Transcript Slide 1
• 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 recepter Fe,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 dc gtt KVO NS OTC Prn qd qid bis in dis Discontinue gutta KeepVein 0pen normal saline over-the-counter pro re nata quaue die quarter in qie