PHARMACOLOGY DEMYSTIFIED
PHARMACOLOGY DEMYSTIFIED
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PHARMACOLOGY DEMYSTIFIEDMARY KAMIENSKI,PhD, RN, FAEN, FNP, CENJIM KEOGHMcGRAW-HILLNew York Chicago San Francisco Lisbon LondonMadrid Mexico City Milan New Delhi San JuanSeoul Singapore Sydney Toronto
Copyright 2006 by The McGraw-Hill Companies, Inc. All rights reserved. Manufactured in the United States ofAmerica. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher.0-07-148344-6The material in this eBook also appears in the print version of this title: 0-07-146208-2.All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of atrademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intentionof infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps.McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use incorporate training programs. For more information, please contact George Hoare, Special Sales, at george hoare@mcgrawhill.com or (212) 904-4069.TERMS OF USEThis is a copyrighted work and The McGraw-Hill Companies, Inc. (“McGraw-Hill”) and its licensors reserve all rights inand to the work. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and theright to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify,create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of itwithout McGraw-Hill’s prior consent. You may use the work for your own noncommercial and personal use; any other useof the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms.THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROMUSING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIAHYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED,INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR APARTICULAR PURPOSE. McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in thework will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill nor itslicensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or forany damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed throughthe work. Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special,punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them hasbeen advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoeverwhether such claim or cause arises in contract, tort or otherwise.DOI: 10.1036/0071462082
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For more information about this title, click hereCONTENTSIntroductionxiiiCHAPTER 1An Inside Look at PharmacologyWhat Is Pharmacology?The Source of DrugsDrugs NamesPrescription versus Over-the-Counter DrugsDrug EffectsDrug SafetyLocating Drug InformationDrug OrdersThe “Five Rights” Way of Drug AdministrationSummaryQuiz12467781112162021CHAPTER 2Drug Action and Drug InteractionsDrug ActionsThe First Pass EffectPharmacodynamicsCategories of Drug ActionTherapeutic Index and Therapeutic RangeSide EffectsSummaryQuiz232433333535363839v
viCONTENTSCHAPTER 3CHAPTER 4CHAPTER 5Pharmacology and the Nursing ProcessThe Nursing ProcessNursing DiagnosisPatient Care PlanTeaching the Patient About DrugsImpact of Cultural Influences inDrug AdministrationMother and the ce AbuseDrug Misuse and AbuseBehavioral Patterns of AddictionHealthcare Professionals andSubstance AbuseDetecting Substance AbuseDelayed ActionSubstances That Can Be AbusedDependence versus TolerancePathophysiologic Changes Occurring inSubstance AbuseCultural Aspects of Substance AbuseCommonly Abused SubstancesNursing AssessmentSummaryQuiz616163Principles of Medication AdministrationThe Nursing Process andMedication 82
viiCONTENTSAssessment Required for Specific DrugsAdministering MedicationEvaluating the Patient AfterAdministering MedicationControlling NarcoticsSummaryQuiz848792939494CHAPTER 6Route of AdministrationMedication and RoutesZ-Track Injection TechniqueTips for Minimizing PainSummaryQuiz9797107109110111CHAPTER 7Dose CalculationsThe Metric System and MedicationConverting Metric UnitsFormulas for Calculating the Desired DoseParenteral MedicationsSummaryQuiz113113116117119121122CHAPTER 8Herbal TherapyInside Herbal TherapyForms of Herbal TherapiesHazards of Herbal TherapeuticsHerbals Therapy and the Nursing ProcessThe Do’s and Don’ts about HerbsCommonly Used HerbsSummaryQuiz125125127128129130131135135
viiiCONTENTSCHAPTER 9Vitamins and MineralsVitaminsVitamins and the Nursing ProcessSummaryQuiz137137148154154CHAPTER 10Fluid and Electrolyte TherapyBody FluidsElectrolytesFluid ConcentrationIV FluidsBlood and Blood ProductsFluid HAPTER 11Nutritional Support TherapiesNutritionNursing ProcessThe Nursing Processing andParenteral Nutritional TherapySummaryQuiz183183189CHAPTER 12InflammationAn Inside Look at InflammationCombating InflammationSummaryQuiz197197199201201CHAPTER 13Antimicrobials—Fighting InfectionMicroorganisms—A Small FormidableOpponentMedication—A Formidable Defender203192193194204204
ixCONTENTSSuperinfectionsPreparing to AdministerAntimicrobial MedicationPenicillin, Nursing Diagnosis,and Collaborative ProblemsPenicillin and Patient EducationCephalosporins, Nursing Diagnosis,and Collaborative ProblemsMacrolides and Drug-Drug InteractionsMacrolides, Nursing Diagnosis,and Collaborative ProblemsClindamycins and Drug-Drug InteractionsLincosamides, Nursing Diagnosis,and Collaborative ProblemsVancomycin and Drug-Drug InteractionsVancomycin, Nursing Diagnosis,and Collaborative ProblemsAminoglycosides andDrug-Drug InteractionsAminoglycosides, Nursing Diagnosis,and Collaborative ProblemsTetracyclines and Drug-Drug InteractionsTetracyclines, Nursing Diagnosis,and Collaborative ProblemsChloramphenicol andDrug-Drug InteractionsChloramphenicol Nursing Diagnosis,and Collaborative ProblemsFluoroquinolones andDrug-Drug InteractionsFluoroquinolones, Nursing Diagnosis,and Collaborative 228229230233234236236238238241
xCONTENTSTuberculosisAntifungal Drugs (Antimycotic 248250251CHAPTER 14Respiratory DiseasesA Brief Look at RespirationUpper Respiratory Tract DisordersLower Respiratory DisordersSummaryQuiz253253256261266267CHAPTER 15Nervous System DrugsA Brief Look at the Nervous SystemCentral Nervous System StimulantsCNS DepressantsAutonomic Nervous -Anticholinergic Quiz269269271273281287287288295296297301302CHAPTER 16Narcotic AgonistsA Close Look at PainInfluences on AdministratingPain MedicationComponents of PainThe Gate Control Theory305305306307307
xiCONTENTSDefining PainPain AssessmentPharmacologic Management of PainSummaryQuiz307308309311312CHAPTER 17Immunologic AgentsA Brief Look at ImmunityVaccinesPreventing DiseasesSummaryQuiz315315321322325326CHAPTER 18Gastrointestinal SystemA Brief Look at the Gastrointestinal SystemSummaryQuiz329329344345CHAPTER 19Cardiac Circulatory MedicationsA Brief Look at the Cardiovascular SystemCirculatory DisordersSummaryQuiz347347364369370CHAPTER 20Skin DisordersA Brief Look at the SkinSkin DisordersSummaryQuiz373373374382383CHAPTER 21Endocrine MedicationsA Brief Look at the Endocrine SystemDrugs and HormonesSummaryQuiz385385386396397
xiiCONTENTSCHAPTER 22Disorders of the Eye and EarEye DisordersPatient Education for Eye MedicationEar DisordersPatient Education for Ear MedicationSummaryQuiz399399403405408408409Final Exam411Answers to Quiz and Final Exam Questions 425Appendix431Index437
INTRODUCTIONOne of the most important roles of the nurse is to administer medications.Understanding how a drug interacts with the human body will help a nurseadminister drugs safely to patients.Pharmacology Demystified shows you: How drugs workHow to calculate the proper doseHow to administer drugsHow to evaluate the drug’s effectivenessHow to avoid common errors when administering drugsAnd much more.You might be a little apprehensive learning pharmacology, especially if youhave little, if any, experience with drugs. Pharmacology can be mystifying.However, it becomes demystified as you read Pharmacology Demystifiedbecause your knowledge of basic science is used as the foundation for learning pharmacology.As you’ll see in Chapter 1, each element of pharmacology is introduced bycombining just the pharmacology element with facts you already know fromyour study of basic science.Pharmacology is different than other basic science that you’ve learned—butnot so different that you won’t be able to quickly build upon your presentknowledge base. All you need is a working knowledge of basic science—andPharmacology Demystified—to become knowledgeable in pharmacology.By the end of this book, you’ll have an understanding of drugs that are usedto cure common disorders. You’ll know how they work, their side effects, adverseeffects, and when they are not to be administered to patients. Furthermore,you’ll learn how long it takes the drug to take effect and how long the therapeutic effect lasts.xiiiCopyright 2006 by The McGraw-Hill Companies, Inc. Click here for terms of use.
xivINTRODUCTIONA Look InsidePharmacology can be challenging to learn unless you follow the step-by-stepapproach that is used in Pharmacology Demystified. Topics are presented in asystematic order—starting with basic components and then gradually moving onto those features found on classy web sites.Each chapter follows a time-tested formula that first explains the topic in aneasy-to-read style and then shows how it is used in a working web page that youcan copy and load yourself. You can then compare your web page with the imageof the web page shown in the chapter to be sure that you’ve coded the web pagecorrectly. There is little room for you to go wrong.CHAPTER 1: AN INSIDE LOOK AT PHARMACOLOGYThe mere mention of drugs brings all sorts of images to mind. However, theseimpressions are based on our experience as patients. Healthcare providers havea different view because they see drugs as an arsenal to combat disease. A drugis more than a pill. It is a compound of chemical elements that interacts with thebody’s chemistry causing a chain reaction of events. Healthcare providers needa thorough understanding of a drug’s action in order to effectively prescribe andadminister the drug to the patient. Therefore you begin in Chapter 1 learning thebasic concepts of pharmacology.CHAPTER 2: DRUG ACTION AND DRUG INTERACTIONSDrugs are not magical. They follow proven scientific principles to interact withcells in your body to bring about a pharmaceutical response—cure your ills. Inthis chapter you’ll learn about the scientific principles that seem to miraculouslymake you better when you feel rotten all over. You will learn how drugs stimulate your body’s own defense mechanism to stamp out pathogens that give youthe sniffles or cause serious diseases.CHAPTER 3: PHARMACOLOGY ANDTHE NURSING PROCESSRemember from your last hospital stay being awakened from a deep sleep bya nurse saying, “time to take your medicine.” The nurse didn’t enjoy disturbing
INTRODUCTIONyou. It was part of standard nursing procedures used to administer medication.You’ll learn about those procedures in this chapter so you too can wake up yourpatients to give them medication.CHAPTER 4: SUBSTANCE ABUSEDrugs can wipe out microorganisms that attack our body. However, some drugscan be abused resulting in an individual becoming dependent on the medication. Substance abuse is the most publicized aspect of pharmacology—and theone least understood by patients and healthcare professionals. This chapterexplores drugs that are commonly abused and discusses how to detect substance abuse.CHAPTER 5: PRINCIPLES OF MEDICATIONADMINISTRATIONAdministering medication can be downright dangerous unless you follow timetested procedures that assure that the patient receives the right drug in the rightdose at the right time using the right route. In this chapter, you’ll learn how thisis done and how to avoid common errors that could harm your patient.CHAPTER 6: ROUTE OF ADMINISTRATIONThe way a drug is administered to a patient is called a route. Your job is toadminister medication using the best route to achieve the desired therapeuticeffect. This depends on a number of factors that include the type of medicationand the patient’s condition. In this chapter, you’ll learn how to administer drugs.CHAPTER 7: DOSE CALCULATIONSAlthough a prescriber specifies a dose of a medication for a patient, a differentdose may be on hand requiring you to calculate the actual dose. With intravenousmedication, the prescriber usually orders a dose to be infused over a specificperiod of time. You must calculate the drip rate to properly set the IV. This chapter shows you how to calculate doses of medication.xv
xviINTRODUCTIONCHAPTER 8: HERBAL THERAPYHerbal therapy is used to treat the common cold, infections, diseases of theGI tract, and about anything else that ails you. Herbs are naturally grown anddon’t have the quality standards found in prescription and over-the-countermedications. You’ll learn about the therapeutic effect of herbal therapies in thischapter and the adverse reactions patients can experience when herbal therapy iscombined with conventional therapy.CHAPTER 9: VITAMINS AND MINERALSVitamins and minerals build a strong, healthy body, so you’ve been told whenyou were growing up. It is true. A balanced diet provides the vitamins and minerals you need to stay healthy. However, many patients don’t have a balanceddiet and therefore experience vitamin and mineral deficiencies. In this chapter,you’ll learn about vitamins and minerals and how to provide vitamin therapy andmineral therapy for your patients.CHAPTER 10: FLUID AND ELECTROLYTE THERAPYSome diseases and treatment of disease can cause an imbalance in the body’sfluids and electrolytes needed for muscle contraction and other functions.Administering electrolyte therapy to the patient restores balance. You’ll learnhow this is done.CHAPTER 11: NUTRITIONAL SUPPORT THERAPIESNutrients are given to patients who are at risk for malnutrition caused by diseaseand by treatment given to cure the disease. Nutrients are also given to strengthenthe patient following a trauma such as surgery. In this chapter, you’ll learn aboutnutritional support therapies, how to prepare them, how to administer them, andhow to avoid any complications that might arise.CHAPTER 12: INFLAMMATIONFortunately, most times the pain goes away and the inflammation subsidesrelatively quickly and doesn’t interfere with daily activities. In this chapter,
INTRODUCTIONyou’ll learn about the process of inflammation and the medications that areprescribed to reduce the redness, swelling, warmth, and pain that is associatedwith inflammation.CHAPTER 13: ANTIMICROBIALS—FIGHTING INFECTIONThe immune system produces antibodies that seek out, attack, and kill microbials. However, this natural defense isn’t sufficient for some patients leavingthem with a runny nose, headache, and fever. They need to call in the cavalry.The cavalry is medication that kills the invading microbial. You’ll learn aboutantimicrobial medication in this chapter.CHAPTER 14: RESPIRATORY DISEASESThe common cold can be annoying. However, some respiratory diseases—suchas emphysema—are debilitating and can slowly choke the life out of a person.In this chapter, we’ll explore common respiratory diseases and learn about themedications that are used to manage the symptoms of the disease.CHAPTER 15: NERVOUS SYSTEM DRUGSThe nervous system is our Internet over which sensory impulses travel theneural pathways to the brain where they are interpreted and analyzed foran appropriate response. Sometimes disease or other disorders cause theimpulse to go astray or be misinterpreted. Drugs can be prescribed that restore the function of the nervous system. You’ll learn about those drugs inthis chapter.CHAPTER 16: NARCOTIC AGONISTSMake the pain go away. That’s what most of us want when we hurt. However,pain is subjective and can be difficult for healthcare providers to manage withthe appropriate medication. This chapter explores pain and how healthcareproviders assess and manage pain. You’ll also learn about narcotic and nonnarcotic analgesics and how they are used to treat pain.xvii
xviiiINTRODUCTIONCHAPTER 17: IMMUNOLOGIC AGENTSWhen the immune system is compromised through diseases including HIV, thebody loses its ability to fight off microorganisms and destroys its own abnormalcells, leaving the patient to experience more episodes of infection that canultimately lead to death. In this chapter, you’ll learn about the therapies used toassist the immune system combat preventable diseases and you’ll also learnabout medications that inhibit the growth of HIV.CHAPTER 18: GASTROINTESTINAL SYSTEMProblems with the gastrointestinal system can be vomiting, ingesting toxins,diarrhea, constipation, peptic ulcers, and gastroesophageal reflux disease. Eachis treatable with the proper medication. In this chapter, you’ll learn about common gastrointestinal disorders and the medications that are frequently prescribedto treat these conditions.CHAPTER 19: CARDIAC CIRCULATORY MEDICATIONSWhen blood vessels become clogged and the heart is unable to pump blood sufficiently, the body loses its ability to distribute oxygen, nutrients, and hormonesand remove waste products placing the patient in grave danger. Fortunately,there are medications that can be taken to treat and prevent cardiovascular disorders. In this chapter, you’ll learn about drugs that affect the heart and keep thecardiovascular system humming.CHAPTER 20: SKIN DISORDERSAcne, dry skin, a rash, and injuries such as cuts, scrapes, puncture wounds, andburns are some disorders that affect your skin. Some of these are more annoyingthan endangering to your existence. This chapter discusses using medications torelieve most of the disorders.CHAPTER 21: ENDOCRINE MEDICATIONSHormones are messengers that influence how tissues, organs, and other parts ofyour body function. An overproduction or underproduction of hormones can
INTRODUCTIONcause the body to function improperly. Hormones are brought back into balanceby using endocrine medications, which are discussed in this chapter.CHAPTER 22: DISORDERS OF THE EYE AND EARCommon eye and ear disorders rarely result in loss of sight and hearing once thedisorder is diagnosed and treated with the proper medication. This chapter takesa look at common disorders that affect the eyes and the ears and discusses drugsthat are used to treat those disorders.xix
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PHARMACOLOGY DEMYSTIFIED
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CHAPTER1An Inside Lookat PharmacologyJust the mention of drugs causes all sorts of images to run through our mind: themagic pill that made you feel better when you were under the weather; the stinging injection that left your arm sore for days; the handful of capsules that cost amonth’s pay; and even the vision of furtive street-corner exchanges.These impressions are from our experiences as patients or consumers.Healthcare providers, however, view drugs differently because drugs are anintegral component of the arsenal used to combat the diseases and physiologicalchanges that disrupt activities of daily living.A drug is more than a pill. It is a compound of chemical elements that interacts with the body’s chemistry causing a chain reaction of events. Drugs aregiven to achieve a therapeutic effect. However, most drugs also have sideeffects. Some side affects are desirable and some are not. Healthcareproviders must have a thorough understanding of a drug’s action in order toeffectively prescribe and administer the drug and evaluate the patient’sresponse to the medication.Throughout this book you’ll learn about drugs: how they work; their therapeutic effects; their adverse effects; their interactions with other drugs; how they1Copyright 2006 by The McGraw-Hill Companies, Inc. Click here for terms of use.
2CHAPTER 1 An Inside Look at Pharmacologyare prescribed; and how they are administered. However, before learning thesedetails, let’s begin in this chapter with the basic concepts of pharmacology.What Is Pharmacology?Pharmacology is the study of chemicals—drugs—on living tissues and how thosechemicals help diagnose, treat, cure, and prevent disease or correct the pathophysiology of living tissues. The term pharmacology is derived from twoGreek words: pharmakon, the Greek word for drugs, and logos, the Greek wordfor science.Pharmacology has its roots in folklore and tradition that dates back to ancienttimes when knowledge of the medicinal effects of plants were passed downthrough generations. By 1240 AD, pharmacology moved from the realm of homeremedies to a science where drug standards were established and a measuringsystem was developed—called the apothecary system—that was used to measure quantities of drugs. Because drugs can vary in strength and purity, pharmacological standards have been developed that govern the manufacturing andcontrol of drugs. The United States Pharmacopeia National Formulary is theonly official book of drug standards in the United States. If a drug is included inthis book it has met the standards of quality, purity, and strength. These drugscan use the letters U.S.P. following the official name of the drug. Accuratedosage and the reliability of the effect the drug will have on a patient is dependent upon the purity and strength of the drug. Purity is the dilution or mixture ofa drug with other materials to give it a form that can be administered. Drugs mayvary in the strength of their action. The strength of drugs from plants candepend on where the plant is grown, the age at which the plant is harvested, andhow the harvest is preserved. Drug packaging standards determine what information needs to be displayed on packages of drugs. You’ll learn more aboutthese later in this book.In addition to these standards, there are a number of important laws that havebeen enacted to control the sale and distribution of drugs.1938 FOOD, DRUG AND COSMETIC ACTBefore 1938 there was no control over pharmaceuticals. This changed when adrug company distributed a sulfa drug to treat pediatric patients. The drugsturned out to be a chemical similar to antifreeze. It was highly toxic and killedmore than 100 people, including children.
CHAPTER 1 An Inside Look at PharmacologyAt the urging of the public, the United States Congress passed the 1938 Food,Drug and Cosmetic Act. This act required: Drugs must be proven save for use before they can be sold.Inspections of drug manufacturing facilities.Safe tolerance levels be identified to prevent the patient from being poisoned.Cosmetics and therapeutic devices be controlled.1952 DURHAM-HUMPHREY AMENDMENTTO THE FOOD, DRUG AND COSMETIC ACTUntil 1952, anyone could distribute drugs. With the passage of the DurhamHumphrey amendment to the Food, Drug and Cosmetic Act of 1938, a group ofdrugs was defined that could only be purchased if the patient had a prescriptionfrom a licensed practitioner.1962 KEFAUVER-HARRIS AMENDMENTTO THE FOOD, DRUG AND COSMETIC ACTThe Food, Drug and Cosmetic Act of 1938 was amended once more in 1962 withthe passage of the Kefauver-Harris Amendment. This amendment tightened controls on drug safety by requiring drug manufacturers to use standard labelingof drug containers. The label lists adverse reactions and contraindications orreasons why the drug should not be used.1970 COMPREHENSIVE DRUG ABUSEPREVENT AND CONTROL ACTBy 1970, there was widespread abuse of prescription drugs. In an effort to contain this problem, Congress passed the Comprehensive Drug Abuse Prevent andControl Act. This act categorized controlled substances according to a schedulebased on potential for abuse. Schedule I is reserved for the most dangerous substances that have no recognized medicinal use. Schedule II drugs have high abuse potential with accepted medicinal use. Schedule III drugs have high abuse potential with accepted medicinal uses. Schedule IV and V drugs have lower abuse potential with accepted medicinal uses.3
4CHAPTER 1 An Inside Look at PharmacologyThe Source of DrugsAsk a child where milk comes from and you might be surprised by his answerthat it comes from the grocery store. The same might be true if you ask an adultwhere drugs come from and he answers from the drug store. Both are correctanswers, but neither identifies the true source.Drugs can be purchased from a drug store, but the origins are from one offour sources.PLANTSA number of plants have medicinal qualities and have been used for centuries asnatural remedies for injuries and illnesses. Pharmaceutical firms harvest theseplants and transform them into drugs that have a specific purity and strengthsufficient to treat diseases.An example of a drug that comes from a plant is digitalis. Digitalis is madefrom leaves of the foxglove plant and is used to treat congestive heart failureand cardiac arrhythmias. Digitalis also strengthens the force of the contractionsof the heart.ANIMALSByproducts of animals, including humans, are a source for drugs because theycontain hormones that can be reclaimed and given to patients who need increasedhormonal levels to maintain homeostasis.For example, Premarin is a drug that contains estrogen that is recovered frommare urine. This is used as hormonal therapy to manage menopausal symptoms.Insulin is another hormonal drug that is used to regulate blood sugar levels inpatients with diabetes mellitus. Insulin can be recovered from humans usingDNA technology.MINERALSOur body requires trace elements of minerals in order to maintain homeostasis.Minerals are inorganic crystal substances that are found naturally on earth.Patients lacking an adequate level of these materials may take specific mineralbased drugs to raise the level of minerals.
CHAPTER 1 An Inside Look at PharmacologyFor example, an iron supplement is a common mineral-based drug that isgiven to patients who suffer iron deficiency, a condition which can lead tofatigue. Iron is a natural metal that is an integral part of body proteins such ashemoglobin that carries oxygen throughout the body. Minerals are obtained fromanimal and plant sources.SYNTHETIC/CHEMICAL DERIVATIVESGreat strides in molecular biology and biochemistry enable scientists to createmanmade drugs referred to as synthetic drugs. A synthetic drug is producedusing chemical synthesis, which rearranges chemical derivatives to form anew compound.Sulfonamides are a common group of synthesized drugs that are used to treatmany infections including bronchitis, pneumonia, and meningitis. Sulfonamidesare designed to prevent the growth of bacteria.HERBALSHerbals are non-woody plants. Some have medicinal qualities classified as adietary supplement—not a drug. Unlike drugs that are governed by the Food andDrug Administration, dietary supplements are not tested or regulated and can besold over-the-counter without a prescription. This lack of monitoring meansthere are no standards for purity and strength for herbals. Two packages of thesame herbal distributed by the same company might have different purity andstrength that makes the effect o
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Genes and DNA Methylation associated with Prenatal Protein Undernutrition by Albumen Removal in an avian model . the main source of protein for the developing embryo8, the net effect is prenatal protein undernutrition. Thus, in the chicken only strictly nutritional effects are involved, in contrast to mammalian models where maternal effects (e.g. hormonal effects) are implicated. Indeed, in .
