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Introduction to Pharmacology PowerPoint Presentation

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Description : Check out this medical presentation on Pharmacology, which is titled "Introduction to Pharmacology", to get yourself acquainted to pharmacology.

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Published on : Jul 20, 2021 | Views : 5150 | Downloads : 14

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Assoc. Prof. I. Lambev Medical University of Sofia E-mail: itlambev@mail.bg INTRODUCTION TO PHARMACOLOGY
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1. OBJECT OF PHARMACOLOGY. RELATIONSHIPS WITH OTHER SCIENCES.
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The word pharmacology is derived from the Greek words pharmacon (drug or poison) and logos (science). Pharmacology deals with the fate and actions of drugs at various levels (molecular, cellular, organ, and whole body) in any animal species.
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1. Pharmacodynamics - how the drugs act on the body? 2. Pharmacokinetics - how the body act on the drugs? 3. Drug Indications and Application 4. Drug Interactions 5. Unwanted (adverse) effects Object of Pharmacology
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Pharmacology is the base of Pharmacotherapeutics (the treatment of diseases with drugs). It overlaps extensively with pharmacy - the science of drug production.
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2. SCOPE AND SUBDIVISIONS OF PHARMACOLOGY How Pharmacology is divided?
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Basic (fundamental) pharmacology Special (organ pharmacology) Experimental (animal) pharmacology Clinical pharmacology Biochemical pharmacology Immunopharmacology Perinatal pharmacology Geriatric pharmacology Pharmacogenetics, etc. Main branches
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Chronopharmacology
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BABYLONIA The ancient man learned from instinct, from observation of birds and beasts. ANCIENT CHINA 3. HISTORICAL REVIEW
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Hippocrates Egypt: Imhotep
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Avicenna Paracelsus Galenus
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UK France Nativelle (1869) Digitoxin Digitalis purpurea (Foxglove) W. Withering (1785)
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F. SERTÜRNER (1783 – 1841) Morphine Papaver somniferum L. (Poppy) Opium - morphine (1806) - codeine - papaverine Afghanistan Pakistan Thailand
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Cinchona succirubra L. (S. America) Quinine Quinidine
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A. FLEMING (1881–1955) Penicillin G A. FLEMING (1881–1955) Penicillin G - P. notatum
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William Osler (1849 – 1919) ,,Good humour ... helps enormously both in the study and practice of medicine.”
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Rauwolfia serpentina Ajmaline Reserpine (1948) In 1920’s - discovery of Insulin and vitamins In 1930’s - modern anaesthetics In 1940’s - penicillins In 1950’s - antihypertensive drugs In 1960’s - neuroleptics In 1970’s - H2-blockers, antiasthmatics In 1980’s - immunosuppressive and antiviral drugs
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Atropa belladonna L. (Deadly night shade) Radix Belladonnae: (cura bulgara) – atropine Belladonna alkaloids have been empirically used for treatment of PD in 1920s in Bulgaria by Ivan Raev.
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The founders of the Dept. of Pharmaco- logy (1945), Faculty of Medicine - Sofia Prof. P. Nikolov (1894-1990) D. lanata A. belladonna Prof. D. Paskov (1914-1986) Galantamine Aminopyridine Morbus Alzheimeri
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Samuel Hahnemann (1755 – 1843)
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4. DRUGS “One of the features which is thought to distinguish man from other animals is his desire to take medicine“. Sir William Osler (1849 – 1919)
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The drugs are chemical substances which are applied to or introduced into a living organism to treat, prevent or diagnose of diseases, and as well as to change some physiological functions (e.g. reproduction).
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- 50% of Drugs have synthetic or SS origin. - 25% are received from plants and they include: alkaloids, glycosides, vitamins, bioflavonoids, etc.
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Drug nomenclature Chemical name INN (“generic name”) or official, resp. approved names, (in USA: Adopted Name – USAN) (in UK: BAN – British Approved Name) Proprietary name (manufacturer’s trade name™ or registered name®)
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Pharmacopoeian names: European Pharmacopoeia (Ph. Eur. ) Pharmacopoeia Internationalis (PhI)
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ATC classification (WHO, EMA)
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INN (DCI) + â ATC Code Paracetamol (INN) Acetaminophen (USAN) ATC code: N02BE01 (= Internet address) INDEX NOMINUM Swiss Pharmaceutical Society
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Pethidine (INN): (Meperidine - USAN) Demerol® Lydol® 1-methyl-4-phenyl- 4-carbethoxypiperidine ATC code: N02AB02
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Stages in development and regulation of new drugs
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Preclinical stage Drug isolation, semisynthesis or synthesis Pharmaceutical development Animal Pharmacology Animal Toxicity (1) (2) (3) (4)
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May apple (Podophyllum peltatum - India, USA) Epipodophyllotoxin Etoposide Podophyllin
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Animal Pharmacology Preclinical testing determines: screening the specificity of effect and the mechanism of action of a new drug the pharmacokinetics of a new drug
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Animal toxicity subacute toxicity (lasts 14 or 28 days) chronical toxicity (lasts 3 or 6 months) mutagenicity, carcinogenicity reproductive studies (teratogenicity) acute toxicity (after a single dose within a 24-hour period which determines median lethal dose – LD50)
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84% were rats and mice 11% fish, birds and reptiles 3% rabbits and ferrets 1% sheep, cows and pigs 0.5% dogs and cats 0.14% monkeys (not for over 12 years!)
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49% for development of new drugs 20% for fundamental biological and medical research These animals are used:
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SHR & SHRSP
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Clinical stage (4 phases) Children and pregnant women cannot participate.
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Human pharmacology (Phase I) This is the first administration of a drug to humans and it usually follows the completion of pharmacological and toxi- cological studies in animals.
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The investigational drug is given to 12-15 healthy volunteers first in single, increasing doses, and then by multiple administration to cover the range of therapeutic use. These studies are conducted to obtain data of safety (the range of dose) and kinetics only.
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It is forbidden!
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A common rule is to begin with one-fifth or one-tenth of the maximum tolerated dose (mg/kg) in the most sensitive animal species.
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Initial clinical trials (Phase II) This is the first administration of a drug to patients. The investigational drug is given to 150 – 500 patients.
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Elimination of drug should be assessed, because patients may metabolize it differently than healthy subjects do. In this phase the efficacy of the investigational drug can be compared with placebo (dosage form without active substance but with the same flavour, mode, appearance).
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The placebo effect is a psychogenic effect. Drugs for treatment of asthma, duodenal ulcer, arterial hypertension have a high placebo effect. Clinical trials with placebo are forbidden if the potential drug has antimicrobial, antidia- betic, or antineoplastic activity.
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Comparative clinical trials (Phase III) The investigational drug is given to 1000 or more patients to provide data permitting statistical evaluations of the drug’s efficacy and safety.
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The studies include double-blind, randomized controlled clinical trials. The efficacy of a new agent must be compared with famous drugs. If there are advantages, the manufacturer can file a Drug Submission with the Regulatory Agency for permission to market the new drug.
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USA: Food and Drug Administration (FDA) UK: Medicines Control Agency (MCA) Bulgaria: Bulgarian Drug Agency (BDA) www.bda.bg; hot line: (02) 944 16 36 Regulatory Drug Agency
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Post marketing control (Phase IV) Standard of Productions (purity, efficacy, safety) Packing, labeling, advertising Scheduling of drugs, to indicate how to use and prescribe.
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Post marketing control also includes control for: Unwanted effects Drug interactions New therapeutic effects (example with Aspirin®)
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Arachidonic acid Cyclooxygenase (Cox) Endoperoxides PGs TxA2 (-) Aspirin Thromboxane A2 synthase (-) 100 mg/24 h >1 g/24 h
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OUT OF DATE Many severe side effects Infertility (> PGF2α) Thrombosis (< PGI2; > TxA2) Bextra® (Valdecoxib): Pfizer (penalty!) OUT OF DATE
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Creating of new drugs – social and financial aspects
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GLP, GMP, GCP
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Drugs for rare diseases – the so-called orphan drugs can be difficult to research, develop, and market. It is very expensive. Since 1983, the FDA has approved for marketing 268 orphan drugs to treat more than 82 rare diseases.
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THE MAIN APPROACHES OF DRUG DISCOVERY AND DEVELOPMENT ARE: 1. Irrational Approach. It involves emperical observations of the pharmacological effects from screening of many chemical compounds, mainly those from natural products.
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2. Rational Approach. It requires three- dimensional knowledge of the target structure involved in the disease. Drugs are designed to interact with this target’s structures to create a beneficial response. 3. Antisense Therapy requires the modifications to oligonucleotides that can bind to RNA and DNA. The antisense drugs stop transcriptional (from DNA) or translocational (from RNA) pathways which participate in the pathogenesis of disease (e.g. antimetabolic drugs and cancer).
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4.Biologics. These are protein-based drugs in the form of antibodies, vaccines and cytokines. 5.Gene Therapy. Its aim is to replace or insert a diseased gene. The diseased gene is taken out from the patient, fixed outside the body (ex vivo) and then reinserted back into the body. In the case of a missing gene, a copy of a new gene is inserted into the patients. This is a hot new topic that raises many ethical considerations to resolve. 6.Stem Cell Therapy: the aim is to grow body parts to replace defective human organs and nerves.
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Regenerative Medicine
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www.bda.bg John Atanasoff (1903 – 2003) Handbooks
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The Swiss Anti-PowerPoint Party has been founded to ban to use of PP. According to the APPP, the use of presentation software costs the Swiss economy US $2.5 billion annually, while across the whole of Europe, presentation software causes an economic loss of US $160 billion. APPP bases its calculations on unverified assumptions about the number of employees attending presentations each week, and supposes that 85% of those employees see no purpose in the presentations. Anti-PowerPoint Party
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www.medpharm-sofia.eu
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Integrative medicine is the combination of the practices and methods of alternative medicine with conventional medicine. The term is relatively recent, and is mainly promoted by proponents of alternative therapies in the west. Some universities and hospitals have departments of integrative medicine. Integrative medicine