Department of Pharmacology

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Department of Pharmacology
Toxicology Medical University
Sofia Dr Rumen Nikolov,
PhD Introduction to Pharmacology. Prescription
and Drug Prescription Writing.
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• Etymologically, pharmacology is the science of
  drugs (Greek pharmakon, medicine or drug and
  logos, study)  
• Pharmacology is a branch of medicine which deals
  with drugs.
• Pharmacology can be defined as the study of the
  selective biologic activity of drugs in living
  matter.

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• A drug is a chemical substance that affects
  processes in living organism and
• used for treatment, prophylaxis (prevention) or
  diagnosis of the diseases.
• Classification of drugs
• OTC (Over-the-counter) drugs - drugs that do not
  require a prescription.
• Prescription drugs - prescription drugs generally
  have a greater potential for adverse effects than
  OTC drugs, require monitoring for interactions
  with other medications, should only be used for a
  restricted time period.

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• Sources of drugs
• Natural plants, microorganisms, animals,
  minerals.
• Synthetic
• Semi-synthetic
• Biosynthetic

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• Natural drugs
• Plants
• e.g. Morphine from Poppy capsules.
• Atropine from Belladonna roots.
• Digoxine from Digitalis leafs.
• Quinine from Cinchona bark.
• Hypericin and hyperforin from Hypericum
  herb.
• Flavone glycosides and terpenoids from
  Gingko leafs.
• Castor oil from Castor seeds.

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• Papaver somniferum
• (Opium Poppy)
• morphine
• codeine

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• Atropa Belladonna
• (Deadly nightshade)
• Atropine

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Digitalis lanata
Digitalis purpurea
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Cinchona tree Quinine
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• Hypericum perforatum
• (St. Johns wort)
• Esbericum caps.
• Remotiv tab.

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Ricinus communis (Castor been)
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• Ginkgo biloba (maidenhair tree)
• Flavonoids
• Diterpene lactones

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• Natural drugs
• Microorganisms
• e.g. Penicillin from Penicillium notatum.
• Streptomycin from Streptomyces griseus.
• Gentamicin from Micromonospora purpurea.
• Vancomycin from Streptococcus orientalis.
• Minerals
• e.g. Calcium, Magnesium, Aluminium salts.
• Liquid paraffin from petroleum.

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• Natural drugs
• Animals
• e.g. Thyroxine from porcine or bovine thyroid
  gland.
• Heparin from porcine gut or bovine lung.
• Insulin from porcine or bovine pancreas.
  
• Omega-3 fatty acids from
• fish oil (Omacor).

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• Synthetic drugs (60-65)
• - They are prepared by chemical synthesis.
• Sulfonamides e.g. Sulfamethoxazole,
  Sulfadioxine
• Fluoroquinolones e.g. Ciprofloxacin,
  Levofloxacin, Moxifloxacin
• Salicylates e.g. Acetylsalicylic acid
• Barbiturates e.g. Phenobarbital
• Benzodiazepines e.g. Diazepam, Bromazepam,
  Lorazepam
• Acetaminophen (Paracetamol)
• Isoniazid

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• Semi-synthetic drugs
• They are prepared by chemical modification of
  natural drugs.
• Ampicillin from Penicillin G
• Dihydroergotamine from Ergotamine
• Dehydroemetine from Emetine

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• Biosynthetic drugs
• These drugs are prepared by cloning of human DNA
  into bacteria like E. coli. Technique is called
  Recombinant DNA technology or Genetic
  engineering.
• Human insulins
• Human Growth Hormones (Somatropin)
• Human Interferons (alpha and beta)
• Human tissue plasminogen activator (Alteplase,
  Reteplase)
• Human Erythropoietin (Eprex)

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• Gene therapy
• - It is the introduction of functional genetic
  material DNA into target cells top replace
• or supplement defective genes. It imparts new
  function to cells.
• Cancers
• Alzheimers disease
• Parkinsons disease
• Diabetes mellitus
• Arterial Hypertension
• Cystic fibrosis
• Multiple sclerosis
• Muscular dystrophy

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• Pharmacopoeia
• An official book published by authorized
  institution in a country containing
• description of commonly used drugs with their
  sources, properties, uses, doses,
• purity and potency.
• Drugs contained in pharmacopoeia are official
  drugs.
• European pharmacopoeia (E.P.)
• British pharmacopoeia (B.P.)
• United States pharmacopoeia (U.S.P.)
• Indian pharmacopoeia (I.P.)

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• Drug nomenclature
• Chemical name which is LONG, COMPLEX AND NOT USED
  CURRENTLY
• Nonproprietary name (some times called generic
  name) given by WHO
• official names (in pharmacopoeias)
• approved names (not yet in
  pharmacopoeias)
• Proprietary name (trade or brand name) - given by
  the manufacturer
• e.g.
• Nonproprietary name Omeprazole
• Brand names Losec (AstraZeneca), Sopral
  (Sopharma), Probitor (Sandoz), Omeprazid (Nobel
  Pharma),
• Ulcoprol (Actavis), Helicid (Zentiva)

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1,3 dimethylxanthine Nonproprietary name
Theophylline ?rade name Novphyllin
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• Prescription
• The prescription is a written order from
• a doctor to a chemist including instructions for
  dispensing or preparing medicines to a certain
  patient.
• It is require that the prescriptions in
• Bulgaria should be in Latin.
• The prescription order may be issued by
  physicians or other licensed medical
  practitioners and dentists.

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• Type of prescription forms
• White Prescription form
• Yellow Prescription form
• Green Prescription form
• Prescription form ?5

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Doctors use a white prescription form to
prescribed drugs without abuse potential.
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Doctors use a yellow form to prescribed drugs
with high abuse potential such as opioids (e.g.
morphine, methadone, fentanyl, pethidine).
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Doctors use a green form to prescribed drugs with
low abuse potential than opioids such as
benzodiazepines (e.g. Diazepam), and barbiturates
(e.g. Phenobarbital)
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Doctors use a prescription form ?5 to prescribed
drugs, which are fully or partially paid by the
National Health Insurance Fund.
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• Structure of the prescription
• The prescription consists of seven parts
  including
• 1. Inscriptio
• 2. Praepositio
• 3. Praescriptio
• 4. Subscriptio
• 5. Signatura
• 6. Nomen medici
• 7. Nomen aegroti

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• Inscriptio
• This part consists identification data such as
  name of the doctor, master degree of the doctor,
  address, and the date.
• e.g.
• Dr. I. Ivanov, dermatologist
• Alexandrovska Hospital
• Sofia, 16.09.2010

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• Praepositio
• This part includes message to the pharmacist
  which express with Rp. or Rp/, an abbreviation
  for Latin word Recipe (Take thou).
• Rp. or Rp/
• Doctor must write new Rp. for each new
  prescription

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Praescriptio
Rp/
Name (Genetivus case)
Dose
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The strength of the drug should be written in
metric units.
1,0 0,1 0,01 0,001 0,0001
1 g 100 mg 10 mg 1 mg 100 mg
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• Subscriptio
• This part is intended direction to the
  pharmacist. Doctor writes the number of the drug
  packing and the drug dosage form.
• e.g.
• Da scatulam ?2 in tabulettis
• or short form
• D. scat. ?2 in tab.
• or
• Da tales doses ?20 in tabulettis
• or short form
• D. t. d. ?20 in tab.

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• Signatura (Label)
• This part is intended direction to the patient.
  It provides instructions for the manner of the
  use of the prescribed drug (how the drug should
  be taken by the patient).
• e.g.
• Signa. Take one tablet 3 times daily.
• or short form
• S. Take one tablet 3 times daily.

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• Nomen medici
• Signature and seal of the doctor may be put at
  the marked place in the prescription blank or
  after the last prescribed drug.
• Nomen aegroti
• This part of the prescription includes name, home
  address, and age of the patient.

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Symbols and abbreviations used in the
prescription ? symbol for divided one
prescription from next prescribed drugs e.g. Rp/
Paracetamoli 500 mg D. sat. ? 1 in tab.
S. Take 1 tablet 3 times daily.
Rp/ Amoxicillini 1 g D. sat. ?
1 in tab. S. Take 1 tablet every 8 h.
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• Symbols and abbreviations used in the
• prescription
• aa (ana partes aequales) is used to
• expressing substances in equal quantities
• ad is used to expressing add to get the
• whole weight (volume) of the solution or
• up to
• q.s. (quantum satis) means sufficient
• quantity.
• M.D.S. means Mix, give and label.
• M.f. (Misce fiat) means Mix to obtain.
• Verte! is used when doctor writes on the back of
  the prescription blank.