Pharmacology

1. Pharmacology Pharmacology is the study of the actions of drugs on the body and the way the body metabolizes drugs. The study of pharmacology includes the biochemical action on the body by drug and incorporates the knowledge and ideas from other scientific disciplines like biology, chemistry and physiology. In this section of the course, we will cover dosage forms and administration, pharmacology itself, pharmacodynamics and a quick overview of body systems like the cardiovascular system, skin, and endocrine systems

2. Source of Drugs • Natural Sources of Drugs • Drugs that originate from plants or animals • Examples: • Acetylsalicylic acid (ASA or Aspirin) originates from the bark of the willow tree. • Cocaine originates from the coca plant (Erythroxylum coca) • Morphine and Codeine originate from the Papaver somnifera plant • Digoxin comes from the Foxglove plant • Vincristine and Vinblastine are called vinca alkaloids and come from the periwinkle plant. • Niacin is a B vitamin (B3) is found in green vegetables • Cyanocobalamine is a B vitamin (B12) found in eggplant and meats • Insulin was originally isolated from pork (porcine) or bovine (cow) pancreas

3. Unusual Sources of drugs • Lepirudin (Refludan®) is an anticoagulant that is used in hospital to treat PE and DVT. Source: ? • The saliva of leeches known as Hirudo medicinalis. A leech is a blood sucking worm • Premarin® is conjugated estrogens used to treat vaginal bleeding and to treat post menopausal Sx in middle aged women. Source:? • The urine of pregnant mares • Captopril is an ACE inhibitor used to treat hypertension and CHF. Source:? • Brazilian arrowhead viper: a poisonous snake

4. Synthetic Drug Sources • Most synthetic drugs are really semi-synthetic in that the drug is chemically modified from a natural source. • Examples are: • Oxycodone (Oxycontin®) • Succinylcholine (Quelicin®) • Piperacillin/Tazobactam (Zosyn®) • Amoxicillin (Amoxil®)

5. Genetically Engineered Drugs • Recombinant DNA technology is a new modality that arised in the late 1970’s and early 1980’s. Greatly accelerated by the Human Genome Program completion in the late 1990’s. • Involves sequencing the gene for a human protein, carrying a vector for that gene (usually a virus), have the vector infect a host (usually a bacteria, E. Coli) and allowing the bacteria to mass produce the gene product for us to market. • Examples: • Recombinant human insulin . Recombinant insulin has almost completely replaced insulin obtained from animal sources (e.g. pigs and cattle) for the treatment of insulin-dependent diabetes ] • Recombinant human growth hormone. (HGH, somatotropin). Growth hormone is administered to patients whose are growth hormone deficient. • Recombinant blood clotting factor VIII. Recombinant factor VIII is a blood-clotting protein that is administered to patients with hemophilia • Recombinant hepatitis B vaccine. Prevention of hepatitis B infection is controlled through the use of a recombinant hepatitis B vaccine, which contains a form of the hepatitis B virus surface antigen that is produced in yeast cells.

6. Drug Nomenclature • Chemical name: the name of a drug according to its chemical structure. Assigned by the Internal Union of Pure and Applied Chemistry (IUPAC) • Generic Name: the name given to a drug in agreement with the originally manufacturer and the US Adopted Names Council. Also called the nonproprietaryname. • Trade Name: the trademark name given to a drug by the original manufacturer. It is also called the proprietary name. No other manufacturer can legally use this name for their version of the drug

7. US adopted Names Council (USANC) • USANC provides a useful list of drug root words that it uses to classify drugs. It is useful to know some of the root words to help you figure out drug classes of the exam

9. Pregnancy Categories • Drugs are classified into 5 classes based on their safe uses in pregnancy • Category A: Studies in pregnant women shows no risk (of birth defects) • Drugs in this case are the safest to use in pregnancy • Category B: Animal studies show no risk • Drugs in this case are still safe to use • Category C: Animal studies show some risk but benefits may outweigh the risk • Category D: Some human risk has been shown or adverse fetal complication are known • ACE inhibitors • Statin Drugs • Tetracycline drugs • Category X: Known teratogen • Thalidomide • Isotretenoin

10. Common Pharmacy Resources • American Hospital Formulary Service Drug Information • Published by American Society of Health System Pharmacists • Information on 30,000 + commercial drugs • Drug Facts and Comparisons • Information on more than 10,000 drugs • Information on more than 5,000 OTC drugs • Presented in table format in comparison of drugs in each class • FDA Approved Drug Products with Therapeutic Equivalence • Called the “Orange book” • Provides information on drugs and generic substitutions

11. Goodman and Gilman’s the Pharmacological Basis of Therapeutics • Information on the clinical pharmacology of drugs in different clinical situations • Physician’s Desk Reference • Contains package inserts information for thousands of drugs • Marketed to physicians • Remington The Science and Practice of Pharmacology • Information of pharmacology and physical properties of drug compounding products • Trissel’s Handbook on Injectable drugs • Provides information on the stability of IV formulations • Compatibility of mixing various drugs in IV admixtures • United States Pharmacopeia (USP) • Official standard setting authority for all prescription medications, and the compounding of medications

12. Pharmacy Publications • AJHP: American Journal of Health Systems Pharmacists • AphA: Journal of American Pharmacists Associations • NPTA: Today’s Technician • Drug Topics • US Pharmacists