Pharmacology

introduction
What is Pharmacology?
Integrated medical science involving
chemistry, biochemistry, anatomy,
physiology, microbiology, and more
Study of drugs, their actions, dosage,
therapeutic uses, adverse effects
Drug therapy is directly linked to the
pathophysiology of a particular disease.
PHARMACOLOGY
(Greek “Pharmacon” – drug, “logos” - teaching)
The science that studies the interaction of the chemical substances with
live organisms, drugs administration for treatment and prophylaxis of
various diseases and pathological processes
 Introduction
Living
Organism

DRUG Physiology

AC O L O GY
ARM
PHPharmacolo
Biochemistry gy
History
Historical Trends Since the beginning people search to treat illness and
cure disease the oldest known prescription found on a clay( 5000 years
ago).
Primitive people through the Egyptian period believe that evil spirit
living in the body.
Hipocrates ( fifth century) advanced idea that disease resulted from
natural causes.
The arabs’ interest of in medicine, pharmacy and chimistry was
reflected in hospitals and schools.
Historical trends
Historical Trends In twenty first century, the emphasis on providing
quality health care.
What is a drug?
A substance that alters
biologic activity
.

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 As per WHO Scientific group
“Any Substance or product that is used and intended to be used to
modify or explore the physiological system or pathological state
for the benefit of the recipient “
Why are drugs
prescribed?
Promote healing
◦ Anti-inflammatory
Cure disease
◦ Antibacterial
Control or slow progress of a disease
◦ Cancer chemotherapy
Prevent disease
◦ Vaccine
Drugs (Cont.)
Decrease risk of complications
◦ Anticoagulants
Increase function and comfort
◦ Analgesics for pain
Provide replacement therapy
◦ Insulin
Reduce excessive activity in the body
◦ Proton pump inhibitors
Sub divisions of
Pharmacology
Terminology Pharmacology:
is a science that studies the effect of the drugs on the body.
Pharmacopeias: are the total of all authorized drugs available within
the country.
Medication: is a substance administered for diagnosis, cure,
treatment, mitigation or prevention.
Prescription: the written direction for the preparation and the
administration of the drug.
Terminology Cont …..
The therapeutic effect: is the primary effect intended that is the
reason the drug is prescribed such as morphine sulfate is analgesia.
Side effect: secondary effect of the drug is one that unintended, side
effects are usually predictable and may be either harmless.
Drug toxicity: harmful effect of the drug on an organism or tissue,
result from overdose or external use.
Drug allergy: is immunological reaction to a drug.
Terminology Cont ….
Drug interaction: occur when administration of one drug before or
after alter effect of one or both drug.
Drug misuse: Is the improper use of common medications in way that
lead to acute and chronic toxicity for example laxative, antacid and
vitamins.
Drug abuse: is an inappropriate intake of substance either continually
or periodically.
Drug dependence: is a persons reliance on or need to take drug or
substance there are two type of dependence:
Terminology Cont …..
Physiological dependence: is due to biochemical changes in the body
tissue these tissue come to require substance for normal function.
Psychological dependence: is emotional reliance on a drug to
maintain a since of wellbeing accompanied feeling of need.
Terminology Cont …..
Drug habituation: denotes a mild form of psychological dependence.
Illicit drug: also called street drug are those sold illegally.
Dose :The aim to give patient a dose of the drug that achieves the
desired effect with out causing with harmful side effect.
Therapeutic index: is a measure of the danger of poisoning and the
higher it is safer of drug is. Aspirin (3.5), digoxin (2).
Bioavailability: Means that the drug has reached the circulation and is
therefore available for all the tissues. (ex: aspirin 600 mg).
Tolerance: A decreasing response to repetitive drug doses.
 Drug categories
Prescription drugs
Are used under only medical supervision
and dispensed by an order of medical
practitioner only

OTC drugs
Can be sold over the counter without
prescription
Drug Nomenclature and
Classification (know
these)
Each drug has a generic name, a trade name, and a chemical name
Generic name: unique, official, simple name for a specific drug
◦ For example, acetaminophen

Trade, proprietary, or brand name

◦ For example, Tylenol

Chemical name: chemical component

◦ For example, N-(4-hydroxyphenyl) acetamide
Examples of Drug
Nomenclature
 DRUG NOMENCLATURE
A drug generally has three categories of names:

(a)Chemical name
 It describes the substance chemically, e.g. 1-(Isopropylamino )-3-(1-
naphthyloxy) propan-2 –ol for propranolol.

(b) Non-proprietary / official name / Approved name

 Name in the official books accepted all over the world

(c)Proprietary (Brand) name

 Crocin for Paracetamol
Essential medicines
Essential medicines, as defined by the WHO are "those drugs that
satisfy the health care needs of the majority of the population; they
should therefore be available at all times in adequate amounts and in
appropriate dosage forms, at a price the community can afford."
 Orphan Drugs
These are drugs or biological products for diagnosis/treatment/ prevention of a
rare disease or condition, or a more common disease (endemic only in resource
poor countries) for which there is no reasonable expectation that the cost of
developing and marketing it will be recovered from the sales of that drug.

e.g. sodium nitrite, fomepizole, liposomal amphotericin B,, rifabutin,, somatropin,

digoxin immune Fab (digoxin antibody), liothyronine (T3) and many more.

Governments in developed countries offer tax benefits and other incentives to

pharmaceutical companies for developing and marketing orphan drugs (e.g.
Orphan Drug Act in USA).
Pharmacopoeias Formulary
British pharmacopoeias Pharmaceutical codex(by pharmaceutical
Society of Great Britain )
United states Pharmacopoeias National Formulary (by American
Pharmaceutical Association)
Indian Pharmacopoeias National Formulary of India
Drugs are classified by
Effects
Classification
◦ Grouped by their primary pharmacologic
action/effect
◦ Drug Classifications
Therapeutic (desired) action may be:
◦ Stimulating or inhibiting cell function
◦ Such as: producing or blocking biochemical
actions in tissues
 Drug Effects (Cont.)
Generally, drugs possess more than one effect on the body.

Indications :Approved for uses to treat

conditions for which the drug has been proved
to be effective
Off-label: uses for which the drug has
shown effectiveness but is not the
approved use.
Contraindications
◦ Circumstances under which a drug should not
be administered
 Drug Effects (Cont.)
Generally, drugs possess more than one effect on the body.

Side effects
◦ Mild, undesirable effects of a drug, even at
recommended dose
Adverse or toxic effects
◦ Drug effects that are dangerous, cause
significant tissue damage, or are life-
threatening
Specific Adverse Drug
Effects
Hypersensitivity―allergic reactions
◦ Reactions may be mild or can result in anaphylaxis.

Idiosyncratic (paradoxic) reactions

◦ Unusual responses to a drug

Iatrogenic
◦ Negative effect associated with administration of drug

Teratogenic
◦ Harmful effect on fetus, developmental defects
Specific Adverse Drug
Effects (Cont.)
Interactions: drug effect modified by combination with another drug
◦ Synergism
◦ Effect of drug combination may be greater than the sum of the effects of the individual drugs.
◦ Antagonism
◦ Combination greatly decreases the effect of each drug.
◦ Potentiation
◦ One drug enhances the effect of a second drug.
 Administration and
Distribution
of Drugs
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Drugs can be administered for acting locally or have a systemic action.
General Information:
Drug enters body by chosen route
Absorbed into blood or acts at local site
Travels in the bloodstream
Arrives at site of action
Exerts its effect
Is metabolized into inactive compounds
Is excreted from the body
 Administration and
Distribution of Drugs
Dose
◦ Amount of drug required to produce the desired effect in adult
◦ Expressed by a weight or measure (mcg, mg, etc.) – often show as ratio of
dose/weight (mg/kg)
◦ Expressed by time factor (e.g., twice a day)

Child’s dose
◦ Best calculated by child’s weight, not age – WHY?

“Loading dose”
◦ Larger dose may be administered initially to raise blood levels to an effective level
◦ Not applicable to all medications – can be dangerous
Administration and
Distribution of Drugs
(Cont.)
Frequency of dosing
◦ Important to maintain effective blood levels of the drug without reaching
toxic levels
◦ Optimum dosing schedule
◦ Established for each drug based on
◦ Absorption, transport in the blood, half-life of the drug
◦ Timing
◦ Directions regarding
◦ Timing related to meals
◦ Daily events
◦ Sleep
Factors Affecting Blood
Levels of Drugs
Regular intake, normal distribution and excretion
Factors Affecting Blood
Levels of Drugs (Cont.)
Factors: taking drug at irregular intervals, missing doses
Factors Affecting Blood
Levels of Drugs (Cont.)
Factors: taking double dose or too frequently
Other Factors Influencing
Blood Levels of a Drug
Liver and kidney function
Absorption and excretion

Circulation and cardiovascular function

Age
Body weight and proportion of fatty tissue
Activity level, exercise
Food and fluid intake
Genetic factors
Health status, presence of other diseases, chronic or acute
Routes,
characteristics
, time to onset
& drug loss

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Routes of Drug
Adminstration
Enteral: (change the oral term in your notes)
◦ involving or passing through the intestine, either naturally via the mouth
and esophagus, or through an artificial opening

Parenteral:
◦ Taken into the body or administered in a manner
other than through the digestive tract

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Write this onto NB
paper

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ENTERAL

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Routes of Drug
Administration

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First pass effect
Refers to the metabolism of the drug in the gut (intestinal areas) or in
the liver BEFORE it reaches the systemic circulation.
Reduces bioavailability of the drug.
First Pass Effect

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 Impact of Support
 Patient compliance:
 the degree to which a patient correctly follows
medical advice

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Prescriptions
Prescription―a signed legal document that must include the following:
Write this onto NB paper
◦ Patient’s name, address, and age (if significant)
◦ Prescriber’s name, address, and identification number
◦ Date
◦ Name and amount of the drug
◦ Dosage
◦ Route and directions for using the drug
◦ Permission for additional quantities
Drug Mechanisms and
Receptors
Common pharmacologic action requires drug-receptor interaction.
Drugs may stimulate receptors directly.
Drugs may block receptor site for normal chemicals of the body
Drugs that interact with several metabolic pathways or common
functions are likely to have greater side effects.
Receptors and Drug
Action