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Pharmacotherapy : The main effects of drugs on different diseases Pharmacodynamic : The effects of drugs on living system Pharmacokinetic : The fate of drugs in living system Pharmacognosy : Natural sources of drugs
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Pharmacotherapy : The main effects of drugs on different diseases • Pharmacodynamic : The effects of drugs on living system • Pharmacokinetic : The fate of drugs in living system • Pharmacognosy : Natural sources of drugs • Pharmacogenetic : Different responses to drugs because of genetic variations
Pharmacokinetic ADME:Absorption,Distribution,Metabolism, Excretion ADME will be changed by Pregnancy Therapeutic index = LETHAL DOSE / THERAPEUTIC DOSE TI of Digoxin,Warfarin and Lithium is very small So they are very Dangerous
Pharmaceutic : Disintegration and Solubility Elixir > Suspension > Cap > Tab > Matrix tab > Enteric coated Pharmacokinetic Absorption , Distribution , Metabolism ,Excretion ADME Absorption from intestine > Skin Absorption from sublingual > subdermal Non ionized > Ionized Route of dug administration : Enteral : Gastrointestinal tract Parenteral : Subcutaneous, Intramuscular,Intravenous,Intrathecal Pulmonary Topical
Distribution • Plasma protein : Albumin , sulfunamide • Binding : Warfain 99%,Cimetidine 20% • Competition : Aspirin and Warfarin ( Bleeding ) • Hypoproteinemia : Liver failure • Adipose tissue : Accumulation ( Thiopental ) • Bone : Tetracycline ( Browning of the teeth ) • Blood brain barrier : Anesthetics • Placental barrier : Anesthetics , Steroids • Bioavailabiliy : Intravenous dose / Administered dose
Excretion: • Kidney : Ionized drugs > non ionized drugs • Alkalinization ( Phenobarbital ) Bicarbonate • Acidification ( Amphetamine ) Vitamin C • G.I.Tract : Morphine • Lungs : Anesthetics • Saliva : Dermatitis ( some intravenous drugs ) • Mammilary glands : pH= 6.5 Morphine
Affinity: Drug binding to its receptor • Efficacy: Effects after drug binding • Potency : Capability of drugs in similar doses Lid4 Pril 1 • Physiologic Ant: two receptors Histamine,Salbutamol • Pharmacologic Ant: one receptor acetylcholine,Atropine • Chemical Ant : Without recepterFe,desferoxamine • Competetive Ant: Acetylcholine,Atropine • Non competetive Ant : Phanoxybenzamine • Partial agonists : Their efficacy is less than full agonist • Loading dose = Volume of distribtion×Total concenration • Therapeutic index= LD 50 / ED50 Digoxin
Predictable adverse effects • Age : Infants and old patients , Chloramphenicol • Body mass : Infants ( per KG ) • Sex : Fat and water ratio ( male and female ) • Time of administration : With meal Aspirin • Idiosyncrasy: unusal responses to drugs • Tolerance : Disappearance of effect Morphine • Tachyphylaxis : Rapid tolerance Local anesthetics • Dependence : Physical,Psychological Morphine
Tincture : Preserved from light , Belladona Syrup : Sweet, Hydroxyzine Elixir : Addition of some materials,Acetaminophen Suspension : Shaking before using,Furazolidone Lotion:With alchohol,Kalamine Ointment : Semisolid shape , Cream : With water , Pill,Dragee : Unfavorable pills Ovule : Vaginal , Clotrimazole Suppository : Indomethacin
bid bis in dis • dc Discontinue • gtt gutta • KVO KeepVein 0pen • NS normal saline • OTC over-the-counter • Prn pro re nata • qd quaue die • qid quarter in qie