 © LNMM - BVCMI

Toxicology

13

Definitions

5/6/2016 © LNMM - BVCMI

Definitions

DRUG

(“medicine”)

14 5/6/2016 © LNMM - BVCMI

Definitions

DRUG

(informal)

15 5/6/2016 © LNMM - BVCMI

Definitions

Prodrug

16 5/6/2016 © LNMM - BVCMI

Definitions

Orphan drug

17 5/6/2016 © LNMM - BVCMI

Definitions

Substance

18 5/6/2016 © LNMM - BVCMI

Definitions

Molecule

19 5/6/2016 © LNMM - BVCMI

Definitions

Active ingredient (active pharmaceutical

ingredient)

20 5/6/2016 © LNMM - BVCMI

Definitions

Inactive ingredients (vehicles, excipients)

21 5/6/2016 © LNMM - BVCMI

Definitions

Biological Product

22 5/6/2016 © LNMM - BVCMI

Definitions

Generic drug

23 5/6/2016 © LNMM - BVCMI

Definitions

Brand drug

24 5/6/2016 © LNMM - BVCMI

Generic Drugs vs. Brand Name Drugs

= Active ingredient(s)

= Use / Effect

= Mechanism of action

= Dosage strength*

= Route **

= Side effects

= Safety

25

* How much of the active ingredient is present in each dosage

** A way of administering a drug to a site in a patient 5/6/2016 © LNMM - BVCMI

≠ Name

≠ Packaging

≠ Appearance

≠ Taste

≠ Price

26


5/6/2016 © LNMM - BVCMI

GENERIC DRUGS BRAND DRUGS

Acetaminophen, Paracetamol Tylenol

Ibuprofen Advil

Warfarin Coumadin

Metformin Glucophage

Cephalexin Keflex

27


5/6/2016 © LNMM - BVCMI

28


5/6/2016 © LNMM - BVCMI

29


5/6/2016 © LNMM - BVCMI

30


5/6/2016 © LNMM - BVCMI

Definitions

Dosage forms

31 5/6/2016 © LNMM - BVCMI

32

Dosage forms

The means by which drug molecules are delivered to sites of action within the body.

Solid: Tablets, capsules, caplet, coated caplet, pills, suppositories, lozenge,

troche, bead, pellet, etc.

Semisolid: Ointment, gel, cream, paste, ointment, foam, etc.

Liquid: Suspension, solution, emulsion, syrup, lotion, shampoo, injection,

tintcture, etc.

Other: Gas, film, patch, plaster, poultice, etc.

Variations: Coated tablets, uncoated tablets, soluble tablets, dispersible

tablets, effervescent tablets, sublingual tablets, buccal tablets, chewable

tablets, grooved tablets, delayed-release, sustained-release, etc.

5/6/2016 © LNMM - BVCMI

Definitions

Routes of

administration

33 5/6/2016 © LNMM - BVCMI

34

Enteral: Oral, buccal, sublingual, rectal.

Parenteral: Intravenous (IV), intramuscular (IM), subcutaneous

(SubQ, SC), epidural.

Topical: Ophthalmic, auricular/otic, nasal, vaginal.

More: Transungueal, transtympanic, intraperitoneal , intratechal,

intrauterine, intracavernosal, intraarticular, intraosseous,

endosinusial, endotracheal, etc.

A way of administering a drug to a site in a patient

Routes

5/6/2016 © LNMM - BVCMI

Definitions

Strength

35 5/6/2016 © LNMM - BVCMI

How much of the active ingredient is present in each dosage (form).

36

Strength

Metric Units: 500 mg tablet, 250 mg capsule, 0.5g/tablet, 5 µg or mcg tablet.

Units: penicillin, insulin, bacitracin, heparin, nystatin, polymixin, and vitamins A, D, and E. Examples: 400,000 U penicillin, 100 U Insulin.

Concentration: For liquid and topical preparations.

• Liquids = w/v: 500 mg/5 mL amoxicillin suspension, 100 units/ml of insulin suspension.

• Solid topical = weight/weight (w/w): 100,000 units/g nistatin cream.

Percentage: specific weight/volume concentration of g/100 units: Example: 5% means 5g of x drug /100ml in liquids. For solids like creams, 1% means 1 gram of x drug / 100 grams of cream.

5/6/2016 © LNMM - BVCMI

Definitions

Dose

37 5/6/2016 © LNMM - BVCMI

5 mL (every 8 hrs)

10 mg (every 12 hrs)

1 tablet (every 24 hrs)

2 drops (every 6 hrs)

10 units (per day)

0.2 units/kg (per day divided in 2 doses)

15 mg/kg (every 6 hours)

5 mg/dose

12.5 mg/kg/dose

2 puffs 15 minutes before exercise and as needed

38

Dose

Amount of drug taken at any one time.

5/6/2016 © LNMM - BVCMI

39

Common household system of measurement and

equivalents

1 Teaspoonful or tsp ≈ 5mL

1 Tablespoon or Tbsp ≈ 15mL

Dropperful ≈ 1 mL

Dose

5/6/2016 © LNMM - BVCMI

40 5/6/2016 © LNMM - BVCMI

41 5/6/2016 © LNMM - BVCMI

42 5/6/2016 © LNMM - BVCMI

43 5/6/2016 © LNMM - BVCMI

44 5/6/2016 © LNMM - BVCMI

Definitions

Dosage Regimen

45 5/6/2016 © LNMM - BVCMI

Frequency at which the drug doses are given.

• Every X hours, minutes, days…

• PRN - as needed

• Daily / Weekly / Monthly

• bid (bis in die) - twice a day; tid (ter in die) - 3 times a day; qid

(quater in die) - 4 times a day

• Before, during, with, after…. meals, sleep time, exercise,

intercourse, etc…

46

Dosage Regimen

5/6/2016 © LNMM - BVCMI

Definitions

Prescription drug

47 5/6/2016 © LNMM - BVCMI

Definitions

OTC (Over The Counter) drug

48 5/6/2016 © LNMM - BVCMI

Definitions

Therapeutic

category

49 5/6/2016 © LNMM - BVCMI

Drugs classification typically based on diseases or

symptoms that drugs are used to treat.

Examples:

Analgesics, Anti-inflammatory agents, Antibiotics, Anesthetics,

Anticonvulsants, Antiemetics, Cardiovascular agents,

Gastrointestinal agents, etc.

50

Therapeutic category

5/6/2016 © LNMM - BVCMI

Definitions

Pharmacologic class

51 5/6/2016 © LNMM - BVCMI

Group of active moieties that share scientifically documented

properties and is defined on the basis of any combination of

three attributes of the active moiety: 1) Mechanism of Action

(MOA); 2) Physiologic Effect (PE); 3) Chemical Structure (CS).

Examples:

• Non-opioid analgesics, opioid analgesics, Nonsteroidal Anti-

inflammatory drugs, glucocorticoids, antidiabetics agents, insulins,

anticoagulants, beta-adrenergic blocking agents, calcium channel

blocking agents, etc.

52

Pharmacologic class

5/6/2016 © LNMM - BVCMI

Drug reactions

53

Definitions

5/6/2016 © LNMM - BVCMI

Warnings and

precautions

54

Definitions

5/6/2016 © LNMM - BVCMI

Contraindications

55

Definitions

5/6/2016 © LNMM - BVCMI

Side effects

56

Definitions

5/6/2016 © LNMM - BVCMI

Activity

57 5/6/2016 © LNMM - BVCMI

Definitions

Pharmacokinetics

(ADME)

58 5/6/2016 © LNMM - BVCMI

Definitions

Drug Interactions 1+1 =2 -Addition-

1+1=3 - Synergism-

1+1=0 -Antagonism-

0+1=2 -Potentiation-

79 5/6/2016 © LNMM - BVCMI

Essential pharmacotherapy concepts and terminology applied ... · Essential pharmacotherapy...

Documents

Transcript of Essential pharmacotherapy concepts and terminology applied ... · Essential pharmacotherapy...