“Pharmacology Midterm” CONTROLLED SUBSTANCE ACT

► Drug Enforcement Administration (PDEA)

► Republic act no. 9165
PHARMACOLOGY "Comprehensive Dangerous Drug Act Of 2002”
 Deals with the study of drugs and their ► Controlled substances in the Hospital
actions on living organism.
▶Possession of Controlled Substance by Individual.

Therapeutic methods
• Drug therapy: treatment with drug CONTROLLED SUBSTANCE DRUG
• Diet therapy: treatment with diet SCHEDULES
• Physiotherapy: treatment natural physical
► Schedule I DRUGS
force (water, light, heat)
• Physiological Therapy: The identification 1. Very high potential for abuse
of stressors and methods that can be used 2. Not currently accepted for medical use
to reduce or eliminate stress.
3. Lack of accepted safety for use under medical
supervision
Drugs Eg.
► Are chemical substances that have effect on • Lysergic acid diethylamide
living organisms. • Peyote
► Therapeutic drugs, which are often called • Heroin
• Hashish
medicines, are those drugs that are said for the
prevention or treatment of the diseases.

► SCHEDULE II DRUGS
DRUG NAMES 1. High potential for abuse

►Chemical names - most meaningful to the 2. Currently accepted for medical uuse
chemist, understands the exact chemical 3. Abuse potential may lead to severe psychological
constitution of the drug and the exact placement of or physical dependence
its molecular groupings.
4. Requires new prescription, no refills.
► Generic name - simpler than the chemical
name, official name. is provided by Adapted Name Eg.
Council (USA) sponsored by the U.S. Pharmacopeial • Amphetamines
Convention, AMA, APA. And be listed on FDA. • Morphine
► Brand name - the name is registered and that
• Vicodin
• Methadone
the use of the name is restricted to the owner of
• Percodan
the drug, which is usually the owner of the drug.
• Methylphenidate
• Adderall
► SCHEDULE III DRUGS S IV; because the abuse potential is low, a
prescription may not be required
1. High potential for abuse but less than the drugs
in schedule I and II 4. Prescription outdates in 6 months; no more than
5 refills in that 6 months
2. Currently accepted for medical use
Eg.
3. Abuse potential that may lead to moderate and
low physical dependence or high psychological • Lomotil
dependence • Robitussin AC

4. Prescription outdates in 6 months; no more than

5 refills in that 6 months
DEFINITION OF TERMS
Eg.
 Cellular receptor - proteins either inside a
• Empirin with codeine cell or on its surface which receive a signal
• Lortab through a chemical affinity.
• Fiorinal  Pharmacodynamics - interaction between
• Tylenol with codeine drugs and their receptors and the series of
• Norco events that results in a pharmacologic
response.
 Agonist - drugs that interact with receptor
► SCHEDULE IV DRUGS to stimulate a response.
 Antagonist - drugs that attached to
1. Low potential for abuse compared to S III 2.
Currently accepted for medical use receptor sites but do not stimulate a
response
3. Abuse potencial that may lead to physical or  Partial agonist - drugs that interact with
psychological dependence compared with drugs in receptor to stimulate a response but inhibit
S III
4. Prescription outdates in 6 months; no more than
5 refills in that 6 months Routes of administration
Eg.  Enteral route- drug is administered
• Phenobarbital directly to the GIT by oral, rectal or
• Chlordiazephoxide nasogastric tube
• Diazepam  Parenteral route- bypasses the GIT with
• Flurazzepham the use of subcutaneous, intramuscular or
• Temazepam intravenous injection.
 Percutaneous route- drugs being
absorbed thru the skin, and mucus
► SCHEDULE V DRUGS membrane-inhalation, sublingual and
1. Low potential for abuse compared with drugs topical administration.

in S IV
2. Currently accepted for medical use
3. Abuse potential of limited physical and
psychological dependence liability compared with
PHARMACOKINETICS (LADME)  Inhalation medication - absorption is
influenced by the depth of the patient's
 Liberation - to be dissolved in body fluids respiration, fineness of the droplet particles,
(GI) before it can be absorbed into body available surface area of mucus membrane
tissue. Eg. Solution, suspension, capsule, in the lungs, contact time and hydration
tablet. state, blood supply and concentration of the
 Absorption - process where drug is drug itself.
transferred from its site of entry into the
body to the circulating fluid of the body
(lymph and blood) for distribution. The rate DISTRIBUTION
depends on the route of administration.
 Refers to the ways in which the drugs are
Guidelines for administration: transported throughout the body by
circulating body fluids to the cites of action
1. Administer oral drugs with the right amount of
or to the receptor cites that the drug will
fluid.
affect.
2. Give parenteral forms properly so that they are  Organs with the most extensive blood
deposited in the correct tissue for enhanced supply receives the distributed drugs most
absorption. rapidly. (Heart, kidney, liver, brain)
 Areas with less extensive blood supply
3. Reconstitute and dilute drug only with the
receives the drug more slowly.
diluent recommended by the manufacturer so that
drug solubility is not impaired.
Two factors that influence drug distribution
1. Protein binding- drugs distributed in
Factors that affect the RATE OF combination with plasma protein which acts as the
ABSORPTION carrier for relatively insoluble drugs.
 Parenteral route- depends o the rate of Drugs that are bound to plasma protein
blood flow through the tissue. are pharmacologically inactive because the
 Subcutaneous injections- have the lowest large size of the complex keeps them in the blood
absorption rate specially if peripheral stream and prevents them from reaching the sites
circulation is impaired. of action, metabolism and excretion.
 Intramuscular injection- are more rapidly
Only the free, or unbound portion of a drug is
absorbed because the blood flow is greater
able to diffuse into tissues, interact with receptors,
compared to subcu.
and produce physiologic effects.
 Intravenous injection - drugs are
dispersed rapidly throughout the body It is only this portion can be metabolized and
 Topical administration - applied to the excreted. The same proportion of bound and free
skin can be influenced by drug drug are maintained in the blood at all times.
concentration, length of contact time, size The free drug acts on receptor sites is
of the affected area, thickness of the skin metabolized, the decrease serum blood level
surface, hydration of the tissue, and the causes some of the bound drug to be released from
degree of the skin disruption. protein to maintain the ration between bound and
free drug.
LIPID SOLUBILITY  (MEC) is the minimum concentration
 (MDR) is the maximum drug response
 Lipid soluble drug has high affinity to
adipose tissue, which serves as the
repository site for these agent.
 More lipid -soluble drugs tend to stay in the
body much longer.
some drugs cannot pass through certain types
of cell membranes, such as the blood brain barrier
or the placental barrier.

METABOLISM
 The process whereby the body inactivates
the drug
 The enzyme systems of the liver are the
primary sites for the metabolism of the
drug, other tissues and organ metabolize
the drug to a minor extent.

EXCRETION ADVERSE EFFECTS OF THE DRUG

► Elimination of the drug metabolites and in  SIDE EFFECTS
some cases, of the active drug itself.  All drugs have the potential to affect
more than one body system
►Two primary routes:
simultaneously
 GI track (feces)  Produces response:
 Renal tubules (urine)  mild- common side effect
 skin – evaporation  Serious adverse effect- leads to
 lungs – exhalation toxicity.
 saliva and breast milk.  Allergic Reaction- hypersensitivity rxn
 Occurs when patient who has been
previously exposed to the drug and has
developed an antibodies to the drug
 s/s-URTICARIA
Irregular shape patches(hives)

 ANAPHYLACTIC REACTION
respiratory distress, cardiovascular
collapse.
TERMINOLOGIES IN DRUG TO DRUG
INTERACTIONS
►Additive effect- two drugs with similar actions
are taken for an increase effect.

►Synergistic effect - the combined effect of two

drugs is greater than the sum of the effect of each
drug given together.

►Displacement- displacement of the protein-

binding sites by a second drug increases the activity
of the first drug because more unbound drug is
available.

►Interference - the first drug inhibits the

metabolism or excretion of the second drug,
thereby causing increase activity of the second
drug.

►Incompatibility- the first drug is incompatible

with the second drug, thereby causing
deterioration when the drugs are mixed in the
same syringe or solution or administered together
at the same site.
►The solution will appear as hazy, formation of
precipitate, or a change in color of the solution.