Welcome to your pharmacology online study Guide

This guide explains clinical pharmacology, drug nomenclature, branches, and all routes of drug administration in this post. A brief intro for the fundementals of pharmacology.

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What is Clinical Pharmacology ?

Clinical pharmacology is the science that studies drug effects on humans and their optimal clinical use.

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Pharmacology splits into three main branches

Pharmacodynamics

Involves the mechanism of drug action (by what way the drug gives it’s action). simply it iswhat the drug does to the body

Pharmacokinetics

Involves the Absorption of the drug , distribution of the drug inside the body , metabolism of the drug,  and elimination of the drug. simply it is what the body does to the drug.

Pharmacotherapeutics

The use of drugs treat or prevent illness

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How drugs are named?

Drugs have defined type of nomenclature that can go by three ways of naming by either :

Chemical Nomenclature

It’s the scientific name that describes that drug at a molecular level.

Pharmacologic Class

Drugs that are similar in mechanism of action are grouped together inside a defined class. Example: calcium channel blocker class.

Therapeutic Class

Drugs could be also grouped by their therapeutic action. Example: antihyperglycemics is a therapeutic class.

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Four sources of drugs

In old times, medications were made from natural sources such as from animals, plants and minerals.

Today in modern world, scientists use chemicals to synthesis drugs. An advantage of synthetic drugs over a natural source is that its free of impurities.

Furthermore, manipulation of drugs at molecular level, allowed scientists to tweak the drug to be more effective. for instance, an antibiotic could have multiple generations that is more effective against a particular group of organisms.

1. Plants as source of drugs

The active components of plants are:
  • Alkaloids: it is a basic substance that reacts with acids to form salt which can dissolve readily inside the body fluids. Its nomenclature usually ends with “-ine”. Examples : nicotine, caffeine, atropine.
  • Glycoside: also an active component inside plants. It usually ends with suffix -in. example digoxin.
  • Gums: are products that have the ability to attract and hold water. Example: starch in seeds.
  • Resins: are the main source of pine tree sap. Usually used as laxatives or local irritants.
  • Oils: greasy and thick liquids that could be fixed or volatile. Examples of volatile liquids are spearmint, juniper and peppermint. Fixed oils are not volatile like olive oil as well as castor oil.

2. Which drug may be derived from an animal source?

Drugs could be obtained from animal sources as well like the body fluids or glands.

Drugs that are obtained from animal sources include:

  • Hormones such as insulin
  • Oils and fats such as cod liver oil
  • Enzymes such as pepsin and pancreatin
  • Vaccines, which are killed, attenuated or modified microorganisms

3. Drugs derived from mineral sources

Minerals are either metallic or nonmetallic. The mineral sources of drugs are used as they occure naturally in nature or is combined with other active ingredients. Drugs that contain minerals are iodine, Epsom salts and iron.

4. Drugs that have been made using recombinant DNA technology

Nowadays, laboratories produce most drugs and can be natural ( from plant, animal, or mineral sources) or synthetic.

Examples of drugs that are produced in laboratories include pantoprazole (synthetic source) and human growth hormone ( natural source ).

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Folk medicine

Traditionally, at old time, people used the plant as a whole, including all its parts ( roots, leaves, buds, stem, seeds). subsequently, it contained large number of impurities and harmful substances. As science evolved, researches sought to isolate those impurities from the active ingredient to avoid the harmful effect of administering the plant as a whole.

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Pharmacology routes of administration

The administration route of the drug largely influence the quantity of the delivered drug and the rate by which the drug is absorbed and distributed across the body. These variables affects the action of the drug and the response of the patient to treatment.

Buccal route

Inside the mouth in the area between the cheek and gum.

Sublingual route

Under the tongue.

Translingual route

On the top of the tongue.

Those routes accelerate drug absorption and prevent their destruction by the stomach acidity or their altering by intestinal enzymes.
Gastric route

Allows administering of the medication right to the GI tract of the patient who can’t swallow the drug orally.

Intradermal route

Injecting the drug into the dermis layer of skin. This route is mostly used to test for allergies or tuberculosis test.

Intramuscular route

Allows administering the drug directly into different muscle groups. It could be provided in either aqueous solutions or suspensions, immunizations, and drugs that are not available in oral form.

Intravenous route

Injecting the drug directly through a vein into the bloodstream.

Oral route

It is the safest and most convenient route of administration. Oral drugs are usually inexpensive compared to other pharmaceutical forms of drugs. This route is used in patients who are conscious and can swallow.

Vaginal and rectal

Includes suppositories, creams, ointments, gels and tablets that can be instilled into the rectum or vagina to treat and infection or treat a local irritation.

Respiratory route

Drugs that are in gases form such as anesthetics are administered through an endotracheal tube in emergency situations. Some medications are given by such devices as inhalers that can be self-administered by the patient such as asthmatic drugs.

Subcutaneous route

Injecting the drug into the skin layer below the dermis and epidermis

Topical route
Drugs are applied topically on a specific area
Drugs injected directly at a specific site such as:
Epidural injections
Injecting drugs into epidural space
Intrathecal infusion
Injecting drugs into the cerebrospinal fluid
Intrapleural infusion
Drugs injection into the pleural cavity
Intraperitoneal infusion
Drugs injected into the peritoneal cavity
Intraosseous infusion
Drugs injected into the vast vascular network of a bone
Intra articular infusion
Drugs injected into a joint

Processing and developing of New Drugs

Nowadays, new medications are developed through scientific researches, unlike in the past where they were found by pure accident! the FDA carefully regulate the development of the new drug process through clinical trials to make sure the drug that is released to the public is completely safe and effective. Any new company that develops a new drug have to file an IND (Investigational New Drug) application.

New drug development phases

After the FDA approves the IND application, the drug must undergo four phases of clinical trials before it is approved and released to the market.

1. Phase I

  • Tests the effect of the drug on a small group about 10-30 HEALTHY volunteers to establish mostly the safety and side effects of the new drug in development

2. Phase II

  • Experimented on small group of people who actually HAVE THE DISEASE needed to treat to establish the effectiveness of the drug.

3.Phase III

  • The trial is done on larger number of patients in an institute or medical center. this provides us with information about the rare side effects or adverse effects of the novel drug.

4. Phase IV

  • Which is usually called “post marketing surveillance” after the drug is released to the market. The pharmaceutical companies receive feedback from healthcare providers about the therapeutic results of the drug and its adverse events. Occasionally some medications appeared to have toxic effect after they have been released to the market and the pharmaceutical companies had to withdraw them.
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However; There are exceptions to this rule

Although almost all Investigational new drug applications go through all clinical trial phases regulated by the FDA, some can receive expedited approval. Example, when AIDS (acquired immunodeficiency syndrome) first threatened public health, THE FDA shortened the time of approval for INDs applications in order to fight the new disease faster. This allowed physicians to start treating new diseases faster using promising novel drugs which aren’t yet approved by the FDA.

Reporting to the FDA

FDA receives problems reported to them through a MedWatch form if there is a program associated with one of the drugs in the market under its regulation. Healthcare provider must write and complete the MedWatch form and send it to the FDA if a drug is found associated to any of the following: Patient’s death, drug caused a life-threatening disease, prolonged the hospital stay of a patient, caused the initial patient hospitalization, caused disability, found to be associated with congenital abnormality.

Pharmacy Cafe

Pharmacy Cafe is a team of pharmacists committed to providing our audience with trusted, real-world, evidence-based health information from the nation's leading healthcare providers and patient advocates, alongside personal patient perspectives and health consumer insights from those on the front lines, in real time.

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