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Pharmacology Introduction to Pharmacology What is Pharmacology?

Lecture 1

Pharmakon in Latin means drug, and Logy means science. So Pharmacology is the science that deals with drugs. But that is not enough .to define it, we need to define Drugs Drug: Any chemical or molecule used to alter body functions, thereby (Preventing, Diagnosing or Treating disease. (PDT Can we consider Water as a drug?? Yes! Because dehydrated patients need water for rehydration, so water is a chemical substance .(H2O) and it is used to treat dehydrated patients Can we consider Oxygen as a drug? Also yes! Because it's a chemical, used sometimes to treat cardiac infarction, hypoxic or .suffocating patients Vaccination during childhood: All children must be vaccinated by drugs, .to prevent the occurrence of an expected disease Pharmacology: the science which deals with drugs. (Origin, (structure, preparation, administration, actions, ADME

ADME: Abbreviation for four pharmacokinetics processes as follows D: Distribution. M: Metabolism. E: Elimination.

A: Absorption. Drug Names:

Chemical name: According to the chemical structure, it is long and rarely used.
1)

Official (Approved or Generic) name: The name which is given by the international organization of drug nomenclature. This organization is an international committee which is responsible for naming drugs.
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Trade (Proprietary or Brand) name: The name which is given by the owner or the manufacturer (the drug company).
3)

Now let's discuss this example of a drug called Diazepam which has sedative or anti-anxiety properties:

Chemical name: 7-chloro, 3-dihydrobenzodiazepine-2-one Official name: Diazepam Trade name: Valium, Stesolid, Valipam. (We have many manufacturers, and many companies that give the drug its brands name.)

A simple example that matters to us as dentists is (Toothpaste). Toothpastes are nearly similar in chemical structure in all variant brand names such as Colgate, Sensodine, Signal, and Crest. All these toothpastes have similar or identical structure, but these different names vary according to the manufacturer. In teaching you Pharmacology we will concentrate on the Official name! If we are to study the trade names of drugs, none of us will pass, because there are too many names and they are very hard to memorize. Thats why we are only taught official names! Sometimes we are given the trade name which is commonly sold in the pharmacy between brackets. Take notice that if you write in a future prescription Diazepam for example, the pharmacist has the right to give you whatever brand name of Diazepam he has available, such as Valium, Stesolid or Valipam. However if you specify a specific brand name, the pharmacist should give you only the brand name specified! Sources of Drugs: Historically speaking, most drugs were derived from plants and animals.
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1)

Plant:
a) Alkaloids:

we will discuss them when we talk about systemic pharmacology. Example: Atropine, Pilocarpine and Morphine. Digoxin

b) Glycosides:

2)

Mineral: Fe used to treat iron deficiency anemia. Ca used to treat bone diseases such as rickets or osteo malasia Diabetes is either: 1)Insulin deficiency.

3) Animal:

In type 1 diabetes there is insulin deficiency not insulin insensitivity, we have to treat those patients by replacement of this deficient hormone, so we give them insulin.

2)Insensitivity of the tissue to normal insulin. From where can we get insulin? Previously insulin was extracted from the pancreas of animals (cattle, calves, pigsetc), so previously we had bovine (cattle) insulin and porcine (pig) insulin. Nowadays, insulin is humanized; it's more similar to human insulin. It is synthesized by different ways.

4) Microorganism:

Most useful antibiotics nowadays are synthesized from cultivation of bacteria or fungi. These microorganisms, by repeated culture, will produce antibiotics which could be used as a treatment for other bacteria or fungi. For example, Penicillin is synthesized from fungal culture. The first synthesized antibiotic which is penicillin was synthesized in1942 by the British microbiologist Alexander Flamming by accident while extracting fungal culture. Then various antibiotics were synthesized either from bacteria or fungi.
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5) Synthetic:

The majority of the drugs nowadays are produced in the drug manufacturing companies by pure chemical synthesis. For example Aspirin. Aspirins structure is known and synthesized chemically in drug laboratories. Another example is Sulphonamides which is an antibacterial agent.

6) Semisynthetic:

A combination of natural product with synthetic product. For example Ampicillin has a pure natural product which is the Penicillin, this pure natural product is chemically modified in the drug laboratories by adding a chemical group (amine) to make it Semisynthetic.

7) Genetic

Engineering (recombinant DNA technology): We talked about animal Insulin earlier, and now we will discuss the humanized Insulin. Humanized Insulin is identical to human insulin. It's impossible however to extract Insulin from the pancreas of humans! Instead we rely on another method which is called Genetic Engineering or recombinant DNA technology to synthesize human insulin or human hormones. What does Genetic Engineering mean? The gene which is responsible for the production of insulin in humans was identified and isolated. As you know the gene is a piece of DNA (DNA segment), so the gene which is responsible for the synthesis of insulin was identified and isolated. What they did next is take that gene to the drug laboratory and inoculate it into certain species of bacteria (strains of E.coli for example), this way the insulin producing gene is being inoculated into the bacteria, and then after cultivating and recultivating, the bacteria start to synthesize insulin. And it is exactly similar to human insulin! This is the recombinant DNA technology. !Nowadays human insulin is mainly synthesized in this way
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We give diabetic patients this human insulin because it will not cause any type of allergy or hypersensitivity or rejection at all. There are many other examples of drugs synthesized by this method as well.

For any treatment that we are going to use, for these drugs to be useful, they first have to be prescribed to the patient, then bought by the patient and taken be him/her only! People should not take any drugs that werent prescribed for them, its like wearing someone elses shoes, they wont fit properly! For a drug to be useful, it should be both prescribed and administered to the patient. Routes of Drug Administration: Before discussing the pharmacology of drugs in details, we must have an idea how they are given to the patient and the various routes of their administration. For a drug to be useful it has to be taken in a proper way. The methods of the entry of drugs are called routes of drug administration. We have two main routes of drug administration: 1) Enteral: Through the GIT.
2)

Parentral: Outside the GIT.

Again, we have two routes, Enteral, which means through the GIT, which starts with the mouth and ends with the anus. Any drug administered through this tube is called Enteral, while any other drug that

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is administered outside this tube is called Parentral (Par in Latin means away from). Enteral Through the GIT Oral Buccal Rectal Parentral Not through the GIT Injections (IV, IM and SC) Topical Inhalation

1) Enteral: Oral: Usually by swallowing, which is the most common route for drug administration.
A.

Buccal/Sublingual: Some drugs are not swallowed; instead they are kept in the buccal area under the cheeks, to be absorbed by the buccal mucous membranes of the mouth. Some other drugs are introduced under the tongue which is called Sublingual.
B. C.

Rectal: Introduced from the other end of the GIT.

2)

Parentral: Injections: Whether IV (intravenous), IM (intramuscular), SC (subcutaneous), or inside the joints, arteries or spinal canal.
A.

Topical: For example ointments ( ,)creams, shampoo (treatment of hair diseases such as scalp lesions).
B.

Inhalation: For example drugs taken to treat bronchial asthma. These drugs are in a gaseous form, they are inhaled through deep inspiration into the respiratory tract.
C.

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Now we will go through them again in more details, mentioning the advantages and disadvantages of each. This lecture we will only cover the oral route and next lecture we will continue.

ORAL (Swallowing Method): A) - Convenient: - Portable (we can take the drug anywhere and anytime) - No pain Advantages:

- Easy to take (all we need is a glass of water) - Cheap: - No sterilization - No Expert (we dont need a Dr. or a nurse to give us the tablet or syrup) The patient should be in a sitting or standing position not in laying position to avoid choking or suffocation! B) Disadvantages:

Variable bioavailability might be produced by the oral method. And dont worry about the term bioavailability because we will discuss it in the future.
1)

First pass effect: It means metabolism of the drug after absorption in the GIT and before reaching the general or systemic circulation, thats the metabolism of drugs in the liver for example, or the GIT mucosa. More details will be discussed later.
2)

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Food can affect absorption: Absorption of a drug administered orally might vary according to the presence or absence of food in the stomach or duodenum. Usually food delays or interferes with the absorbed amount of the drug.
3)

Local effect, taste, irritation, effect on flora: Some drugs have a bad taste so that their intake orally is not acceptable by many patients.
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Some other drugs might be irritant to the mouth or the GIT mucosa, as some patients might complain of nausea or even vomiting shortly after taking the drug, this nausea or vomiting is due to irritation of the stomach, esophagus and duodenum and so on. Another disadvantage comes with the antibiotics of the broad spectrum type, it tends to kill most of the stomach bacteria which might alter the balance between useful bacteria and pathogenic bacteria which are present normally in our GIT, and this might lead to GIT diseases.

We have different types of bacterial flora, pathogenic (harmful) bacteria and useful bacteria such as the bacteria that help in synthesizing vitamins (vitamin K or B12). These two types are normally present in a state of balance, but broad spectrum antibiotics might disturb this balance by killing the useful bacteria which are more sensitive to the action of these antibiotics, leaving the space for the pathogenic bacteria to multiply producing a harmful consequence.
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Unconscious patients: For example comatose patients ( ,)but the alternative route used here is injections.
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Examples: Tablets, capsules, solutions, syrup, suspension, elixir.

The Syrup contains soluble drugs while when the drug is insoluble in water, the drug particles will be suspended in the solvent forming a product called suspension.

Also in the syrup the drug is dissolved in a sweet aqueous solution but in the elixir the drug is dissolved in a hydro-alcoholic solution (the hydro-alcoholic solvent is water and alcohol). The solubility of the drug is increased in hydro-alcoholic solution and it is called an elixir.

THE END! Done by: Anwar Durrah.

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