001 Introduction To Pharmacology
001 Introduction To Pharmacology
2. Attendance
3. Laptops and eating are not allowed
OBJECTIVES of the Course
By the end of the course student should know:
• the basic principles underpinning how drugs work
• how drugs enter the body, reach their targets of action,
eliminated from the body
• therapeutic & adverse effects of drugs can differ markedly
between patients-> individualisation of dosage
• factors which determine the efficacy, pharmacokinetics and
adverse effects of drugs -their inter-relationships to your
patients
• Basic and clinical pharmacology of drugs which you as
practitioners
– Can prescribe
– Patients under your care are taking and their dental implications.
OBJECTIVES of the Course
Pharmacokinetics
• It describes what the body does to the drug:
absorption, distribution, metabolism and clearance.
Subdivisions of Pharmacology
Clinical pharmacology
•It deals with the clinical application of pharmacological
principles.
Pharmacogenomics
•It deals with the influence of genetic variation on drug
response
Toxicology
•It is the study of the side and adverse effects of drugs as
well as harmful interactions
Therapeutics
•Optimal treatment for specific diseases or conditions using:
Drug, surgery, do nothing, lifestyle changes: preventive, public
health
General Properties of Drugs
• Vary in size
– Lithium for mania: Molecular Weight = 7
– Tissue Plasminogen Activator: 7000
– Generally, most drugs are 100-1000 in size: small
molecules
Plants
Human-derived proteins/steroids
Fungi/bacteria
Synthetic chemicals
Recombinant proteins
Pharmacokinetics
1-ORAL ROUTE:
Some drugs are absorbed from the stomach; however, the duodenum is a major
site of absorption because of its larger absorptive surface.
Advantages:
The oral route is the safest, easiest, most convenient and most economic route.
Disadvantages:
- Irritant drugs can cause nausea and vomiting .
- Protein drugs such as insulin are inactivated in the GIT.
- Insoluble drugs are not absorbed.
- Some drugs form complexes with some food constituents and so not absorbed.
- The action comes slowly and so it is not suitable for emergency cases.
- This route is not suitable when the patient is unconscious or uncooperative
(children).
- Some drugs are inactivated by first-pass metabolism 90% of nitroglycerin is
cleared through the liver so it is not administered orally.
What is first pass effect?
The greater the first-pass effect, the less the agent will reach
the systemic circulation when the agent is administered orally.
2- SUBLINGUAL ROUTE
Advantages:
– Rapid absorption and thus suitable in
emergency such as anginal attack
(Nitroglycerin).
– NO first pass effect
Disadvantages
– The drug should be soluble in saliva and
effective in a small dose.
3- RECTAL ROUTE
• The drug is used in the form of suppository or enema
• It may be used for local action (treatment of hemorrhoids) or
systemic action (antipyretics).
Advantages:
– Minimum first pass effect.
– No destruction of drugs by intestinal enzymes or by stomach
acidity.
Disadvantages:
– Poor or incomplete absorption
– Rectal irritation
II-PARENTERAL
Introduces drugs directly into the systemic circulation .
Advantages:
Parenteral administration is used for:
• Drugs that are poorly absorbed from the GIT (Heparin)
• Agents that are unstable in the GIT (Insulin)
• Unconscious patients
• When a rapid onset of action is required (emergency)
• No first-pass effect
• Most control over the dose of drug
Disadvantages:
• Irreversible
• May cause pain, fear, and infections.
Intramuscular (IM)
• Drugs administered IM can be aqueous solutions or depot
preparation (long acting).
• Absorption from aqueous solution is fast while slow from depot
preparations.
Subcutaneous (SC)
• Like IM injection, requires absorption .
• Small amounts of adrenaline (vasoconstrictor ) are sometimes
combined with a drug to restrict its area of action and decreases
movement of a drug.
• Examples of drugs utilizing SC administration include:
– Insulin
– Contraceptive implants
III-OTHER
Inhalation
• Provides rapid delivery of a drug across the
large surface area of the respiratory tract
producing an effect almost as rapidly as with
IV injection.
• Used for drugs that are gases (e.g. anesthetics) or those that
can be dispersed in an aerosol.
• Effective in patients with respiratory problems (bronchial
asthma) because the drug is delivered directly to the site of
action and systemic side effects are minimized.
Intranasal
• This route involves administration of drugs directly into the nose.
• e.g. Nasal decongestants
The abused drug, cocain.
Intrathecal/intraventricular
• When it is necessary to inject drugs
into the cerebrospinal fluid.
• e.g. for the treatment of meningitis
and in spinal anaesthia.
Topical
• For local effects.
• For example, creams, eye drops, sunscreens,…etc.
Transdermal
• Achieves systemic effects by application of drugs to the skin,
usually via a transdermal patch.
• This route is most often used for the sustained delivery of
drugs, such as the anti-anginal drug nitroglycerin, the antiemetic
scopolamine
Thank you