Introduction to Pharmacology - University of Surrey - Sept 24

Introduction to Pharmacology Dr Martin Hawes Senior Lecturer Veterinary Pharmacology and Therapeutics 1  What to expect Before the lecture Revision Refresh your memory on key topics (esp. physiol...

Introduction to Pharmacology Dr Martin Hawes Senior Lecturer Veterinary Pharmacology and Therapeutics 1  What to expect Before the lecture Revision Refresh your memory on key topics (esp. physiology) Pre-read Max 4 pages – please read so we can focus on the harder topics in the lectures Lectures In-person Please attend in person to get the most out of class discussions and practical tasks (lectures recorded) After the lecture Skills Exercises to develop your prescribing skills and drug drug knowledge Quiz Five questions with formative feedback to check understanding of LOs Saturday, 07 September 2024 2  Resources Ritter, J., Flower, R. J., Henderson, G., Page, C., Datta, S. T., Xiu, P., & Page, Riviere, J. E. (Jim E., & Papich, M. G. Loke, Y. K., MacEwan, D. J., Robinson, E. C. P. (2019) Pharmacology (Fifth (2018) Veterinary pharmacology and S. J., & Fullerton, J. (2024) Rang and edition) Elsevier. therapeutics (10th ed.) Wiley Blackwell. Dale’s pharmacology (Tenth edition.) Elsevier. Saturday, 07 September 2024 3  Pharmacology vs Therapeutics Pharmacology - The mechanisms and actions of drugs Wow! How does that work? Therapeutics - The treatment of disease using drugs OK Fido, now you might feel a small scratch !! Saturday, 07 September 2024 4  What is a drug? A drug is a substance that, when introduced into the body, produces a biological effect for an intended purpose. Saturday, 07 September 2024 5  Learning Objectives Be aware of the various ways of naming medicines Identify and use the active ingredient as the primary term of reference when describing a veterinary medicine Understand the groupings of medicines into classes related to structure and properties Describe a veterinary medicine in terms of its physical characteristics Give examples of excipients and understand their role in the formulation of medications Understand in principle the process of medicines development to include: the drivers of drug discovery and the costs and timescale involved in bringing a new medicine to market Saturday, 07 September 2024 6  Learning Objective 1 Be aware of the various ways of naming medicines  Naming medicines Pre-read Drugs known by their International Non-proprietary Name (INN name) also known as their generic name - assigned by the WHO. Drug companies may give their products a brand name – also known as the proprietary name. Saturday, 07 September 2024 8  Naming medicines Chemical formula C21H23NO5 Structural formula IUPAC ID (5α,6α)-7,8-didehydro-4,5-epoxy-17 -methylmorphinan-3,6-diol diacetate Street names Generic Name (INN) Saturday, 07 September 2024 9  Learning Objective 2 Identify and use the active ingredient as the primary term of reference when describing a veterinary medicine  Naming medicines Brand name/ Active ingredient Proprietary name (generic name) Saturday, 07 September 2024 11  Veterinary examples Saturday, 07 September 2024 12  Learning Objective 3 Understand the groupings of medicines into classes related to structure and properties  Drug classes Drugs can be classified based on: 1. Their physicochemical properties (chemical nature) 2. The target to which they bind (pharmacological action / mechanism of action) 3. The clinical outcome they produce (pharmacotherapeutic action). Understanding the mechanism of action and characteristics of a drug class can often (but not always) help predict the effects of all the drugs within that class - makes it easier to memorize drugs - can help you select the most appropriate medication – improves safe and effective prescribing Saturday, 07 September 2024 14  Drug classes Physicochemical properties - e.g.– β-lactam antibiotics penicillin, amoxicillin, ampicillin, flucloxacillin cefradine, cefuroxime, cefovecin, ceftazidime Saturday, 07 September 2024 15  Drug classes Mechanism of action – e.g. cyclooxygenase inhibitors (NSAIDs) celecoxib, valdecoxib, firocoxib meloxicam, piroxicam, tenoxicam Saturday, 07 September 2024 16  Drug classes Clinical outcome they produce e.g. anti-epileptic drugs phenobarbital diazepam imepitoin potassium bromide Rottweiler epileptic seizure phenobarbital https://www.youtube.com/watch?v=Lzm0Nsi0oP0 Saturday, 07 September 2024 17  Learning Objective 4 Describe a veterinary medicine in terms of its physical characteristics  Physical characteristics of a medicine Tablets & capsules Injections Spot-ons Solutions Suspensions IV infusions Eye drops Drenches Creams & ointments Saturday, 07 September 2024 19  Learning Objective 5 Give examples of excipients and understand their role in the formulation of medications  Excipients Taken from Kemsley (2014) cen.acs.org Saturday, 07 September 2024 21  Excipients Butylhydroxytoluene Antioxidant Aluminium stearate Anticaking agent, stabilizer Stearic acid Emulsifying agent Poultry liver powder Flavouring agent Triglycerides medium chain Solvent (for flavouring) Saturday, 07 September 2024 22  Learning Objective 6 Understand in principle the process of medicines development to include: the drivers of drug discovery and the costs and timescale involved in bringing a new medicine to market  Drug discovery and development Please read Chapter 60 - Drug discovery and development, in Rang and Dale’s Pharmacology before 22 October. Saturday, 07 September 2024 24 Developing your prescribing skills Prescribing Framework Assess the patient Monitor and Identify treatment review options Provide Present options information to client Prescribe Adapted from the Royal Pharmaceutical Society Competency Framework for all Prescribers 26  Prescribing skills Saturday, 07 September 2024 27  Prescribing Information: Summary of Product Characteristics Veterinary Medicines Directorate - Product Information Database http://www.vmd.defra.gov.uk/ProductInformationDatabase/ Saturday, 07 September 2024 28  Summary of Product Characteristics Veterinary Medicines Directorate - Product Information Database http://www.vmd.defra.gov.uk/ProductInformationDatabase/ Saturday, 07 September 2024 29  Key Points LO - Be aware of the various ways of naming medicines and be able to identify and use the active ingredient as the primary term of reference when describing a veterinary medicine International Non-proprietary Names (INN) identify the active pharmaceutical ingredient in a medicinal product The INN is also known as the generic name INNs are public property, selected and published by the WHO Proprietary (or brand) names are given to a medicinal product by the pharmaceutical company that makes the product Proprietary name Metacam Generic name meloxicam Saturday, 07 September 2024 30  Key Points LO – Understand the groupings of medicines into classes related to structure and properties Drugs are grouped into classes of similar physicochemical characteristics, MoA or clinical outcome they produce Pharmacologically related substances often (but not always) have a similar stem in their generic name (e.g. penicillin, amoxicillin, ampicillin, flucloxacillin) Physchem Characteristic Mechanism of action Clinical outcome e.g. β-lactam antibiotics e.g. cyclooxygenase inhibitors e.g. antiepileptic drugs (NSAIDS) Saturday, 07 September 2024 31  Key Points LO – Describe a veterinary medicine (physical characteristics) LO – Give examples of excipients and understand their role in the formulation of medications Drugs are administered to patients via different formulations designed to optimize therapeutic effect and tolerability Formulations contain excipients (e.g. flavouring, preservatives, antioxidants) to make them into suitable medicinal products Saturday, 07 September 2024 32  Key Points The properties of a medicinal product (including presentation, uses, dosage & administration and warnings) are described in the ‘Summary of Product Characteristics’ (UK and EU) or ‘Prescribing Information’ (USA) Summary of Product Characteristics Veterinary Medicines Directorate Product Information Database http://www.vmd.defra.gov.uk/ProductInformationDatabase/ Saturday, 07 September 2024 33  Key Points LO – Understand the process of medicines development Drug development is high risk, high cost, but potentially highly profitable. A new drug for human use typically costs $2billion to bring to market New drugs take 10-15 years to come to market. Companies are protected from generic competition for 20 years by patents. Saturday, 07 September 2024 34  Key Points LO – Understand in principle the process of medicines development Drug discovery involves target identification, validation, lead identification and optimization, in vitro and in vivo testing Toxicology in animals is required by law before new drugs can be given to humans Clinical development involves increasingly large studies, initially in healthy volunteers (Phase I) and then in patients (Phase II and III) to produce a large database of safety and efficacy data sufficient to satisfy regulatory approval for a new medicine Phase IV trials are conducted after launch and designed to generate long-term safety data, competitive data, and expand indications Saturday, 07 September 2024 35