Lesson 1 - Introduction to Pharmacology PDF

Lesson 1 INTRODUCTION TO PHARMACOLOGY 3° Medicine Professor: Vittoria Carrabs PhD Academic year: 2024/25  Summary 1. Pharmacology 2. Aims of Pharmacology 3. Basic concepts 4. Drug development 5. Pharmacovigilance 6. Drug nomenclature 7. Drug Classifications 8. Types...

Lesson 1 INTRODUCTION TO PHARMACOLOGY 3° Medicine Professor: Vittoria Carrabs PhD Academic year: 2024/25  Summary 1. Pharmacology 2. Aims of Pharmacology 3. Basic concepts 4. Drug development 5. Pharmacovigilance 6. Drug nomenclature 7. Drug Classifications 8. Types of pharmacological treatments 9. Medical Prescription  1. PHARMACOLOGY If physiology deals with function, anatomy deals with structure, and biochemistry deals with the chemistry of the living body… then pharmacology deals with changes in the function, structure and chemical properties of the body caused by chemicals. W.D.M.Paton, Annual Review of Pharmacology and Toxicology 1986; 26:1-22 Pharmacology is the scientific study of the effects of drugs and chemicals on living organisms where a drug can be broadly defined as any chemical substance, natural or synthetic, which affects a biological systems.  What is pharmacology? PHARMACOLOGY Pharmakon (drug) logos (word-meaning knowledge) Biomedical science that studies the properties and interaction of drugs with cells, tissues and living organisms. What is a drug? A chemical substance of known nature, [...] which produces a biological effect when administered to a living organism. 4  Pharmacology in history Ebers Papyrus Extensive development of biomedical sciences (877 Recipes + 700 Drugs) and experimental pharmacology Experimental Experimental pharmacology Therapeutics Magic potions and plant- and organic chemistry Biochemistry derived remedies/poisons (Pasteur) Molecular Biology 2800 b.C. 1500 b.C. 1800 a.C. 1900 a.C. Nowadays Priests Apothecaries Pharmaceutical industry 5  Current Pharmacology Current pharmacology can be subdivided, for strategic reasons: Drug Organism Applications 6  Current Pharmacology Current pharmacology can be subdivided, for strategic reasons: Drug Pharmacognosy: active compound of botanical origin. Chemical pharmacology: chemical structure of pharmaceuticals, their production and relationship with activity. Pharmacotechnics: manipulation of raw materials. Ethnopharmacology: medicinal plants used by indigenous. 7  Current Pharmacology Current pharmacology can be subdivided, for strategic reasons: Organism Pharmacokinetics: the effect of the organism on the drug. Pharmacodynamics: the effect of the drug on the organism. Pharmacometry: quantifies the effects of the drug as a function of dose. Pharmacogenomics: influence of genetic factors. Chronopharmacology: influence of biological characteristics, time or biological cycles. 8  Current Pharmacology Current pharmacology can be subdivided, for strategic reasons: Therapeutic Applications Clinical pharmacology: medical speciality dealing with the evaluation of the effects of drugs in humans, as well as the RATIONAL USE OF DRUGS. Pharmacotherapy (a consequence of clinical pharmacology): the science and application of drugs for the prevention and treatment of disease. Toxicology (its own science): focuses on the harmful effects of drugs and other chemical substances. Pharmacoepidemiology: the impact of drugs on large populations. Pharmacoeconomics: cost of drugs and diseases. Gene therapy: introduction of a gene. 9  2. AIMS OF PHARMACOLOGY 1. Rational use of drugs Patients receive medication appropriate to their clinical needs, in appropriate doses, for an appropriate period of time and at the lowest possible cost to them and the community (WHO, 1985). Benefits/risk balance Risks Benefits Adverse effects Cost Reduced morbidity Problems of Improves quality of life administration Effectiveness (overdose, Easy administration poisoning, and dosing absorption problems...) 10  2. AIMS OF PHARMACOLOGY 2. Rational therapeutic process Does the drug penetrate the patient well? Formulations / Routes of administration / Therapeutic compliance Does the drug reach the site of action? Pharmacokinetics Does the drug produce the expected pharmacological effect? Pharmacodynamics Does the pharmacological effect translate into a therapeutic effect or a toxic effect? Toxicity 11 2. AIMS OF PHARMACOLOGY 3. Clinical pharmacology (science+clinical speciality) ü identify factors that alter the response to a drug ü communicate the importance of these factors ü individualise treatments according to these factors ü monitor response in order to readjust treatment if it is not correct 12  2. AIMS OF PHARMACOLOGY 4. Review Of Pharmacological Treatment Aims: o Optimise the effect of the medication. o Minimise the number of drug-associated adverse reactions (ADRs). o Detect interactions, duplications and inappropriate treatments. o Improve compliance. o Improve efficiency. o Differentiate an ADR from a new pathology 13  2. AIMS OF PHARMACOLOGY 4. Review Of Pharmacological Treatment Deprescribing: withdrawal of inappropriate drugs supervised by a medical professional. It may include dose adjustment or include changes of type of drug. Individualized. Gradual. Characteristics of each drug (withdrawal syndrome or rebound effect). Development of patient follow-up programs. 14 3. BASIC CONCEPTS DROGUE In the classical sense, refers to the raw material, generally of vegetal origin (dry herb) 15 3. BASIC CONCEPTS 16  4.DRUG DEVELOPMENT Drug development refers to the process of bringing a new drug to the market 1. Discovery and Development 2. Preclinical Research 3. Clinical Research 4. FDA Review 5. FDA Post-Market Safety Monitoring (Pharmacovigilance) PHASES OF CLINICAL RESEARCH Fun facts: 70% of drug candidates move to phase II 33% of drug candidates move to phase III 25-30% of drug candidates move to phase IV 20  5.PHARMACOVIGILANCE A public health activity that aims to identify, quantify, evaluate, and prevent risks associated with the use of drugs once they have been marketed (RD 1344/2007). OBJECTIVES: Identify and assess adverse reactions (ARs) arising from acute or chronic drug use (ADRs). Establish the causal relationship (cause of ADR). Know the true benefit/risk balance of each drug and the factors that may increase the risk. 21  6. DRUG NOMENCLATURE CHEMICAL NAME - Chemical structure of the drug. - Must follow the International Rules of Chemical Nomenclature (IUPAC) N-(4-hydroxyphenyl) acetamide GENERIC NAME/ -Established by official national and international bodies (INN: international Non-proprietary non-proprietary name). name -They are publicly owned and are not protected by a patent. Paracetamol o acetaminophen TRADE NAME - It consists of the protection that is officially given and certified by the government to industrially exploit the composition of a drug. Gelocatil, Tachipirina, Efferalgan, Apiretal, Dafalgan, Termalgin, etc. 22  6. DRUG NOMENCLATURE CHEMICAL NAME GENERIC NAME/ Non- proprietary name TRADE NAME 23 savoir les exemples ?? 6. DRUG NOMENCLATURE Examples: Drug group desinence Beta-adrenergic blockers -alol -olol α1-adrenergic antagonists - antihypertensives -azosin Angiotensin-converting enzyme inhibitors(IECA) -pril Angiotensin receptor antagonists type 1(ARAII) -sartan Statins -statin Benzodiazepine -azepam -azolam Tetracyclines -cycline Penicillin derivatives -cillin 24  NATURE AND SOURCES OF DRUGS 1. Natural source: Plant (Morphine, digoxin, quinine, atropine, nicotine, caffeine…) Animal (Insulin, thyroid extract, heparin…) Mineral (Liquid paraffin, magnesium sulfate, kaolin, Ca, Cl…) Microorganism (Bacteria and fungi, isolated from soil are important sources of antibacterial substances, e.g., penicillin) 2. Synthetic source: Laboratory sources (e. g Analgesics, hypnotics, anticancer drugs, e.g. Paracetamol, Aspirin…) 3. Other sources: Genetic engineering (DNA recombinant technology) e.g insulin and growth hormones, genes. Hybridoma technique (e. g monoclonal antibodies).  7. DRUG CLASSIFICATION 7.1 Therapeutic classification Therapeutic utility for the treatment of specific diseases USEFULNESS OF THE CV SYSTEM THERAPEUTIC CLASSIFICATION Decrease blood clotting Anticoagulants Lower plasma cholesterol levels Hypolipidemic agents Lower blood pressure Antihypertensives Treatment of angina Antianginal Resets heart rhythm Antiarrhythmic  7. DRUG CLASSIFICATION 7.2 Pharmacological classification Based on the mechanism of action of the drug MECHANISM OF ACTION PHARMACOLOGICAL CLASSIFICATION Calcium channel blockers Calcium channel blockers Decrease plasma volume Diuretics Peripheral blood vessel Vasodilators dilators  7. DRUG CLASSIFICATION 7.3 Anatomical Therapeutic Chemical Classification (ATC) It divides drugs into several groups according to the organ and system on which they act, as well as in function of its chemical and pharmacological properties First level: Main anatomical group (A-V) Second level: Main therapeutic group (2 numbers) Third level: Therapeutic/pharmacological subgroup (a letter) Fourth level: Chemical/therapeutic/pharmacological subgroup(a letter) Fifth level: Chemical (2 numbers) N02BA01: Aspirin®  8. TYPES OF PHARMACOLOGICAL TREATMENTS 1. Aetiological or curative treatment - Combats the cause of the pathological mechanism. E.g.: Use of antibiotics in infections. 2. Pathogenic or corrective treatment - Does not fight the cause, but acts against the pathological mechanism. E.g. Insulin administration in diabetics. 3. Prophylactic treatment - Prevention of disease. E.g. Vaccines. 4. Suppressive treatment - Temporary relief of disease. E.g. Palliative treatment of patients with cancer. 5. Functional or symptomatic treatment - Relieves or suppresses the symptoms of the disease. E.g.: Anticatarrhal drugs. 8. MEDICAL PRESCRIPTION Medical prescription: A standardised and compulsory document of a healthcare nature, by means of which doctors, dentists, podiatrists or nurses legally authorised to do so, and within the scope of their respective competences, prescribe to patients the medicines or medical devices subject to medical prescription, to be dispensed by or under the supervision of a pharmacist, in pharmacies and medicine cabinets dependent on them or, in accordance with the provisions of current legislation, in other health establishments, care units or pharmaceutical services of primary care structures, duly authorised to dispense medicines. (Real Decreto 1718/2010) It is a formal communication from a healthcare professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Sources of information SOU RCE E L I ABLE TA R S N O PE D IA I WIKI