INTRODUCTION TO PHARMACOLOGY

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Pharmacology
Greek word pharmakon (drugs) + logos (study) Study of drugs and their actions on living organisms
Drugs - chemical substances that have an effect on living organisms Medicines drugs used in preventing or treating diseases
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Drug Names
Chemical name chemical composition Generic name common or non-proprietary name Official name name as listed in FDA or any other government agency Trademark brand name
Example: Chemical name 4-thia-1-azabicyclo[3.2.0]heptane2-carboxylic acid, 6-([{aminophenylacetyl}amino]-3,3dimethyl-7-oxo-,[2S-<2,-5,6{S*}]) Generic name ampicillin Official name Ampicillin, USP Brand names Amoxil, Binotal, Cetacillin, Corsacillin
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Drug Classification
According to organ body system affected Example CV drugs, CNS drugs, GI drugs
According to therapeutic use or clinical indications Example antacids, antibiotic, diuretics According to physiologic or chemical action Example anticholinergics, beta blockers According to prescriptive use Prescription vs. OTC drugs Illegal drugs also known as recreational drugs
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Pharmacokinetics
Absorption

Excretion

Pharmacokinetics

Distribution

Metabolism
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Absorption
Process by which a drug is transferred from its site of entry into the body and to the circulating body fluids.
Dependent on: 1. Route of administration 2. Blood flow through the tissues where the drug is administered 3. Solubility of the drug Important points: 1. Administer oral drugs with adequate fluids 2. Parenteral drugs should be administered in the correct route 3. Reconstitute or dilute drugs only with recommended diluents
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Absorption
Routes of administration 1. Enteral oral, rectal, NG tube 2. Parenteral SC, IM, IV, intrathecal 3. Percutaneous inhalation, sublingual, topical
Factors affecting drug absorption: 1. Topical drug concentration, length of contact time, size of affected area, skin surface thickness, tissue hydration, degree of skin disruption 2. Inhalation depth of respirations, fineness of droplet particles, available surface area of mucus membranes, contact time, hydration status, blood supply to area, drug concentration 3. Parenteral rate of blood flow through the tissues
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Distribution
Ways in which drugs are transported by body fluids to the sites of action, metabolism, and excretion.
Factors affecting drug distribution: 1. Protein binding degree of drug binding to protein molecules rendering inactive; the greater the protein binding, the lesser is the available active or free drug 2. Lipid solubility tendency of some drug molecules to stay in the body a lot longer because they are stored in adipose tissues Implications: If drug blood levels drop, drug molecules bound to protein or deposited in adipose are released to maintain equilibrium
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Metabolism
Process of inactivating drugs; also known as biotransformation Factors affecting drug metabolism: 1. Genetic variations of enzyme systems 2. Concurrent use of other drugs 3. Exposure to environmental pollutants 4. Concurrent illnesses 5. Age

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Excretion
Process of eliminating drugs and its metabolites
Plasma half-life time required for 50% of a drug to be eliminated from the body; dependent on persons ability to metabolize and excrete any given drug Example: Drug A 500mg has a plasma T of 6 hours 8am 2pm 8pm 2am 8am 500mg (100%) of drug in body 250mg (50%) of drug in body 125mg (25%) of drug in body 62.5mg (12.5%) of drug in body 31.25mg (6.25%) of drug in body
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Factors affecting Drug Action

1. Age extremes of age are most sensitive 2. Body weight OW require greater doses; UW require lesser doses 3. Metabolic rate increased BMR require larger doses or greater frequency 4. Illness altered pharmacokinetics 5. Psychological factors attitudes, expectations, willingness, placebo effect 6. Tolerance a person requires a higher dosage to produce the same effects that lower doses once provided 7. Dependence inability to control ingestion of drugs 8. Cumulative effect consumption exceeds rate of excretion
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Pharmacodynamics
Physiologic and biochemical effects of a drug on the body Therapeutic effect desired and intentional effects Side effect additional effects aside from the intentional effects Adverse effects undesirable side effects with some potentially harmful Additive effect 2 drugs with similar actions taken for double effect Propoxyphene + aspirin = added analgesia Synergistic effect combined effect of 2 drugs is greater than the sum of the effect of each drug given alone Aspirin + codeine = much greater analgesia Antagonistic effect one drug interferes with the action of another Tetracycline + antacid = decreased tetracycline absorption
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Pharmacodynamics
Displacement displacement of a drug by another drug increases the activity of the first drug Warfarin + valproic acid = increased anticoagulant effect Interference one drug inhibits the metabolism or excretion of a second drug causing increased activity of the second drug Probenecid + spectinomycin = prolonged antibiotic effects by spectinomycin Incompatibility one drug is chemically incompatible with another drug leading to deterioration when the 2 drugs are combined or mixed in the same solution Ampicillin + gentamicin = ampicillin inactivates gentamicin

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