Introduction to Pharmacology

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INTRODUCTION toPHARMACOLOGY
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MEDICINE IN ANCIENT EGYPT
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EARLY MESOPOTAMIAN CULTURE
PRIMITIVE AMERICAN INDIAN CULTURES
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HIPPOCRATES MEDICINE BECAME A SCIENCE
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SOURCES OF DRUGS
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TERMS to REMEMBER

• DRUG
• PHARMACOLOGY
• CLINICAL PHARMACOLOGY
• pharmacokinetics
• pharmacodynamics
• PHARMACOTHERAPEUTICS

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PROPERTIES OF IDEAL DRUG

• EFFECTIVENESS (EFFICACY)
• SAFETY
• SELECTIVITY
• REVERSIBILITY
• PREDICTABILITY
• EASE OF ADMINISTRATION
• LACK OF DRUG INTERACTIONS
• LOW COST
• Chemical stability
• SIMPLE NAME

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NO DRUG IS IDEAL
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FACTORS THAT DETERMINEINTENSITY OF DRUG
RESPONSES
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INDIVIDUAL VARIATION
Ch.8

• AGE
• GENDER
• WEIGHT
• KIDNEYS
• LIVER
• GENETIC

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NURSES ROLE(patient care)

1. PREADMINISTRATION ASSESSMENT
2. DOSAGE ADMINISTRATION
3. EVALUATING PROMOTING THERAPEUTIC EFFECTS
4. MINIMIZING ADVERSE EFFECTS
5. MINIMIZING ADVERSE INTERACTIONS
6. MAKING PRN DECISIONS
7. MANAGING TOXCITY

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NURSES ROLE(patient education)

1. DRUG NAME THERAPEUTIC CATEGORY
2. DOSAGE
3. SCHEDULE
4. ROUTE OF ADMIN
5. EXPECTED RESPONSE
6. MEASURES TO ENHANCE RESPONSE
7. DURATION OF TX
8. METHOD OF STORAGE
9. INTERACTIONS
10. WHO TO CALL

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NURSING PROCESS

• ASSESSMENT
• ANALYSIS (nursing diagnosis)
• PLANNING
• IMPLEMENTATION
• EVALUATION

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LEGISLATION

• 1906 Pure Food and Drug Act
• free of adulterants (nothing _at_safety or
  effectiveness)
• 1938 Food Drug and Cosmetic Act
• 1st to regulate safety
• 1962 Harris- Kefauver Amendments
• proof of effectiveness
• 1970 Controlled Substances Act
• regulates drugs with potential for abuse
• 1992 accelerated approval
• 1997 FDA Modernization Act
• 2002 BEST PHARMACEUTICALS FOR CHILDREN ACT
• 2003 PEDIATRIC RESEARCH EQUITY ACT

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DRUG DEVELOPMENT

• PRECINICAL TESTING 1-5 yrs
• evaluation of drug prior to testing in humans
  (toxicities, pharmacokinetics, useful biological
  effects)
• CLINICAL TRIALS 2-10 yrs
• Phase 1 nl volunteers
• Phase II and III - patients to determine safety,
  effectiveness and dose ranges
• Phase IV- post market surveillance

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DRUG NAMES
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EXAMPLES OF LOOK-ALIKE TRADE-NAMES
Trade name Celebrex Cerebyx Celexa
Generic name celecoxib fosphenytoin citalopram
Formulation capsules injection tablets
Pronunciation sell'-uh-brecks ser'-uh-bicks sell-eks'-uh
Indication pain seizures depression
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EXAMPLES of SOUND-ALIKE TRADE
NAMES
Accutane Accupril
Adderall Inderal
Alprazolam Lorazepam
Clonidine Klonopin
Covera Provera
Cozaar Zocor
Haldol Stadol
Lamictal Lamisil
Prilosec Prozac
Xanax Zantac
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WHAT DOES the BODY DO to the DRUG??
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PHARMACOKINETICS

• ABSORPTION
• DISTRIBUTION
• METABOLISM
• EXCRETION

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DISSOLUTION
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TYPES OF ABSORPTION

• PASSIVE ABSORPTION
• ACTIVE ABSORPTION
• PINOCYTOSIS

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FACTORS THAT AFFECTABSORPTION

• BLOOD FLOW
• PAIN
• STRESS
• HUNGER
• FASTING
• FOOD
• ph
• EXERCISE
• ROUTE OF ADMINISTRATION

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FIRST PASS EFFECT
BIOAVAILABILITY
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FACTORS THAT AFFECTDISTRIBUTION

• PROTEIN BINDING
• BLOOD FLOW
• BODY TISSUE AFFINITY

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HALF-LIFE

• THE TIME IT TAKES FOR HALF OF THE DRUG
  CONCENTRATION TO BE ELIMINATED

4 8 HRS ? SHORT HALF-LIFE 24 HRS?
LONG HALF-LIFE
STEADY STATE?drug intake amount excreted
therefore!!...........serum conc.
therapeutic effect
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FACTORS THAT AFFECT EXCRETION

• RENAL FUNCTION ( GFR, Cr Cl)
• LIVER FUNCTION
• BILE, FECES, LUNGS, SALIVA, SWEAT,
  BREAST MILK
• URINE ph
• DOSAGE

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WHAT DOES the DRUG DO to the BODY??
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PHARMOCODYNAMICS

• DOSE RESPONSE/MAXIMAL EFFICACY
• ONSET, PEAK, DURATION OF ACTION
• RECEPTOR THEORY
• AGONIST/ANTAGONIST (STIMULATOR/INHIBITOR-BL
  OCKER MIMETIC/LYTIC)
• SPECIFIC- NON/SELECTIVE-NON (moa)
• CATEGORIES OF DRUG ACTION
• STIMULATORS/DEPRESSOR,,REPLACEMENT,
  INHIBITION/KILLING/IRRITATION
• THERAPEUTIC INDEX/RANGE
• PEAK AND TROUGH
• LOADING DOSE
• SIDE EFFECTS
• PHARMACOGENETICS
• TACHYPHYLAXIS (TOLERANCE)
• PLACEBO EFFECT (PSYCHOLOGIC BENEFIT)

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Oral vaccine could help epilepsy and stroke
patients
By Emma Reid, February 25, 2000People who
suffer from epilepsy, stroke or other brain
traumas often have very high levels of brain
activity during an episode or an attack. This
high level of activity can cause an unpleasant
chain of events leading to brain cell death.
Researchers from the Jefferson Medical College in
Philadelphia, PA have developed a way to reduce
the 'high activity' response in rats using an
important oral vaccine. The oral vaccine
stimulates the production of antibodies which
block an important receptor in the brain ,
preventing glutamate from binding to receptor
sites (like on the lower cell in the image and
sending messages along the chain.
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Always remember to check the name (trade and
generic), dosage form, strength, and indication
(reason the drug is being prescribed) before
giving it to a patient. An error may have been
made before you received the order! A complete
list of more than 800 sound-alike trade names can
be found on the United States Pharmacopeia (USP).
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John G is receiving an experimental drug (AK22)
for the treatment of actinic keratosis, a skin
lesion that, if untreated, will progress to a
skin cancer called squamous cell carcinoma. The
drug is delivered in a cream applied to the
lesions twice a day.
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After 3 weeks, Johns lesions have fewer scales
and are less red. Some have disappeared. The
science of what AK22 does to the body is called

1. pharmacokinetics.
2. pharmacognosy.
3. pharmacodynamics.
4. toxicology.

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DRUG INTERACTIONS
PHARMACOKINETIC
PHARMOCODYNAMIC
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