Module3

IntroductiontoPharmacology

1
1.1 1.1.1

Definitions
Pharma PharmaCOLOGY

Studyofproperties&effectsofdrugs Pharmacologyeffects: TherapeuticEffects SideEffects

1.1.2 PharmacoKINETIC

(desirable) (undesirable/harmful)

HOWthebodyHANDLESthedrugoverperiodoftime: Absorption o Absorptionbeginsatsiteofadministration o RATEandEXTENTofabsorptiondependson: Routeofadministration Dosage Dosageform Distribution o distributionistransportofthedrugthroughbloodstreamtovarioustissuesatitsactionsite o Barrierstodrugdistribution:bloodbarriers/placentalbarrier Biotransformation o Process:drugischemicallyconvertedtoametabolite(inorderforbodytometabolizedrug) Excretion o Iseliminationoftoxic/inactivemetabolites o Kidneysprimaryorganforexcretion o Otherorgans:intestine/lungs/glands/skin Aboveeffectspt.responsetodrugtherapy
1.1.3 PharmacoDYNAMICS

ThedrugseffectONthebody Studyofhowdrugactsonlivingorganism Drugactionachievedbybiochemicalinteractionbetweendrugandcertaintissuecompoundsinbody (usuallyreceptors) Interactionbetweendrugandbiologicalsystemdividedinto2classes: o Pharmacokineticinteraction o Pharmacodynamicinteraction Includepharmacologicalresponseobservedrelativetoconcentrationofdrugatactivesiteinorganism

1.2 Dose

Amountofmedicationgiven
1.3 Action

Therapeuticeffectsexpectedonbody
1.4 Indication

Conditioninwhichadrugcanandshouldbegiven Therapeuticusesforparticulardrug
1.5 Contraindication

Conditioninwhichadrugshouldnotbegiven

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1.6 SideEffects

IntroductiontoPharmacology

Actionofthedrug,otherthandesiredeffects
1.7 Depressant

Substancethatdecreases/suppressesabodyfunction/activity E.g.Entonox
1.8 Drug

ANYsubstancetakenbymouth,inhaled,appliedtopicallytotreat/preventdisease/conditionorinjected intomuscle/bloodvessel/cavityofthebody
1.9 DrugAllergy

Systemicreactiontodrugresultingfrompreviousexposure
1.10 DrugDependence

Astateinwhichdrugwithdrawalproducesintensephysical/emotionaldisturbance
1.11 Tolerance

Decreaseresponsetorepeatedadministrationofdrugpossiblenecessityincreaseofdosage/change medicationtomaintaintherapeuticeffect.

SourcesofDrugs

Drugsarederivedfrom5majorsources: Plants Animalsandhumans Mineralsormineralproducts Microorganisms Chemicalsubstancesmadeinalaboratory

DrugClassification
Bodysystems ClassofAgent Mechanismofaction

Drugsareclassifiedby: PHYSIOLOGICClassification: CHEMICALClassification: THERAPEUTICClassification:

4
4.1

DrugNames
ChemicalName

PRECISEdescriptionofchemicalconstitutionofdrug Usefulforchemist
4.2 GenericName

REFLECTSchemicalfamilydrugbelongsto NameMUSTbeapprovedbytheWorldHealthOrganisation(WHO) Isthesamethroughouttheworld

4.3 TradeName

Namegiventodrugbymanufacturer AppearwiththesignR()

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IntroductiontoPharmacology

Drugmaybemanufacturedbymanycompaniesandthereforehavemanytradingnames
4.4 OfficialName

Nameunderwhichitislistedinofficialgovernmentpublications EXAMPLE:

5
5.1

DrugSchedules
Schedule1

NOPRESCRIPTIONNEEDED MaybesoldtoanypersonOVERageof16 MaybesoldtoanypersonUNDERageof16if: Writtenletteraccompaniesperson,lettermustbewrittenbysomeoneknowntotheseller OrderMUSTberetainfor6monthsafterdateofsale

5.2 Schedule2

MaybesoldtoanypersonOVERageof16 MaybesoldtoanypersonUNDERageof16if: Prescriptionisneeded Prescriptionmustbewrittenbysomeoneknowntotheseller OrderMUSTberetainfor6monthsafterdateofsale SellermustenterinprescriptionbookdetailsofEVERYSALE

5.3 Schedule3

Verbal/writtenprescriptionISNEEDED Repeatprescriptionsmaybefilledfor6months(NOLONGER) SellermustenterinprescriptionbookdetailsofEVERYSALE

5.4 Schedule4

Verbal/writtenprescriptionISNEEDED IfVerbalwrittenprescriptionMUSTbeprovidedwithin7daysofissuedverbalprescription IfrepeatprescriptionrepeatMUSTbeshownonprescriptionhowmanytime/andintervals NOrepeatshownonprescriptionpharmacistcanONLYdispenseonce SellermustenterinprescriptionbookdetailsofEVERYSALE

5.5 Schedule5

ONLYwrittenprescription Drugscanonlybeusedformedicalpurposes MayNOTbeprescribedforsatisfaction/habit IfrepeatprescriptionrepeatMUSTbeshownonprescriptionhowmanytime/andintervals NOrepeatshownonprescriptionpharmacistcanONLYdispenseonce SellermustenterinprescriptionbookdetailsofEVERYSALE ONLYMinisterofHealthcanprescribeitforreasonsotherthanmedical

5.6 Schedule6

ONLYwrittenprescription PrescriptionMUSTbepresentedwithin30daysofissue QuantityMUSTNOTexceedamountneededfor30days NOREPEATprescriptions Drugscanonlybeusedformedicalpurposes MayNOTbeprescribedforsatisfaction/habit SellermustenterinprescriptionbookdetailsofEVERYSALE

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Module3 ONLYMinisterofHealthcanprescribeitforreasonsotherthanmedical
5.7 Schedule7

IntroductiontoPharmacology

ONLYwrittenprescription PrescriptionMUSTbepresentedwithin30daysofissue QuantityMUSTNOTexceedamountneededfor30days NOREPEATprescriptions Drugscanonlybeusedformedicalpurposes MayNOTbeprescribedforsatisfaction/habit SellermustenterinprescriptionbookdetailsofEVERYSALE ALLdetailsrelatingtosalemustbeenteredinSCHEDULE7SUBSTANCEREGISTER Mustbebalancedquarterly

5.8 Schedule8

PROHIBITEDforhumanuse Except:foranalytical/researchpurpose PermitmustbeissuesbySecretaryofHealthonrecommendationofMedicinesControlCouncil

5.9 Schedule9

ONLYobtainedfromDirectorGeneralofHealthandpopulationdevelopment ONLYunderexceptionalcircumstancesamphetaminesandtheirderivatives

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6.1

ScopeofManagement
HealthAct63of1977

Drugmayonbeprescribebymedicaldoctor/dentist NOAMBULANCEPERSONNELMAYPRESCRIBEDRUGS ONLYadministerdrugsyouarequalifiedfor Drugsinpossessionofambulancepersonnelmustbelistedindrugregister MayONLYcarrydrugsforthelevelyouarequalifiedfor Personisresponsibleforsafekeepingofdrugsintheirpossession Paramedicsareheldresponsibleforsafeandtherapeuticallyeffectivedrugadministration Paramedicspersonallyresponsiblelegally/morallyandethicallyforEACHdrugtheyadminister PARAMEDICS Usecorrectprecautionsandtechniques Observeanddocumenteffectsofdrugs Keepknowledgebasecurrenttochange/trendsinpharmacology Establishandmaintainprofessionalrelationships Understandpharmacology Performevaluationtoidentifydrugindications/contraindications Seekdrugreferenceliterature Takedrughistoryfrompt. Prescribedmedication Name Dose Strength Overthecountermedication Vitamins

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Module3 Drugreactions Consultwithmedicaldirection(medicalofficeronduty)

IntroductiontoPharmacology

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7.1

DrugForms
Solids

Capsule Cream Ointment Patch Powder Tablet Suppository

7.2 Liquids

powderingelatinecover Waterbased Oilbased Transcutaneous Slowrelease Paperpackaging Compressedpowder Entericcoated(EC) Slowrelease Rectaladministration AlcoholbasedORALmedication Dilutedformofointment Concentratedmedication Alcoholbasedtopicalpreparation Dilutedformofcream Ingredientscompletelydissolve Powdersuspendedinwater SugarbasedORALmedication DilutedalcoholicextractsTOPICAL

Elixir Emulsion Extract Gel Lotions Solution Suspension Syrup Tincture

7.3

Aerosols/Sprays

Atomizedmedicationforinhalation
7.4 Parenteral

Ampoules Vial

SingledoseBREAKABLE Multidosecontainers(rubberseal)

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8.1

RoutesofAdministration
ENTERALroute

AdministeredalonganyportionofGIT Gastric Oral Rectal SmallIntestine

8.2 PARENTERALroute

DrugsgivenbyINJECTION Intramuscular (muscle) Intraosseous (bone) Intravenous (veins) Subcutaneous (underskin)

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8.3 PULMONARYroute

IntroductiontoPharmacology

Medicationgivenbyinhalation HaswantedlocaleffectsUNWANTEDsystemiceffects
8.4 TOPICALroute

Administeredthroughskin/mucousmembranes ONLYLIPIDsolublecompoundsabsorbsthroughskin UseINTACTsurfaceskin Massagingskinpromotesdrugsabsorption

Drugs

Involvesmovementofdrugmoleculesfromsiteofentrytogeneralcirculation Absorptionbeginsatsiteofadministration RATEandEXTENTofabsorptiondependson: Routeofadministration Dosage Dosageform

9.1 DrugAbsorptionFactors/Variablethateffectdrugabsorption

9.2

Solubility/insolubilityofdrug(ifitsmetabolizedornot) Natureofabsorptionsurface(cellmembrane)drugmusttransverse Bloodflowtositeofadministration pHbalanceofthedrugenvironment Drugconcentration Routeofadministration Bioavailability

FactorinfluencingActionsofDrugs

9.3

Age BodyMass Gender Environment Timeofadministration Pathologicalstate Geneticfactors Psychologicalfactors

Specialconsiderationspt.

9.4

PregnantPatients PaediatricPatients GeriatricPatients

Geriatric/ElderlyPatients

Commoncausesofnoncompliance/medicationerrors: Medicationistooexpensive Forgetfulness/confusion Forgetinstructionregardingneedtocompletemedicationtherapy Symptomsdisappear

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9.5

IntroductiontoPharmacology

Errorintakingselfadministeredmedication Noncompliancemaybedeliberate(lookingforattention)
DrugReservoirs

Twomaintypes: Plasmaproteinbinding Tissuebinding

9.5.1 PlasmaProteinBinding

Circulationinbloodstream Toolargetoleavebloodstream
9.5.2 TissueBinding

Occursinfattissueandbone Servesasstabledrugreservoir Canremainforup3hours

9.6 BiologicalHalflife

Rateofbiotransformationandexcretiondeterminesdrugshalflife Canbedefinedasrequiredtimetoexcretehalfamountofdruginbody
9.7 DRUGSTORAGE

Certainprecepts/principlesguidemannerinwhichdrugsaresecured/stored/distributed/accountedfor
9.7.1 Drugpotencyeffectedby

9.8

Temperature Light Moisture Shelflife

Pain

Twocomponentsofpain
9.8.1 Sensationofpain

9.8.2

Involvesnervepathwaysandthebrain
Emotionalresponsetopain

Mayberesultof Anxiety Previouspainexperience Age Gender Culture

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