Introduction to

Pharmacology
 50-2

Introduction
Pharmacology – science or study of drugs

Medication errors can result in injury or death

Medical assistant
Knowledge of the foundations of pharmacology
Understand role of drugs in ambulatory
medical facilities
Pharmacology – is the study of
how chemicals interact with living
organisms to produce biologic
effects.

Chemicals that produce

therapeutically useful effect are
called drugs.
 Pharmacology
 a branch of medical science
that is concerned with the
effects of a drug in the
human body & the fate of
the drug when taken into the
body
 also deals with interactions
when 2 or more drugs are
taken simultaneously
 Definitions
 Pharmacology – the study of drugs
 Drugs – chemicals that have effects on living
organisms (should be listed in the national
pharmacopeia)
 Drug products – commercial preparations of drugs –
contain the active ingredient combined with inactive
ingredients (vehicles, excipients, binders, fillers)
 Medicines – drugs used for the prevention or treatment
of illness
 Drug interactions – a change in the effects of a drug
when taken concomitantly with another; due to effects
on absorption, distribution, metabolism, excretion
(ADME)
Definitions

 Pharmacy – the
production, preparation,
& dispensing of drugs
 Pharmacist – one who is
involved in the
preparation &
dispensing of drugs
Medicines
Prohibited drugs
 Definitions
 Philippine National Drug Formulary (PNDF) – the
national pharmacopeia: lists all the drugs that are
being used in our country
 Therapeutics/Pharmacotherapeutics – clinical
application of Pharmacology; the rational use of
drugs in the treatment of diseases
 Toxicology – the study of adverse effects on humans
of prophylactic & therapeutic drugs, food & beverage
additives, and industrial chemicals incorporated into
consumer products
 Definitions
Pharmacodynamics – the effects of a drug on
the body:
Affinity, Potency, Efficacy
Pharmacokinetics – what the body does to the
drug:
Absorption, Distribution, Metabolism,
Excretion
Pharmacotherapeutics – the rational use of
drugs to treat diseases :
Clinical application of Pharmacodynamics &
Pharmacokinetics
 50-11

Drugs and Pharmacology

Drug – chemical compound used to prevent,
diagnose, or treat disease

Pharmacognosy – study of characteristics of

natural drugs and their sources
Pharmacodynamics – study of what drugs do
to the body
 50-12

Drugs and Pharmacology (cont.)

Pharmacokinetics – study of what the body

does to drugs
Pharmacotherapeutics – study of how drugs
are used to treat disease
Toxicology – study of poisons or poisonous
effects of drugs
Pharmacodynamics
 Mechanism of action of a
drug to produce a
therapeutic effect

 Interaction between drug

and target cells and
body’s response to the
interaction
Pharmacodynamics
MECHANISM OF DRUG ACTION: (DRUG ACTION IS
DETERMINED BY WHERE AND HOW A DRUG INTERACTS
WITH THE BODY)

– is the part of pharmacology that

focuses on how drugs produce
biologic effects by interacting with
specific targets at the drug’s site
of action.
– The magnitude of the effect
produced by a drug is related to
the effective concentration of the
drug present at the site of action.
 Site of Drug Action
- a few drugs are administered in
such a way that they enter the body
fluid where they are intended to act.

For ex:
antacid – enters the stomach,
dissolves and neutralizes stomach
acid. (Alteration of gastric pH is the
only intended action of this drug)
 Drug Receptors
- Natural components of the body
intended to respond to some chemical
normally present in blood or tissues.

- The ability to bind to a specific

receptor is determined by the chemical
structure of the drug. This binding
action resembled a lock and key fit.
 The site on the receptor that interacts with a drug has a
definite shape. Drugs conforming to that shape can bind and
produce a biologic response.
Thus, Drug A interacts with a specific receptor that
recognizes its critical features, but Drug B binds to different
type of receptor. Drug C fails to bind because the specific
receptor that would recognize it does not exist on the cell
shown.
 Agonist and Antagonist
- Any compound, either natural or
synthetic, that binds to a specific receptor
and produces a biologic effect by
stimulating that receptor is called agonist.

- Some drug produce their action not

by stimulating receptors but by preventing
other natural substances from stimulating
receptor. These drugs are called
antagonist.
 For ex:
Norepinephrine – binds to specific
protein in the heart called the beta adrenergic
receptors. Stimulation of these receptors
causes the heart to beat faster.

Propanolol – blocks beta-adrenergic

receptors and prevents agonists
(norepinephrine) from stimulating the
receptor normally.
Pharmacokinetics
HOW DRUG DOSAGE RELATES TO DRUG ACTION: (THE ROLE
OF ROUTE OF ADMINISTRARTION AND ELIMINATION)

– is the study of how drugs enter

the body, reach their site of action,
and are removed from the body.
- Most 80% of drugs used in clinical
practice are administered orally,
primarily because of the ease and
convenience of administration by this
route.
Pharmacokinetics
– is the study of:
1) how drugs enter the body
(absorption),
2) reach their site of action
(distribution),
3-4) and are removed from the
body
(biotransformation and excretion).
 Pharmacokinetics
 What the body does to a drug.
Absorption
 Conversion of a drug into a form the body can use
 Allows the drug to enter the blood and tissues
 Rate and extent of absorption depend on
Route of administration
Characteristics of the drug

Distribution
 Transportation of a drug from site of administration to site of
action
 Pharmacokinetics (cont.)
Metabolism
 Drug molecules are transformed into
metabolites
 Usually in liver, some in kidneys
 Affected by age, genetic makeup, and
characteristics of drug

Excretion
 Manner in which a drug is eliminated
from the body
 Most via urine
 Pharmacotherapeutics
Clinical pharmacology
Drug names
Generic – official name
International nonproprietary name
Chemical name
Trade – brand or proprietary name

Generic and trade names used most often

 Nomenclature
 Chemical name – description of the molecular
structure of the drug
 e.g. N-(4-hydroxyphenyl) acetamide
 0fficial / Legal name – generic – name by which the
drug is known; usually indicates the class of the drug
 e.g. Acetaminophen / Paracetamol
 Brand name – a name assigned to a drug by the
manufacturer (pharmaceutical company):
 e.g. Tylenol; Calpol; Tempra
 Pharmacotherapeutics (cont.)
 Drug categories  Indication and labeling
 Action on the body  Indication – reason(s) for
using a drug
 General therapeutic
effect  Must be approved by
FDA to be part of labeling
 Body system affected
 Off-label use
 Pharmacotherapeutics (cont.)
Safety
Adverse reaction to drug

Interaction with another medication

Be alert to patient complaints after starting a

new drug

Efficacy – drug is working as expected

 Pharmacotherapeutics (cont.)
If a patient complains a drug is not working
The patient may not understand how the drug
works
Dosage may need to be adjusted
Therapeutic level may not have been reached
Wrong drug may have been prescribed
Some drugs work better for one patient than
another
Some forms of drugs work better
 50-31

Drugs and Pharmacology (cont.)

Prescribe – physician gives a patient a
prescription to be filled by a pharmacist

Administer – give a drug by injection, mouth,

or other route that introduces it into the body

Dispense – health-care professional distributes

the drug, in a properly labeled container, to the
patient for whom it is prescribed
 50-32

Medical Assistant’s Role in

Pharmacology
 Prescription drugs –  You should
physician’s order  Be sure the physician is
required to dispense and aware of all
administer medications the patient
is taking
 OTC drugs – purchased  Ask patients about use
by patient for self- of alcohol and
treatment recreational drugs

 Provide patient
education
 50-33

Medical Assistant’s Role in

Pharmacology (cont.)

Administration of drugs
Check state regulations scope of practice
Understand pharmacologic principles
Translate prescriptions
Answer basic patient questions
Adhere to legal requirements
Keep accurate records
 50-34

Sources of Drugs
Natural products
Plants
Animals
Minerals
Bacteria and fungi
Foxglove – source of digitoxin

Chemical development of natural products

Synthesis of chemical makeup of a drug
Manipulation of genetic information
 Kinds of Drug Therapy
 Acute – improve a life-  Prophylactic – prevent
threatening or serious disease
condition

 Empiric – given before test  Replacement – provide

results are available chemicals a patient lacks

 Maintenance – maintain
health  Supportive – for a condition
other than the primary
 Palliative – reduce severity of disease
a condition or pain
 Supplemental – avoid a
deficiency
 Toxicology
Study of poisonous
effects of drugs
Adverse effects
Drug interactions

Patient education
Inform physician of
any adverse effects
Discuss concerns with
physician or
pharmacist
Sources of Drug Information
Sources must be up-to-date
PDR
Information provided by pharmaceutical
companies
Information closely resembles package insert
Published annually

Drug Evaluations – published

annually by the AMA
 Sources of Drug Information

USP/NF
Official source of drug standards
Published about every 5 years

AHFS – published by the

American Society of
Hospital Pharmacists
 The FDA Regulatory Function

 New drugs  OTC drugs

 Clinical trials
 Safety  Prescription drugs
 Efficacy
 Pregnancy categories
 Drug manufacturing A
 Identity B
 Strength C
 Purity D
 Quality X
 Classification
 origin/source:
 natural – plants, animal products, minerals
 Synthetic – man-made
 chemical structure
 acid
 base
 procurement
 Rx – prescription – can be obtained only with a doctor’s
prescription
 OTC – over the counter – doesn’t need a doctor’s
prescription
 Classification
 according to body system affected
 GI drugs, CNS drugs, etc.
 according to mechanism of action
 H2 receptor blocker, sympathomimetic, etc.
 according to therapeutic use
 diuretic, analgesic, anti-inflammatory, sedative, etc.
 anti–pathogens (anti-microbial);
 function modifiers (anti-HPN);
 restoratives (replenish deficiencies)
 Classification
 Category 0 – prophylactic drugs: used in the prevention of
disease e.g. vaccines
 Category I – drugs directed toward the etiology of the
disease e.g. antibiotics
 Category II – drugs used in treating specific disease
processes e.g. chemoTx
 Category III – drugs used to alleviate specific disease
manifestations e.g. anti-diarrheal
 Category IV – drugs used to treat nonspecific disease
manifestations e.g. analgesics for pain
 Category V – drugs that are used in a non-therapeutic
manner e.g. anesthetics
 Clinical Drug Trials
 Phase I : test the drug on a small number of healthy volunteers
(except in drugs with significant toxicity)
 to determine the effects of a drug at different dosages &
 to compare the effects of the drug on animals & on humans;
 to detect toxicity
 Phase II : test the drug on a small number of patients with the
disorder to be treated –
 to determine efficiency (Efficacy)
 Phase III : test the drug on a large number of patients with the
disorder
 to strengthen the data on safety & efficacy
 Phase IV : monitor patients already using the drug
 to further establish safety & efficacy in actual therapeutic
situations
 Drug Development
 years 1 – 2 : in vitro studies
 years 2 – 4 : animal testing
 years 4 – 8 : clinical / human testing
 years 8 – 9 : new drug application; granting of patent
 years 9 – 20 : marketing; post-marketing surveillance
/ safety monitoring
 year 20 : patent expires; generics become available
 Relevant Laws
 Executive Order no. 49 :
 “Directing the Mandatory Use of the Philippine
National Drug Formulary (PNDF) Volume I as the
Basis for Procurement of Drug Products by the
Government”
 outlines procedures to be followed in the
implementation of the order with regards to the
responsibility of the Therapeutics Committee/Physician,
certification or requisition & issue vouchers by a
requisitioning officer, the Commission on Audit’s role in
monitoring compliance, & for requesting drugs not in
the PNDF
 Relevant Laws
 Republic Act no. 6675 :
the Generics Act of
1988 – “An Act to Promote,
Require and Ensure the
Production of an Adequate
Supply, Distribution, Use
and Acceptance of Drugs
and Medicines Identified by
their Generic Names”
 The Generics Act : State
 To promote, encouragePolicy
& require the use of generic
terminology in the importation, manufacture, distribution,
marketing, advertising & promotion, prescription & dispensing
of drugs
 To ensure the adequate supply of drugs with generic names at
the lowest possible cost and endeavour to make them available
for free to indigent patients
 To encourage the extensive use of drugs with generic names
through a rational system of procurement & distribution
 To emphasize the scientific basis for the use of drugs, in order
that health professionals may become more aware & cognizant
of their therapeutic effectiveness
 To promote drug safety by minimizing duplication of
medications &/or use of drugs with potential adverse drug
interactions
 Relevant Laws
 Administrative Order no. 51 series of 1988: “Implementing
Guidelines for the Department of Health Compliance with RA
6675(Generics Act of 1988)”
 Administrative Order no. 63 series of 1989: “Rules &
Regulations to Implement Dispensing Requirements Under the
Generics Act of 1988”
 Administrative Order no. 62 series of 1989: “Rules &
Regulations to Implement Prescribing Requirements under the
Generics Act of 1988”
 Administrative Order no. 90 series of 1990: “Amendment to
A.O.62 S.1989 Re: Rules & Regulations to Implement
Prescribing Requirements”
 Republic Act no. 9502 series of 2008: “Universally Accessible
Cheaper and Quality Medicines Act of 2008”
Botika ng Barangay
 The BnB program aims to
promote equity in health
by ensuring the availability
and accessibility of
affordable, safe and
effective, quality, essential
drugs to all, with priority for
marginalized, underserved,
critical and hard to reach
areas.
 Botika ng Barangay
 The Botika ng Barangay (BnB) refers to a drug outlet
managed by a legitimate community organization (CO/non-
government organization (NGO) and/or the Local Government
Unit (LGU), with a trained operator and a supervising
pharmacist specifically established in accordance with
Administrative Order No. 144 s.2004. The BnB outlet should
be initially identified, evaluated and selected by the concerned
Center for Health Development (CHD), approved by the
National Drug Policy-Pharmaceutical Management Unit
(NDP-PMU 50), and specifically licensed by the Bureau of
Food and Drugs (BFAD) to sell, distribute, offer for sale
and/or make available low-priced generic home remedies,
over-the-counter (OTC) drugs and two (2) selected, publicly-
known prescription antibiotic drugs (i.e. Amoxicillin and
Cotrimoxazole).
 Writing Prescriptions
Parts of a prescription
Subscription –
Superscription directions to the
 Patient information pharmacist

Signature – patient
Inscription instructions
 Name of the drug
 Amount of drug per dose
 Writing Prescriptions (cont.)
Prescription for a
single medication
 Writing Prescriptions (cont.)
Prescription for
multiple medications
 Writing Prescriptions (cont.)
 Keep prescription blanks  Telephone prescriptions
secure  Only at request of the
physician

 Follow facility policy

 Document carefully
 Vaccines
 Special preparations made from
microorganisms

 Administered to produce reduced

sensitivity to or increased
immunity to an infectious disease

 Body creates antibodies in

response to an antigen (vaccine)
 Antibody Formation
1. Antigen enters body
2. White cells produce antibodies
3. Antibodies combine with antigens
to neutralize them
4. This arrests or prevents reaction or disease
5. Vaccines stimulate antibody formation and reduce
symptoms if patient is exposed to disease
 Immunizations
 Schedule for immunizations
for children up to age 16
years

 Pre-exposure immunizations

 Post-exposure immunizations
– antiserum or antitoxin that
contains antibodies
 Immunizations (cont.)
Medical assistant should be familiar with
Indications
Contraindications
Dosages
Administration routes
Potential adverse effects
Methods of storing and
handling
 Patient Instruction on
Medications
Medical assistant role is important

OTC drugs
Should not be used to avoid medical care
May not produce enough therapeutic benefit
May be dangerous in combination with other
substances or drugs
May mask symptoms or aggravate a problem
 Patient Instruction on Medications
(cont.)
 Prescription drugs
 Inform patient about special
considerations and drug
safety precautions

 Encourage patient to
 Maintain a complete list
of medications
 Report adverse reactions
 Patient compliance
 Patient Instruction on Medications
(cont.)

To prevent medication errors, be sure patient

understands prescription
How and when to take the medication
Appropriate language
Demonstrate if necessary
Review warnings about
the medication
 Forms of Medication
 Form  Description
1. Capsules - Solid dosage form for
oral use. Medication is
enclosed in gelatin shell
that dissolves in stomach
or intestine. Gelatin gel is
colored to aid in product
identification.
2. Douches - Aqueous solutions
used as cleansing or
antiseptic agent for part
of body or body cavity.

-Clear fluids for oral

3. Elixirs use. Contain water and
alcohol with glycerin
and sorbitol or another
sweetener sometimes
added.
4. Enteric-coated drugs - Solid dosage form
for oral use. Drug in
tablet form is coated
with materials
designed to pass
through stomach and
dissolve in intestine,
where drug may be
absorbed.
5. Patches - Inner surface of the
patch contains skin
and allows
transdermal
absorption of lipid-
soluble drugs.

- Solid dosage form of

6. Pills oral use. Formed into
small globules or
ovoids.
7. Suppositories - Solid dosage form to
be inserted into body
cavity where
medication is
released as solid
melts or dissolves.

8. Tablets - Solid dosage form

shaped like discs or
cylinders.
9. Syrups - Drug dissolved in
concentrated solutions of
sugar such as sucrose.
Flavors may be added to
mask unpleasant taste.

- Finely divided drug

10. Suspensions particles that are
suspended in suitable
liquid medium before
being injected or taken
orally.
11. Transdermal - Relatively lipid-soluble
creams drugs that may be
absorbed transdermally.

- Solid dosage form

12. Troches/ shaped like discs or
Lozenges/Pastilles cylinders that contain
drug, flavour, sugar.
Troches dissolve in
mouth, releasing drug
for action in mouth or
throat.
Thank You !