1. & the certified athletic trainer
Pharmacology
& the certified athletic trainer

2. ATC and Drugs
Study findings
Health advisor
Watch dog for abuse

3. Terms Drug vs Medicine Pharmacology Dosing Potency Pharmacokinetics
Pharmacodynamics
Dosing
Standard
Pediatric
Loading
Potency

4. Pharmacology Pharmacotherapeutics Toxicology Pharmacokinetics
Pharmacodynamics
Drug Absorption / Distribution
Drug Metabolism / Excretion
Cellular Effects
Systemic Effects

5. Routes of Administration
Enteral vs Parenteral
Systemic Effects
Oral (Ingestion) – liquid, tablets, capsules
Pros and Cons
Enteric coated pills
Sustained release tablets/capsules
Injection (Parenteral) – subcutaneous, intravenous, intramuscular
Other – intranasal, inhalation, sublingual, buccal, rectal, transdermal

6. Routes of Administration
Local Effects
Topical – applied to the skin to treat skin conditions
Otic
Opthalmic

7. Pharmacokinetics
Refers to movement of drugs across body membranes to reach the target organ
4 phases (ADME)
Absorption
Distribution
Metabolism
Elimination

8. Pharmacokinetics (phase 1)
Absorption
from GI tract to bloodstream – ingestion
All other methods go directly into blood
Some drug binds to blood protein, some free floating
Bioavailability – amount of drug available to use following digestion
Exercise’s effect on Absorption
Rate of dissolution
Surface Area
Lipid solubility

9. Pharmacokinetics (phase 2)
Distribution – movement from circulation into tissues
Delivered to target areas
Exercise increases distribution
Affected by poor circulation
How does a drug exert it’s effect?
Lipid solubility of drug
Receptor
Physical or Chemical means

10. Drug Actions
Activation (Stimulation) – increase the rate of functional activity
Inactivation (Depression) – decrease the rate of functional activity
Blocking – prevents an action or response
Inhibition – changes cell functioning
Substitutive (Replacement) – substitute an equivalent substance to restore optimal condition
Curative – destruction or prevention of growth
Irritation – abnormal excitation of function

11. Drugs in the Body Example Site of action (Target organ) - Neuron
Synapses – space between axon and dendrites
In central and peripheral nervous system
Dendrite – receive impulse from adjacent neuron
Cell body – processes incoming information; formulate action potential
Axon – transmits action potential
Neurotransmitter – protein chemical messenger that carries an AP across synapse

12. Site of Action Effects on Synapses – either excitatory or inhibitory
Receptors – protein molecules on a cell membrane that can interact with drugs

13. Dendrite
Axon
Neurotransmitter

14. Dendrite
Axon

15. Dendrite
Axon
Drug binds to presynaptic receptor

16. Dendrite
Axon
Drug binds to postsynaptic receptor

17. Dendrite
Axon
Drug mimics neurotransmitter

18. Dendrite
Axon
Drug destroys enzyme that should destroy neurotransmitter

19. Agonist +

20. Agonist -

21. Antagonist

22. Factors Affecting Drug Actions
Age – infants and elderly more sensitive
Gender – affects women differently
Hormones, % body fat, less H2O
Mindset –
Dosage –
Potency –
Purity –
Tolerance –

23. Pharmacokinetics
Metabolism (phase 3) – clearing of drugs from the body
Liver
“First pass effect”
Makes drug inactivative
Exercise slows metabolism
Liver illness slows metabolism – causes a buildup of unmetabolized drug
Excretion (phase 4) – removal of drug from the body
Exercise slows excretion
Kidney illness slows excretion

24. Example of Pharmacokinetic Process (Aspirin)
Orally administered
Absorbed in Stomach and SI
80-90% binds to protein, so 10-20% exits blood and has therapeutic effect
Compared with 20-50% binding w/ Tylenol
Metabolism begins in blood and ends in liver – changes to salicylic acid
Excreted by kidney

25. Pharmacokinectic Terms
Half-life
Duration of Action
MEC
Toxic Concentration
Therapeutic Range
Maximal Efficacy

26. Drug Interactions Definition Depends on many factors…..
2 Types of Interactions
Pharmacokinetic Interactions
Pharmacodynamic Interactions
Additive Effect 2+2=4
Synergistic Effect 2+3=5
Antagonistic Effect 2+2=1

27. Drug Interactions (con’t)
Alcohol and Foods
Preventive Methods
Label
Computerized record keeping
Adverse Drug Reactions (ADR)
Allergies
Negative side effects
Minor or severe
Local or systemic
Seek Tx and requires discontinuation of drug

28. Guidelines for ATC’s Read label for appropriate dosage
Consider possible interactions
Recognize adverse reactions and act quickly
IV and those absorbed thru thin most mucus membrane take effect quicker than oral administration
Drug effects are maximal at peak concentration level, but ADME can all be affected by a variety of factors
Be aware of all meds an athlete is taking