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1Introduction to Pharmacology and the History of Drugs

Introduction to PharmacologyPharmacology

fascinating and multifaceted disciplineimpacts

chosen career in health care personal lives

plays a part in our lives from our role as healthcare team members to that of consumers

Introduction to PharmacologyStudy of pharmacology covers a broad

spectrum of diverse, yet interrelated, topics:botanymolecular chemistryresearchtoxicologylegislationpatient education

Introduction to Pharmacology• The study of pharmacology covers:

botanymolecular chemistryresearchtoxicologylegislationpatient education

Origins of Pharmacology Words• Pharmacology

the study of drugs and their interactions with living organisms

derived from the Greek word pharmakon (meaning medicine or

drug) suffix –logy (means the study of)

Origins of Pharmacology WordsMolecular pharmacology

the study of the chemical structures of drugs and the action of drugs at the molecular level within cells.

Pharmacodynamicsthe mechanism of action by which drugs

produce their effects (desired or undesired) based on time and dosage

Origins of Pharmacology WordsPharmacogenetics

how the genetic makeup of different people affects their responses to certain drugs

Pharmacogenomicsusing genome technology to discover new

drugs.

Origins of Pharmacology WordsPharmacokinetics

how drugs move through the body in the processes of absorption, distribution, metabolism, and excretion.

Pharmacotherapyusing drugs to affect the body therapeutically.

Figure 1-1 Medications. Medications or medicines are drugs that are used to prevent, diagnose, or treat symptoms, signs, conditions, and diseases. Steve Bartholomew © Dorling Kindersley.

Medical Uses For DrugsDrugs have three medical uses

prevent diseasediagnose diseasetreat symptoms, signs, conditions, diseases

The study of these uses is know as pharmacotherapy.

Medical Uses For DrugsPreventive Use:

prevent the occurrence of diseases or conditions.

prophylaxis (Greek origin: to keep guard before)

Examples: prevent motion sickness prior to traveling prevent pregnancy vaccinations

Medical Uses For DrugsDiagnostic Use:

by themselvesin conjunction with procedures/testsExamples:

Radiopaque contrast dye Cardiac Stress Test

Figure 1-2 Preventive use of drugs. Dramamine is an over-the-counter drug that is taken to prevent motion sickness and vomiting. The word vomiting does not appear on the drug package, but the word antiemetic, which means pertaining to against vomiting, appears at the top right.

Medical Use for DrugsTherapeutic use:

used for symptoms, conditions, or diseases, to control, improve, or cure

Examples: antibiotic drugs analgesic drugs insulin

Drugs in Ancient Times• Egyptians

treated diseases with frogs’ bile sour milk Lizards blood pigs’ teeth sugar cakes dirt spiders’ webs hippopotamus’ oil toads’ eyelids

applied moldy bread to abrasions has some therapeutic

basis penicillin was

extracted from a mold

Drugs in Ancient Times• Chinese

practiced healing arts emphasized use of

herbs and some minerals• herbal preparations

were used in conjunction with acupuncture massage exercise

few animal products

Shen Nong: wrote first Chinese

book on herbal medicine

contained 365 different herbal remedies

Figure 1-3 Chinese herbal medicines. This Chinese pharmacist prepares herbal medicines in much the same way that his ancestors did, by using dried herbs which are then crushed into powder. He is making four batches of the same medicine, each of which contains the same mixture of herbs. The wall behind him holds drawers of many different types of dried herbs. In 1970, the Chinese Academy of Medical Science compiled a collection of traditional herbal remedies. American pharmacists evaluated those remedies and found that 45 percent of them were therapeutic, according to Western standards of medicine. © Phil Schermeister/CORBIS.

Drugs in Ancient Times

Other CulturesNative Americans of North America

Aztec Indians of Mexico grew herbs with medicinal properties Montezuma maintained royal gardens of

medicinal plants.

Greeks and Romans furthered the study of medicine important first steps

Drugs in Ancient Times

Ancient drugs were prepared according to standard recipes involved drying, crushing, and combining a variety of

plants substances from animals Minerals

The symbol RxLatin word for recipe (meaning take)indicates a prescription

the combining of ingredients to form a drug.

Drugs in Ancient Times• Because little was known , it was a matter of

much guessing• Some drug ingredients

based on medical lore and superstitionhad therapeutic valueothers were worthless or harmful

Figure 1-4 Foxglove plant. This beautiful wild flowering plant is commonly known as foxglove, but its scientific name is Digitalis lanata. The drug digitalis (which is no longer in use) came from this plant, as does the modern drug digoxin (Lanoxin), which is used to treat congestive heart failure.

Modern Drugs Derived From Natural Sources

• Drugs Derived from Plantsfoxglove plant

derivative, drug digoxin (Lanoxin) for congestive heart failure

belladonna plant original source of two drugs

atropine scopolamine

Modern Drugs Derived From Natural Sources

• Drugs Derived from Plantsopium poppy

used as a painkiller recreational drug sap from the seedheads contain opium

• source of illegal street drug heroin• source of the prescription drug morphine

Modern Drugs Derived From Natural Sources

• Drugs Derived from PlantsColchicine

drug used to treat gout derived from autumn crocus known as Colchicum

autumnaleEphedrine

present in the leaves of a bushy shrub Chinese burned leaves to treat respiratory ailments ephedrine present in over-the-counter

bronchodilatorsYams

estrogen hormone replacement therapy drugs

Modern Drugs Derived From Natural Sources

• Drugs Derived from Plantsdaffodil bulbs

The Alzheimer’s drug galantamine (Razadyne)Drugs dissolved into plant sources

gums oils (many drugs contain a type of oil) bases

Table 1-1 Other plant sources of some modern drugs Getty Images, Inc.

Modern Drugs From Natural Sources

Drugs Derived from AnimalsThyroid supplement drugs

composed of dried (desiccated) animal thyroid gland tissue

used to treat hypothyroidism

Modern Drugs From Natural Sources

Drugs Derived from AnimalsPregnant Mare’s urine

drug Premarin, a female hormone replacement• used to relieve the symptoms of menopause• Pregnant Mare’s Urine

Modern Drugs From Natural Sources

Drugs Derived from AnimalsLanolin

common ingredient of topical skin drugs obtained from the purified fat of sheeps wool

Insulin In the past, only source from ground-up

animal pancreas

Figure 1-6 NPH Iletin II insulin. The drug label clearly shows that the source of this insulin is from pork (in vertical capital letters). Copyright Eli Lilly and Company. Used with permission.

Drugs Derived from Minerals

• Minerals individual dietary supplementsPotassium: potassium chloride

• Trace mineralsincluded in many multivitamin supplementsquinapril (Accupril) contains red iron oxide

as an inert ingredient

Drugs in the 1800s and 1900s• Pharmacists prepared the drugs they

dispensedapothecary system of measurement

minims drams ounces grains scruples

Drugs in the 1800s and 1900s

Much has changed since thenMany now completely syntheticOther natural drugs, to create new

drugs, have undergone chemical modifications molecular restructuring

Pharmacists no longer prepares medications dispenses them provides patient information and

education.

Mislabeled and Dangerous DrugsMost physicians attempted to treat patients

accuratelybased on what little scientific knowledge was

available2100 B.C., the Code of Hammurabi gave severe

penalties for malpracticethroughout medical history ineffective,

mislabeled, and dangerous drugs have been manufactured, advertised, and prescribed

Mislabeled and Dangerous Drugs

During the 1700s and 1800scommonly sold without regulationaccompanied by extravagant claims of

curesoften contained addicting ingredients

without its presence being listed opium morphine cocaine

Figure 1-7 Cocaine in a common drug. This 1885 advertisement was for the drug Cocaine Toothache Drops. It was not known at that time that cocaine was a highly addictive drug. Children as well as adults became addicted to this drug. National Library of Medicine.

Mislabeled and Dangerous Drugs

• Consumer warnings did not exist:against the misuse of drugspossibility of addictiondangerous drug side effectsprevailing dictum was “Let the buyer

beware”