Want to learn more about the intersection of pharmacology and medical assisting? A medical assistant must be aware of basic pharmacology including commonly prescribed medications, drug categories and classifications, drug schedules, side effects and adverse effects, measurement, mathematical conversions, and dosage calculations, common approved medical abbreviations, forms of medication, look-alike and sound-alike medications, routes of drug administration, rights of drugs and medication administration, physician’s desk reference and online resources, and principles of storage and disposal of medication. With the knowledge of pharmacology, the medical assistant can properly help patients take the correct medication with the proper dosage and administration instructions.
Commonly Prescribed Medications
The medical assistant must be familiar with common prescriptions in many different insurance companies’ formularies. Medication is used to treat many different conditions and disease. As the physician prescribed these medications, the medical assistant will need to code them in medical records and process prescriptions with pharmacies.
- Lipitor – prescribed to treat cholesterol and lower the risk of stroke, heart attack and heart complications for people with type 2 diabetes or coronary heart disease.
- Synthroid – prescribed to treat or prevent enlarge thyroid gland caused by hormone imbalances, radiation treatment, surgery or cancer.
- Prinivil – prescribed to treat high blood pressure or congestive heart failure.
- Prilosec – prescribed to treat symptoms of gastroesophageal reflux disease and other conditions caused by excess stomach acid.
- Metformin – prescribed to improve blood sugar in people with type 2 diabetes.
- Norvasc – prescribed to treat high blood pressure or chest pain.
- Zocor – prescribed to lower cholesterol and triglycerides in the blood.
- Lortab – prescribed to treat chest pain and high blood pressure.
- Cozaar – prescribed to treat high blood pressure.
- Ambien – prescribed to treat insomnia
- Zoloft – an antidepressant used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorder, PTSD and PMDD.
- Flomax – an alpha-blocker that relaxes the muscles in the prostate and bladder neck, making it easier to urinate.
- Flonase – nasal spray used to treat nasal congestion, sneezing, runny nose and itchy or watery eyes caused by allergies.
- Lexapro – prescribed to treat depression and anxiety.
- Xanax – prescribed to treat anxiety and panic disorders.
- Plavix – prescribed to prevent blood clots after a recent heart attack or stroke.
- Wellbutrin – prescribed to treat depression.
- Cialis – prescribed to treat impotence or erectile dysfunction.
- Prozac – prescribed to treat major depressive disorder, bulimia nervosa, obsessive-compulsive disorder and panic disorder.
- Crestor – helps lower bad cholesterol fats including LDL and triglycerides and raise good cholesterol including HDL in the blood.
Drug Categories & Classifications
The medical assistant should know that drugs are classified into different categories based on the reaction or use of the drug for medical purposes. Here is a subset of drugs by classification or category:
- Analgesics – pain relievers
- Anorexics – appetite suppressants.
- Antacids – neutralizes acids in the stomach.
- Antiarthritics – relieves the symptoms of arthritis.
- Antibiotics – helps stop bacterial growth.
- Antifungals – treats fungal infections and stops the growth of fungi.
- Antineoplastics – helps prevent the growth of malignant cells.
- Biologicals – drugs created from living organisms
- Antiarrhythmics – acts against irregular heart activity.
- Contraceptives – drug to prevent pregnancy.<
- Decongestants – reduces congestion and swelling in the nose and throat.
- Vasodilators – relaxes the blood vessels.
- Laxatives – helps loosen the bowels and relieve constipation.
- Sedatives – used to induce calm.
- Tranquilizers – used to reduce mental anxiety.
- Antipyretics – used to reduce fever.
- Diuretics – helps eliminate fluid by increasing urine output by the kidneys.
- Stimulants – substances that increase or stimulate the normal activity of the central nervous system. Examples include caffeine, weight loss pills, energy drinks, nicotine and cocaine
- Depressants – substances that slow down the normal activity in the brand. Examples include opiates, alcohol and tranquilizers
- Anti-Depressants – drugs used to treat major depressive disorders, dysthymia, anxiety, and obsessive-compulsive disorders.
- Barbiturates – drug used as a central nervous system depressant that can produce mild sedation to total anesthesia.
- Anti-Psychotics – sedative psychiatric medication commonly used for delusion or hallucinations.
- Anticonvulsants – drug used to treat epileptic seizures.
The US Drug Enforcement Administration (DEA) has categorize drugs into five schedules based on acceptable uses, the potential to for abuse and the strength of possible addiction:
- Schedule 1 Drugs – drugs with no current accepted medical use and a high potential for abuse. Examples include heroin and marijuana.
- Schedule 2 Drugs – drugs that have a higher potential for abuse than Schedule 1 drugs. Examples include cocaine, Ritalin, and oxycodone.
- Schedule 3 Drugs – drugs with a moderate to low potential for physical and psychological dependence. Examples include ketamine, Vicodin, codeine and anabolic steroids.
- Schedule 4 Drugs – drugs with a low potential for abuse and low risk of dependency. Examples include Xanax, Darvocet and Ambien.
- Schedule 5 Drugs – used for antidiarrheal, antitussive and analgesic purposes. Examples include Robitussin AC, Lomotil and Motofen.
Side effects, Adverse Effects, Indications, and Contra-Indications
Before a drug can be used and be sold at a pharmacy or over-the-counter, it must be approved by the Food and Drug Administration (FDA). Once the drugs are deemed safe and efficient, the FDA will approve the drug, if it deems its benefits outweigh its risks. The National Cancer Institute (NCI) defines an adverse effect as an unexpected problem that occurs during treatment with a drug. There are many different side effects and adverse effects that can be caused by medication. The following is a subset of those effects:
- Constipation – the condition of the digestive system where a person has hard feces and has difficulty expelling them from the colon.
- Skin Rash – a noticeable change in the texture or color of the skin. The rash may consist of scaly, bumpy, itchy or irritated skin.
- Diarrhea – abnormally loose or watery stool
- Dizziness – the feeling of being faint, woozy, weak or unsteady and can create the false sense that an individual’s surroundings are spinning or moving.
- Drowsiness – the feeling of being sleepy or lethargic
- Dry Mouth – also known as xerostomia; the inability of an individual to produce enough saliva to keep the mouth wet.
- Headache – a symptom of pain in the head or neck.
- Insomnia – habitual sleeplessness and the inability to fall or stay asleep.
- Nausea – an uneasy sensation that makes an individual feel like vomiting.
- Suicidal Thoughts – an individual who experiences suicidal ideation however may not carry it through.
- Abnormal Heart Rhythms – the improper beating of the heart, either irregular, too fast or too slow.
- Internal Bleeding – a loss of blood that occurs from the vascular system into a body cavity.
- Cancer – a disease in which abnormal cells divide uncontrollably and destroy body tissue.
- Erectile Dysfunction – an inability for a man to keep an erection during sexual intercourse.
There can also be side effects from vaccinations including fever, nausea or malaise and skin reactions or pain at the vaccination site. Drug Interactions are adverse effects while mixing multiple drugs or ingesting specific foods. For example, eating grapefruits can affect blood levels as they interact with drugs that include blood pressure and cholesterol medications. Medical professionals should talk to their patients about any side effects or adverse effects and what to do if they happen.
Measurement, Mathematical Conversions, and Dosage Calculations
There are many different measurements, mathematical conversions and dosage calculations for medicine as it is administered to a patient. The following is a subset of Pharmacokinetic metrics:
- Dose – amount of the drug administered
- Dosing Interval – the time lag between each drug dose to be administered.
- C-Max – the peak plasma concentration of a drug after it has been administered.
- t-max – the time it takes for a drug to reach the C-Max
- C-Min – The lowest concentration a drug reaches before the next dose of the medicine is administered.
- Elimination Half-Life – the time required for the concentration of the drug to reach half of its original dose.
For a list of medical measurement conversion metrics visit NursingCentral. The following is a subset of measurement conversions:
- 1 gram (g) = 1,000 milligrams (mg)
- 1 millimeter = 1 cubic centimeter (cc)
- 1 milliliter – 15 minims (M) = 15 drops (gtt)
- 500 milliliters = 1 pint (pt)
- 1,000 milliliters = 1 quart (qt)
- 3,785 milliliters = 1 gallon (gal)
- 1 kilogram = 2.2 pounds (lb)
- 0.06 gram = 60 milligrams = 1 grain
- 2.5 centimeters = 1 inch
- C = (F-32) x 5/9
- F = (C x 9/5) + 32
Common Approved Medical Abbreviations
When medicine is prescribed, many medical assistants will need to know what common approved medication abbreviations mean to help educate patients. For a list of medical measurement abbreviations visit Wikipedia. Some common approved medication abbreviations include:
- a – before
- a.c. – before meals
- am – before noon
- aq – water
- bid – twice a day
- cap – capsule
- dil – dilute
- DS – double strength
- ext – external
- g – gram
- gtt – drop
- H – hypodermic
- inj – injection
- IV – intravenous
- kg – kilogram
- L – liter
- lb – pound
- mcg – microgram
- noct – night
- oz – ounce
- p.c. – after meals
- PO – by mouth
- pm – afternoon or evening
- qh – every hour
- qs – as much as needed
- qt – quart
- R – rectally
- Rx – prescription
- sld – once daily
- stat – immediately
- tab – tablet
- tbsp, T – tablespoon
- tds – three times a day
- tsp – teaspoon
- ung - ointment
Forms of Medication
Medication can come in many formats and the medical assistant should know how to administer each form and educate the patient on proper ingestion of each form of medication. The different form of medications include liquid, tablet, capsule, topical medicine, suppositories, drops, inhalers, injections, implants, patches and sublingual tablets or liquid.
- Liquid – the active ingredient in the medicine is combined with a liquid to make it easier to take or better to absorb.
- Tablet – the active ingredient is combined with another substance and pressed into a round or oval solid shape. Tablets can be soluble or dispersible and can be safely dissolved in water.
- Capsule – the active ingredient in the medicine is contained inside a plastic shell that dissolves slowly in the stomach.
- Topical Medicine – creams, lotions or ointments that are applied directly to the skin.
- Suppositories – the active ingredient is combined with another substance and presented in a bullet shape to be inserted into the rectum.
- Drops – used to reach the affected area directly for conditions of the eyes, ears and nose.
- Inhalers – the active ingredient of the medicine is released under pressure directly into the lungs.
- Injections – medicine is injection under the skin, into a muscle or directly into a vein.
- Subcutaneous Injections – given just under the surface of the skin.
- Intramuscular Injections – given into a muscle
- Intravenous Injections – given into a vein.
- Implants or Patches – medicine is absorbed by the body through the skin.
- Sublingual Tablets or Liquid – tablet or liquid not swallowed but held in the cheek so that the mouth lining absorbs the active ingredient.
The Institute for Safe Medication Practices (ISMP) maintains a look-a-like drug name list. They use bolded tall man letters to help draw attention to the dissimilarities in look-alike drug names. The list can be found at the ISMP.org Website.
Routes of Drug Administration
Medication can be administered through many different body parts. Each route of administration has a different name. A list can be found at the FDA.gov website. Pharmacokinetics is the analysis of drugs as they are administered to a human body. Here is a subset of administration routes and their names:
- Buccal – administration of the medicine directed toward the cheek from within the mouth.
- Dental – medicine that is administered to a tooth or teeth.
- Interstitial – medicine is administered in the interstices of a tissue.
- Intracardiac – medicine administered to the heart.
- Intravenous – administration of medicine through the vein.
- Nasal – administration of medicine by way of the nose.
- Oral – medicine administered by the mouth.
- Rectal – medicine administered by the rectum.
- Topical – medicine that is administered on the particular spot of the outer body.
Pharmacokinetics – The analysis of drugs from the initial liberation, to absorption, through the distribution, to the chemical metabolism and finally the excretion from the body.
- Liberation – the process of releasing a drug into the body.
- Absorption – the process of a drug entering the blood.
- Distribution – the dispersion of drugs throughout the fluids and tissues of the body.
- Metabolism – the recognition by the body that a foreign substance is present and the irreversible transformation of the parent compounds into daughter metabolites.
- Excretion – the removal of the drug from the body.
Rights of Drugs & Medication Administration
There are many ways to prevent medication errors and a common way to do this is by understanding the rights of drug administration. The following is a list of 10 rights of drug administration:
- Right Drug – check and verify the drugs name and form. Beware of look-alike and sound-alike medication names.
- Right Patient – check the name, address, date of birth and/or ID band before giving the medication.
- Right Dose – double check the prescription as ordered by the physician. Be aware of the difference between adult and pediatric doses.
- Right Route – check the order and route of administration; whether oral, IV, etc.
- Right Time and Frequency – check when the drug should be given and the last time the drug was taken.
- Right Documentation – the medical assistant will need to make sure they write the time and any remarks on the chart correctly.
- Right History and Assessment – review the patient’s history of drug interactions and allergies.
- Drug approach and Right to Refuse – the patient should be given the right to refuse a medication after the medical assistant thoroughly explains the effects
- Right Drug-Drug Interaction and Evaluation – review of medications or diet that can cause a bad interaction for the patient with the drug prescribed. Also, check the expiration date of the medication given.
- Right Education and Information – educate the patient with enough knowledge that they understand the expected side effects.
Physicians' Desk Reference and Online Resources
The Physician’s Desk Reference (PDR) is a commercially published compilation of manufacturer’s prescribing information on prescription drugs. Similar information can be found online at the Prescribers’ Digital Reference. It is indexed into four sections including by manufacturer, by product, the category index and generic index. The PDR offers color images of medications and product information consistent with FDA labeling.
Principles of Storage and Disposal of Medication
Heat, air, light and moisture may damage medication. Keep all medication in a cool and dry place. Pills and capsules are easily damaged by heat and moisture. Aspirin pills break down into vinegar and salicylic acid that can irritate the stomach. Always store medicine out of reach and out of sight of patients in a medical facility, especially children. Medicine that has changed color, texture or smell should not be used. Do not administer pills that stick together, are harder or softer than normal, or are cracked or chipped.
The Secure and Responsible Drug Disposal Act of 2010 was made public by the U.S. Drug Enforcement Administration (DEA) as the final rule regarding the disposal of pharmaceutical controlled substances in accordance with the Controlled Substance Act. A small number of medicines taken by someone other than the person for whom they are prescribed can be especially harmful. It is recommended that all unused medicine is sent to an authorized collector and disposer. The U.S. Drug Enforcement Administration (DEA) hosts National Prescription Drug Take Back events. Local law enforcement agencies or your local police station may have a collection sight for unused medicine. Long-term care facilities may also be a good option to dispose of unused medicine or any other DEA-authorized collector.
Ready to pass on the knowledge of pharmacology? Interested in becoming a medical assistant? The Medical Assisting program at Daymar College is designed to prepare current and future employees for the fast-paced changes encountered in the health care industry, and to help develop training, skills and attitudes necessary to excel in medical assisting. Contact us to learn more about a great opportunity to become a medical assistant.