PHARMACOLOGY AND HEALTHCARE
Pharmacology is a fascinating and multifaceted, discipline, which impacts not only on our
professional careers but on our personal lives as well. From our role as members of the
healthcare team to that of consumers, pharmacology plays a part in our lives.
The study of pharmacology covers a broad spectrum of diverse yet interrelated topics such as
botany, molecular chemistry, research, clinical observation, toxicology, legislation and patient
education.
Pharmacology is the study of drugs and their interactions with living organisms. The term
pharmacology comes from a Greek work meaning medicine. The term drug is derived from a
Dutch word which means dry and refers to the use of dried herbs and plants as the first
medicines. The Latin word for drug is medicina from which we derive our term medicine.
Pharmacology is concerned with the nature of drugs and medications, their actions in the body,
drug dosages, side effects of drugs, etc. Drugs are used to prevent, treat, and cure diseases,
and in some instances to diagnose diseases.
Different forms of a drug are appropriate for different routes of administration. Some drugs are
ineffective when administered in a certain form while others are available and approved for use
in several forms. Some common manufactured drug forms are the tablets, the capsule, creams,
ointments, lotions, powders, liquids and foams.
There are various routes of drug administration. Some drug may be approved for use via more
than one route and are manufactured in the different forms appropriate for those different
routes. Each route of administration has distinct disadvantages and advantages. A drug given
by one route may be therapeutic, while given by another route it may be ineffective, harmful, or
even fatal. Therefore, every drug prescription or drug order always includes the form of the
drug, as well as the route of administration.
The oral route of administration is through the mouth. It is routinely abbreviated as p.o. which is
Latin per os which means through the mouth. Tablets, capsules and liquids are all given orally.
The oral route is the most convenient route of administration and the most commonly used.
Drugs may be swallowed to then dissolve in the stomach, or they may be placed under the
tongue to dissolve. This is known as the sublingual route of administration. Drugs may also be
given by the rectal route of administration or vaginally. A relatively new route of administration
is that of transdermal. The drug is applied to the skin but its effects are felt throughout the entire
body. Some drugs, particularly those intended for the respiratory system may be inhaled in the
form of a gas or finely vaporized liquid solution and absorbed in the lungs. Another route of
administration is parenteral. This is a general term, which includes all those routes of
administration other than by mouth. In particular, the parenteral route of administration includes
intradermal, subcutaneous, intramuscular, and intravenous routes of administration.
Drugs exert their effects in a number of ways and at a number of sites within the body.
Basically, drugs act in two ways; locally or systemically. A local effect is limited to the site of
administration and those tissues immediately surrounding it. Drugs applied topically are
example of those that exert a local effect. A systematic drug effect is not limited to the site of
application but can be felt throughout the body, particularly evident in certain organs and
tissues. Drugs taken orally and subcutaneously usually exert a systemic effect. In addition, all
drugs have both a therapeutic or intended effect and side effects. The therapeutic effect will
cure a disease, decrease disease symptoms, or even prevent a disease. The perfect drug
would have a complete therapeutic effect perfectly suited for its use but would have no side
effects. Unfortunately, this perfect drug does not exist. Side effects vary widely with the type of
drug administered. They may be mild or quite severe. Many drugs exert gastrointestinal side
effects, which include anorexia, nausea, vomiting and or diarrhea. Common side effects which
are expressed in the central nervous system may include drowsiness, excitement, or
depression. Also drugs may react with other drugs in the system causing side effects. Many
patients are treated with more than one drug at a time. In particular, elderly patients with
chronic medical problems may consume a number or medications several times. When
administered simultaneously, some drugs react to each other in particular way to either
accentuate or diminish the action of each.
Before we begin a discussion of various body systems and the drugs that are prescribed for
them, it would be wise to take a brief look at the subject references. Drug reference books are
an invaluable source of information for the healthcare professional. No medical transcription
practitioner or student should be without an up-to-date drug reference source. A number of
excellent references are available on loan from libraries and hospitals or by direct purchase
from the publisher. These include the American Drug Index, the Physician’s Desk Reference,
as well as medical word and phrase books, which contain drug terms. More detailed drug
information can be found in Drug Facts and Comparisons and the American Hospital Formulary.
If a reference book cannot provide the answer to a drug question, the medical transcriptionist
may even seek help from a pharmacist. Some drug references are arranged in alphabetical
order. Other references are grouped by color-coded pages into generic, trade or brand names,
and classification of drugs. Some drug references give an extensive description of the drug, its
indications, dosages, etc. Others provide a briefer description or simply give the heading or
classification to which a drug belongs. In looking up a drug name, it is important not only to
verify the correct spelling, but to also determine that the drug that you have selected is
appropriate for the medical condition described. This is an extremely important consideration
because many drugs sound very much alike in their pronunciation, but differ greatly in their use.
For example, Xanax and Zantac sound very much alike in their pronunciation; however, their
uses are quite different. Xanax is used to treat anxiety, while Zantac is used to treat duodenal
or gastric ulcers.
Drugs are generally given in very small dosages and must be measured with extreme care.
Nearly, all drugs manufactured and prescriptions written are done so according to standard
metric measurements. These measurements include the gram, milligram, and microgram.
Amounts less than one are indicated with a decimal point. A less widely used form of
measurement not from the metric system is that of grains. Grains comes from the old
apothecary system used during colonial times. We still use other apothecary measurements
including the pint, quart and gallon. Amounts less than one are expressed as a fraction rather
than a decimal. An example of a drug still commonly prescribed in the grains is that of the
thyroid medication Synthroid.
We will now look at the various medical specialties and the drugs, which are prescribed to treat
diseases in these various body systems.
Because of the superficial nature of the most dermatologic diseases, they respond well to
topical drug therapy. Mild cases of skin diseases, such as acne, psoriasis, poison ivy, contact
dermatitis, etc. can be successfully treated with topical agents. Dermatologists commonly
prescribe categories of drugs such as anti-inflammatories or steroids, antipruritics, acne drugs,
and local anesthetics. See if you can successfully locate and spell the following dermatological
drugs. Some of these drugs are generic, which means that they should not be capitalized;
others are trade or brand names, which means that the first letter should be capitalized;
Accutane, which is used for acne; Benadryl, which is an antihistamine used for itching; Lotrimin,
which is an antifungal agent; Kwell, which is used to treat scabies; triamcinolone, which is a
topical corticosteroid; Valisone, which is also a topical corticosteroid; Xylocaine, which is a local
anesthetic; salicylic acid, which is used to remove warts; and Betadine, which is a skin cleanser
with antibacterial action.
Urologists treat patients with a variety of medical conditions, including urinary retention, kidney
stones, and urinary infections. See if you can successfully locate and spell the following
urologic drugs, both generic and trade names: Duvoid, an antispasmodic prescribed for urinary
bladder retention; Pyridium, a urinary analgesic; Bactrim, an antibiotic for urinary tract infections.
For diseases of the gastrointestinal tract, gastroenterologists prescribe a variety of
classifications of drugs. These include antacids, antispasmodics, histamine antagonists (also
known as H2 blockers), antiflatulents, laxatives, and drugs to prevent diarrhea. See if you can
successfully locate and spell the following gastrointestinal drugs, both generic and trade names:
Maalox, an antacid; Carafate, a drug used to treat duodenal ulcer; Tagamet, a drug used to
treat duodenal and gastric ulcers; ranitidine, a drug used to treat duodenal and gastric ulcers;
Axid, a drug used to treat duodenal ulcer; simethicone, a drug which relieves the formation of
gas in the stomach; Dulcolax, a laxative; Colace, a laxative; Lomotil, used to relieve diarrhea;
and Azulfidine, an antibiotic-type preparation used to treat ulcerative colitis.
In the treatment of musculoskeletal disorders, the orthopedist or orthopedic surgeon sees many
patients with medical conditions such as arthritis, bursits, sprains, and strains, as well as
fractured bones. A majority of the medications prescribed are for the relief of pain, muscular
spasm, or to relieve inflammation. See if you can successfully locate and spell the following
orthopedic drugs, both generic and trade names: Flexeril, a muscle relaxant; Robaxin, a muscle
relaxant; cortisone, given as an injection for problems such as bursitis; ibuprofen, a nonsteriodal
anti-inflammatory drug; Feldene, a drug which belongs to the category NSAID; and Voltaren, a
drug used for osteoarthritis and rheumatoid arthritis.
The cardiologist treats patients with disorders of the cardiovascular system. These disease
processes may include high blood pressure, congestive heart failure, peripheral vascular
disease, arteriosclerotic heart disease, angina pectoris, and cardiac arrhythmias. See if you can
successfully locate and spell the following cardiac drugs, both generic and trade names:
digoxin, a cardiac glycoside, which is used to treat congestive heart failure; Lasix, a diuretic, in
fact, but which is used to treat congestive heart failure; nitroglycerin, which is use sublingually
as an ointment or transdermally as a patch for the prevention and treatment of angina pectoris;
lidocaine, which belongs to the classification of drugs known as calcium channel blocking
agents; Lopressor, a drug used to treat hypertention, which belongs to the category known as
beta blockers; clonidine, a drug used for hypertension; and Capoten, an antihypertensive agent,
which is also known as an ACE inhibitor.
Respiratory drugs are prescribed for the treatment of emphysema, asthma, and respiratory
infections, such as pneumonia or bronchitis. See if you can successfully locate and spell the
following respiratory drugs, both generic and trade names: Proventil, a bronchodilator;
theophylline, a bronchodilator; Theo-Dur, a bronchodilator; Beclovent, a steroid which is inhaled
into the lungs; ampicillin, an antibiotic given for upper respiratory tract infections; and Septra, an
antibiotic.
Common disorders of the endocrine system include diabetes mellitus and hypo- or
hyperthyroidism. There are two types of diabetes mellitus. Type I or insulin-dependent
diabetes mellitus can be treated only with subcutaneous injections of insulin. Type II diabetes
mellitus also known as non-insulin-dependent diabetes mellitus or adult-onset diabetes mellitus
can be managed with weight control, dietary restriction, and the use of oral medication. This
oral medication is not insulin but is able to stimulate the pancreas to produce just enough insulin
to supply the patient’s need. It is interesting to note that insulin is measured in units not with the
metric systems as are most other drugs. Hypothyroidism is treated with the administration of
synthetic thyroid hormone. As mentioned previously, thyroid hormone is administered in units of
measure known as grains. See if you successfully locate and spell the following endocrine
drugs, both generic and trade names: NPH insulin; Humulin insulin; DiaBeta, an antidiabetic
agent; Diabinese, an antidiabetic agent; Glucotrol, an oral hypoglycemic agent; Synthroid, a
thyroid supplement and Cytomel, a thyroid supplement.
The practicing obstetrician or gynecologist encounters many disease conditions of the female
reproductive system. These include pelvic inflammatory disease and endometriosis, sexually
transmitted diseases, yeast and Trichomonas infections, and abnormal bleeding patterns. In
addition, nondisease conditions such as menopause, pregnancy, and the need for contraception
may warrant drug administration. See if you can successfully locate and spell the following
gynecological drugs, both generic and trade names: Estraderm, an estrogen replacement drug
used for menopause, which is given by the transdermal route; Premarin, an estrogen
supplement for menopause; Estrovis, used for menopause; Provera, used to treat amenorrhea
and abnormal uterine bleeding; Ortho-Novum, a birth control pill; Demulen, an oral
contraceptive; Norinyl, an oral contraceptive; Vibramycin, an antibiotic used to treat pelvic
inflammatory disease; Bicillin, a penicillin used to treat syphilis; Flagyl, used to treat
Trichomonas infection; Monistat, an antifungal medication given as a vaginal suppository to
treat yeast infections; prenatal vitamins, given to pregnant women; Clomid, to include ovulation
in women with fertility problems; and Danocrine, for the treatment of endometriosis.
Medical conditions of the ears, nose and throat consist mainly of infections and allergic
responses. These are treated with various antibiotics, decongestants, antihistamines, and
steroids. See if you can successfully locate and spell the following ENT drugs, both generic and
trade names: Sudafed, a nasal decongestant; Vancenase, a topical nasal steroid; Entex LA, a
long-acting decongestant; Benadryl, an antihistamine; amoxicillin, an antibiotic for throat and ear
infections.
Ophthalmic drugs include Timoptic, used to treat glaucoma; Opticrom, used to treat allergic
conjunctivitis, and Viroptic, used to treat herpes simplex virus infection of the eye.
Neurological and psychiatric drugs encompass those used to treat epilepsy, Parkinson’s
disease, sleep disorders, anxiety, psychosis, and depression. See if you can successfully
locate and spell the following neurological and psychiatric drugs, both generic and trade names:
Dilantin, used to treat grand mal seizures; phenobarbital, used to treat grand mal seizures;
Valium, given intravenously to treat status epilepticus, and also used to prevent seizures during
the alcohol withdrawal: Sinemet, used to treat Parkinson’s disease; Cogentin, used to treat
Parkinson’s disease; lithium, a drug used to treat manic-depressive disorders; Librium, used
treat anxiety; amitriptyline, an antidepressant; Ludiomil, an antidepressant; Desyrel, an
antidepressant; and Dalmane, a sleeping pill.
Susan M. Turley, MA, CMT
Author, Understanding Pharmacology
(Regents/Practice Hall, Englewood Cliffs, New Jersey)