Pharmacology

o The study of medicines and how drugs are administered and how the body responds

Drug
o General term for any substance capable of producing biological responses in the body

Medication
o Drug after it has been administered

Definition of terms:
o Chemical name: assigned using standard nomenclature established by the International
Union of Pure and Applied Chemistry (IUPAC). This is also helpful in predicting
substance’s physical and chemical properties
o Generic name: drug assigned by the U.S. Adopted Name Council
o Generic names are less complicated and easier to remember than chemical names
o Trade name: assigned by the company marketing the drug. The name is usually selected
to be short and easy to remember. Also called the proprietary or product or brand name
o Bioavailability: physiological ability of the drug to reach its target cells and produce its
effect. May be affected by inert ingredients and tablet compression
o Negative Formulary List: list of trade-name drugs that pharmacists may not dispense as
generic drugs. These drugs may be dispensed exactly as written in the prescription, using
the trade-name the physician prescribed

Length of New Drug Approval

TIMELINE (years)ACTIVITY
11 Research and development before a drug is submitted to FDA
1 Phase I- Clinical trial 20-80 healthy volunteers
2 Phase II- Clinical trial 100-300 volunteer with disease
3 Phase III- Clinical Trial 1000-3000 clients in hospital and clinic agencies
For every 5000 chemicals that enter preclinical testing, only 5 make it to human testin
Of these 5 potential drugs, only 1 is approved.

Pharmacotherapy
 o 1988: officially established as an agency in USA (FDA: U.S Department of Health and
Human Services)
o Pharmacotherapy: application of drugs to prevent disease and ease suffering
o Therapeutic agents: classified as traditional drugs, biologic or alternate therapies

Pharmacotherapy across the lifespan

o Pre0existing illness (seizure, hypertension)
o Maternal illness unrelated to pregnancy
o Complications

Placenta-semipermeable membrane
o Fetal membrane contains enzymes that detoxify certain substances as they pass the
membrane
o Water soluble, ionized, bound to plasma proteins X placenta

Physiologic changes during pregnancy

A. Absorption
o GI: slowed by progesterone, acid is decreased
o Respi.: Increased tidal volume and pulmonary vasodilation (increased absorption)
o Endocrine: increased metabolism
o Cardiov.: increased CO, increased Plasma volume, Reg. blood flow
B. Distribution and metabolism
o Circulatory: increased hemodilution
o Blood flow to skin, kidney and uterus
o Anticonvulsant, carbamazepine, phenytoin (metabolism)
C. Excretion
o Renal: increased renal plasma flow, increased renal tubular absorption, increased
glomerular filtration rate

Gestational age and drug therapy

A. Consequences
o Intrauterine fetal death o Behavioral abnormalities
o Physical malformations o Neonatal toxicities
o Growth impairment
FDA Pregnancy categories
CATEGORY DEFINITION
A Adequate, well-controlled studies in pregnant women have not shown an
increased risk of fetal abnormalities
B Animal studies, have revealed no evidence of harm to the fetus; however there
are no adequate, well-controlled studies in pregnant women or
Animal studies have shown an adverse effect, but adequate, well-controlled
studies in pregnant women have failed to demonstrate a risk to the fetus
C Animal studies have shown an adverse effect, but adequate, well-controlled
studies in pregnant women have failed to demonstrate a risk to the fetus or No
animal studies have been conducted, there are no adequate, well-controlled
studies in pregnant women
D Studies either adequate and well-controlled or observational-in pregnant women
have demonstrated a risk to the fetus; however, the benefits of therapy may
outweigh the potential risk
X Studies either adequate and well-controlled or observational in animals or
pregnant women have demonstrated positive evidence of fetal abnormalities. The
use of the product is contraindicated in women who are or may be pregnant

Drug Monograph
o A statement that specifies the kinds and amounts of ingredients a drug or class of drugs
may contain, the directions for the drug’s use, the conditions in which it may be used
and the contraindications to its use.

Legal drugs: Prescription and over the counter drugs

Complimentary therapies:
o Complementary and alternative therapy: natural plant extract, herbs, vitamins, minerals
and dietary supplements

Ethical issues in psychopharmacology considerations for clinical practice

 o Serious adverse metabolic effects (eg, hyperglycemia, diabetes) associated with atypical
antipsychotics

Problems in prescribing practice

o Failure to keep abreast of changes o Consumer pressure
o Pharmaceutical company influence on o Illegibility of prescriptions
practice and drug samples o Failure to detect or anticipate drug
o Lack of time interactions

Pharmacodynamics
o Pharmaco “medicine” Dynamics “change”
o This refers to how a medicine changes the body
o A branch of pharmacology concerned with the mechanics of drug action and the
relationships between drug concentration and responses in the body

Pharmacodynamics and interclient variability

o ED50 - median effective dose. A dose required to produce a therapeutic response in 50%
of a group of clients
o LD50 - median lethal dose. A dose that will be lethal in 50% of a group of animals
o TD50 - dose that will produce a given toxicity in 50% of a groups of clients.
o Therapeutic index = TD50 / ED50. The value representing the margin of safety of a drug
the higher the therapeutic index the safer the drug.
o Graded dose = response relationship describes how the therapeutic response of a drug
changes as the medication dose is increased
o Potency: the dose of medication required to produce a particular response, and efficacy,
the magnitude of maximal response to a drug, are means of comparing medications
o Drug receptor theory: used to explain the mechanism of action of many medications

Agonist
 Partial agonist Substances that compete with drugs for
receptor binding and can cause drug-
drug and drug-food interactions.
Antagonist

Pharmacokinetics
o Study of drug movement throughout the body
o 4 components of pharmacokinetics: ADME properties

Passage of drugs through plasma membranes

A. Diffusion or passive transport: movement of a chemical from an area of higher
concentration to an area of lower concentration
B. Active transport: movement of a chemical against a concentration or electrochemical
gradient.

Absorption of medications

Sites of absorption
o Skin o Mucous membranes
o GIT o Respiratory tract

Factors affecting the absorption of drugs

o Form (tablet, syrup)
o Route
o Dose (the higher the quicker)
o Acids are for ACIDS
o Bases are for BASES