Introduction to Pharmacology

New Goals of Pharmacology?

D. All of the above:

• A. Explain the concept of the relationship between genetics and medical pharmacology:

• Pharmacogenetics is the study of how genetic differences influence individual drug responses. Understanding genetics can help personalize treatments, optimize treatment effectiveness, and minimize side effects.

• B. Explain the concept of personalized therapy in medicine:

• Personalized medicine is an approach to treatment that considers the unique biological characteristics of each patient, including their genes, proteins, microbiome, and lifestyle. The goal of personalized medicine is to deliver optimal treatment outcomes and minimize side effects for each patient.

• C. Understand the principles of prescribing medication:

• Principles of prescribing medication include:

• Understanding the patient’s condition, medical history, current medications, drug allergies, and other health issues.

• Selecting the appropriate medication for the condition, dosage, duration of treatment, and route of administration.

• Clearly documenting information about the medication, how to use it, precautions, and follow-up appointments.

• Providing comprehensive information to the patient about the medication and how to use it.

Note: A clear understanding of the relationship between genetics and medical pharmacology, as well as personalized therapy in medicine, is crucial for applying pharmacological knowledge in practice.

Does pharmacology study the effect of drugs on dead bodies?

>> No

Pharmacology studies the effects of drugs on living organisms, their mechanisms of action, and the factors influencing drug action.

Drug Formulary is “the entire collection of drugs authorized for circulation worldwide, along with usage instructions.”

>> Incorrect (In a single country)

A drug formulary is a list of medications approved for distribution and use in a specific country.

Is a Prescription just a written document?

>> Yes

A prescription is a document written by a doctor, either by hand or using electronic prescribing software, that details the medication, dosage, route of administration, duration of use, and necessary precautions for the patient.

What are the four steps of pharmacokinetics?

>> Absorption, Distribution, Metabolism, Excretion

Note: Pharmacokinetics studies the process of how the body handles a drug from the time it is administered until it is eliminated from the body.

How many types of drug dependence are there?

>> Two types: Physiological and Psychological

• Physiological: The body becomes dependent on the drug for normal functioning, leading to withdrawal symptoms when the drug is stopped.

• Psychological: This stems from psychological satisfaction and emotional responses to drug use, leading to a desire to use the drug to maintain feelings of pleasure, excitement, or stress relief.

Is Drug habituation a mild form of physiological drug dependence?

>> Incorrect (Psychological)

Habituation is a phenomenon where the body becomes accustomed to the effects of a drug, requiring increased doses to achieve the same effect. Habituation is a mild form of psychological drug dependence.

The therapeutic effect: Is it the main and side effects of a medication when it is prescribed?

>> Incorrect (No side effects)

Therapeutic effect is the main effect of a medication used to treat a disease. Side effects are unwanted effects of the medication that may occur in addition to the therapeutic effect.

Side effects are usually caused by?

>> Typically due to overdose, allergic reactions, or drug interactions.

Note: Side effects can occur at any dosage but are more common at high doses or with prolonged use of the medication.

Drug interaction: Does it occur when one medication is used before, after, or at the same time as another medication and does not change or changes the effects of one or both medications?

>> Incorrect (Does not include “at the same time” or “does not change”)

Drug interaction is a phenomenon where the effect of one drug is altered when used simultaneously with another drug. Drug interactions can increase or decrease the effects of medications or lead to new side effects.

Is this statement correct?

“Drug misuse: Improper use of medications leading to acute and chronic poisoning; for example, laxatives, antacids, and vitamins.”

>> Incorrect (Replace “medications” with “common medications”)

Drug misuse is the inappropriate use of medications, not as prescribed by a doctor, which can lead to acute or chronic poisoning. Examples include using laxatives in excessive doses, frequent use of antacids, or taking unnecessary vitamins.

What is Pharmacotherapeutics?

>> Clinical use of medications, including medication selection, dosage, treatment duration, and route of administration, tailored to each patient.

Is Pharmacognosy the clinical use of medications?

>> Incorrect (Study of naturally-sourced medications (plants, animals))

Pharmacognosy is the study of the origin, chemical composition, pharmacological effects, and clinical applications of medications derived from natural sources.

How many types of drug names are there?

>> 4 types:

• Generic name: International common name, widely used in the medical field, e.g., paracetamol.

• Official name: The official name of the drug recognized by the health regulatory agency, e.g., Acetaminophen.

• Brand name: Name given to the drug by the manufacturing company, often multiple brand names for the same drug, e.g., Panadol, Efferalgan.

• Chemical name: The scientific name of the drug based on its chemical formula, e.g., N-(4-hydroxyphenyl)acetamide.

What is the Generic name?

A. Common name

What is the main difference between the Generic name and the Brand name?

>> Economics

• Generic name: Medications are less expensive due to no research, development, advertising, and marketing costs.

• Brand name: Medications are more expensive because the manufacturing company has to pay for research, development, advertising, and marketing.

Note: Generic name and brand name medications have the same active ingredients and similar effects, but their costs differ.

What name will a medication have after its brand name copyright expires?

C. Generic name

What is another name for Proprietary name or trade mark?

>> Brand name

What is the Active ingredient?

B. Official name (Original name)

What is the International common name?

A. Generic name (Common name)

What is the official name of 6-chloro-1,1-dioxo-3,4-dihydro-2H-1,2,4-benzothiadiazine-7 sulfonamide (chemical name)?

A. Thiazide

Is HCTZ a diuretic?

>> Yes

HCTZ (hydrochlorothiazide) is a thiazide diuretic.

Is Paracetamol a brand name?

>> Incorrect (Generic name)

What is the generic name of N-(4-hydroxyphenyl)acetamide (chemical name)?

A. Paracetamol

How many years has pharmacology been developing?

>> 150 years

Which era is this?

“Drugs derived from animals and plants are non-toxic, aiming to eliminate disease-causing objects or spirits from the body.”

>> Period 1

When did the ointment containing thyme emerge, and in which era?

>> 2100 BC, Period 2

When did ointment containing beaver oil and opium emerge, and in which era?

>> 1500 BC, Period 2

What field’s development led to pharmacology becoming a new scientific discipline with significant advancements?

B. Chemistry and Physiology

“Along with understanding … has provided … for drug use and understanding the physiological effects and influence of medications on living organisms.”

A. “pathogenesis”, “scientific basis”

When was Morphine extracted from opium poppy?

>> 1804

After Codeine was extracted, other medicinal substances were successfully extracted from medicinal plants, opening a new path in pharmacology?

>> Incorrect (Morphine)

Morphine was successfully extracted from opium poppy in 1804, marking a new step in pharmacology.

Name three major achievements in the 20th century?

>> – Successful extraction of insulin (1921)

– Discovery of antibiotics (1928)

– Anticancer drugs (1940)

Note: The 20th century saw a boom in drug inventions, marking a significant transformation in the field of pharmacology.

When was insulin discovered?

>> 1921

Who was the first diabetic patient treated with insulin?

B. A child with type 1 diabetes

Who is considered the father of American Pharmacology?

>> John Jacob Abel

When was the first Department of Pharmacology established at the University of Michigan?

>> 1891

How many branches of pharmacology are there? List them.

>> Two branches:

• Pharmacokinetics: Studies how the body handles a drug from the time it is administered until it is eliminated from the body.

• Pharmacodynamics: Studies the effects of drugs on the body, their mechanisms of action, and the factors influencing drug action.

What is the commonality among the branches of pharmacology?

>> They all depend on protein activity.

Where are the receptors for steroid hormones located?

B. In the cytoplasm

What is the nature of the signal transduction pathway following receptor binding?

>> Signal transduction pathway

Note: A signal transduction pathway is a series of consecutive chemical reactions that occur within a cell after a drug binds to its receptor, leading to a specific biological response.

Does each receptor usually have only one agent that binds to it?

>> Incorrect

Each receptor can have multiple agents that bind to it, with varying affinities.

What are some plants that were previously used as sources of drugs?

B. Digitalis, vincristine

Note: Digitalis is extracted from the Digitalis purpurea plant and is used to treat heart failure. Vincristine is extracted from the periwinkle plant and is used to treat cancer.

Are Fe, Zn, I, Pb among the sources of drugs used in the past?

>> Yes

• Fe (Iron): Iron supplement for treating anemia.

• Zn (Zinc): Zinc supplement for treating zinc deficiency.

• I (Iodine): Iodine supplement for treating goiter.

• Pb (Lead): Lead is not used as a medicine due to its high toxicity.

What are monoclonal antibodies?

A. Medications produced using recombinant technology

What is insulin?

A. Medications produced using recombinant technology

What are antibodies?

C. Biosimilars

What are antibiotics?

C. Biosimilars

What are vaccines? (Choose 2 answers)

B. Medications produced from treated cells

C. Biosimilars

What are interleukins?

C. Biosimilars

Note: Medications produced using recombinant technology are medications created using DNA recombinant technology, allowing the production of biologically active proteins. Medications produced from treated cells are medications created using living cells, often bacterial or yeast cells, to produce biologically active proteins. Biosimilars are medications designed to mimic naturally occurring biological molecules, having similar effects to natural molecules. Small molecule drugs are medications with simple chemical structures, often organic molecules.

How many dosage forms of medications are there?

>> 3 forms: solid, semi-solid, liquid

If a medication does not have a score line, will it definitely be ineffective if divided?

>> Incorrect (It may be effective but uncontrolled)

Note: Medications without score lines are typically capsules, tablets, or powders. Self-dividing medications can lead to uncontrolled dosage, posing health risks.

What are the forms of administering medication through the gastrointestinal tract?

>> – Oral

– Sublingual

– Suppository

What is the purpose of sublingual medication?

>> – Absorption through blood vessels under the tongue – directly into the bloodstream

– Faster action of the medication, avoiding the effects of gastrointestinal factors

What are the disadvantages of sublingual medication?

>> – Small medication size

– Active ingredients irritating to the gastrointestinal tract (ulcers, etc.)

– Unpleasant taste

What are the disadvantages of suppositories?

>> – Excipients irritate the rectal mucosa, causing diarrhea

– Difficult to store

Is an advantage of oral medication that it does not irritate the stomach and duodenum?

>> Incorrect

Note: Oral administration is the most common route, but some medications can irritate the stomach and duodenum, causing side effects like nausea, vomiting, and abdominal pain.

Is a disadvantage of oral medication that it is expensive?

>> Incorrect

Note: Oral administration is the least expensive route compared to other routes like intravenous, intramuscular, subcutaneous injections, or inhalation.

What route has the highest bioavailability?

B. IV (Intravenous)

Note: Bioavailability is the percentage of the drug absorbed into the bloodstream after administration, denoted by F%. Intravenous administration has 100% bioavailability because the medication is directly injected into the bloodstream.

Which of the following are local anesthetics?

D. All of the above:

• A. Ethyl chloride (chloroethane) and cold CO2: Local anesthetic used for minor procedures like blood draws and wound suturing.

• B. Lidocaine 10%: Local anesthetic used for procedures like injections, incisions, and suturing.

• C. Benzocaine 4% or 10%: Local anesthetic used for procedures like incisions, suturing, and wound application.

List the stages of pre-clinical studies (3 stages).

>> – Basic research

– Drug discovery

– Pre-clinical

Note: Pre-clinical studies are studies conducted on animals to determine the safety and efficacy of medications before clinical trials on humans.

How many phases are there in clinical trials for drug development? List them.

>> 4 phases:

• Phase 1: Study of drug safety and dosage in healthy individuals.

• Phase 2: Study of drug efficacy and side effects in patients.

• Phase 3: Study of drug efficacy and safety on a large scale, including many patients and multiple medical centers.

• Phase 4: Study of drug safety and efficacy after market release, monitoring long-term side effects.

What is Phase 3 of drug development?

>> Study of drug efficacy and safety on a large scale, including many patients and multiple medical centers.

How many phases are there in clinical trials?

>> 3 phases

In what phase of drug development does testing begin on patients with the disease?

>> Phase 2

Which phase is considered the multi-center, multi-country phase?

>> Phase 3

How many participants are involved in the clinical trials of the first three phases?

>> Phase 1: 20-100

Phase 2: 100-200

Phase 3: >1000

What method is used in Phase 3 to provide information about drug effects?

>> Double-blind method

Note: The double-blind method is a research method where both the patient and the treating doctor are unaware of whether the patient is receiving the actual medication or a placebo. This eliminates the influence of psychology and expectations on the treatment outcome.

Which phase of drug development determines the short-term effects of the medication?

>> Phase 2

What disease was Viagra originally researched to treat?

>> Heart disease, ischemic heart disease

Note: Viagra was initially developed to treat heart disease but was later found to be effective in treating erectile dysfunction.

Besides its anti-inflammatory, analgesic, and antipyretic effects, what other effect does Aspirin have?

>> Anti-platelet aggregation – anticoagulant

Note: Aspirin inhibits platelet aggregation, helping to prevent cardiovascular diseases like myocardial infarction and stroke.

Why was Lipopais withdrawn from the market?

>> It lowered cholesterol levels but damaged skeletal muscle, leading to acute kidney failure

Note: Lipopais was a cholesterol-lowering medication but had the dangerous side effect of damaging skeletal muscle, leading to acute kidney failure, even death.

The medication … regulated blood sugar but caused major cardiovascular events, leading to its withdrawal from the market.

>> Rosiglitazone (Avandia)

Note: Rosiglitazone was a blood sugar-regulating medication but had the dangerous side effect of increasing the risk of myocardial infarction and stroke, leading to its withdrawal from the market.

Can pencils be used for prescriptions?

>> Incorrect

Note: Prescriptions must be written in ink or with a ballpoint pen to avoid erasures and alterations.

What should be done if a prescription needs to be corrected?

>> Sign a confirmation next to the correction

Which medications must be prescribed and dispensed by prescription?

(1) Addictive medications

(2) Psychotropic medications

(3) Specially controlled medications

(4) Antibiotics

(5) Hormones (excluding contraceptives)

(6) Cardiovascular medications

(7) Intravenous fluids

(8) Radioactive medications

(9) Anti-tuberculosis medications

(10) Corticosteroids

>> (1) to (7)

Do over-the-counter pain relievers, fever reducers, and stomach medications require a prescription?

>> No

Do daily contraceptive pills need a prescription and be sold by prescription?

>> Incorrect

Note: Daily contraceptive pills can be purchased at pharmacies without a prescription, but consulting a doctor is recommended to choose the appropriate medication.

Do intravenous fluids need to be prescribed and sold by prescription?

>> Incorrect

Note: Intravenous fluids must be prescribed by a doctor, as they can cause serious side effects if not used properly.

Is the drug content the amount of medication used during the entire treatment course?

>> Incorrect (It is the amount of pure medication in a single unit of the formulation)

Must the drug content be listed below the name of the drug?

>> Incorrect (Next to the name of the drug)

What are the standard units of weight in prescriptions?

>> – Gram

– Milligram

– Microgram

When must the unit of drug content be grams?

>> When 1 gram or more

Where should the total drug dosage be listed?

>> On the same line as the name of the drug

Which medication groups require the day of medication use to be numbered in sequence? (6 medications)

>> (1) Addictive medications

(2) Psychotropic medications

(3) Antibiotics

(4) Radioactive medications

(5) Anti-tuberculosis medications

(6) Corticosteroids

Morphine plays a crucial and irreplaceable role in cases of …?

>> “chronic pain and malignant pain”

“Only … can control pain in terminal malignancies.”

>> “morphine”

Note: Morphine is a potent analgesic that is effective in relieving chronic and malignant pain, especially in the terminal stages of cancer.

In addition to the above information, keep the following points in mind when studying Pharmacology:

• Stay updated on knowledge: Pharmacology is a constantly evolving scientific field, with new drugs being discovered and new knowledge being added. Therefore, you need to regularly update your knowledge to ensure it is accurate and relevant to practice.

• Master basic knowledge: Basic knowledge of pharmacology is the foundation for understanding drug mechanisms of action, how to use medications safely and effectively, and potential side effects.

• Always ask questions: When studying Pharmacology, you should actively ask questions to understand the material, especially challenging or unclear concepts.

• Practice: Pharmacology is a practical science, so you need to regularly practice to improve your skills in using medications and handling situations.

Good luck with your studies!