PHARMACOLOGY

Abdullah Khattak
 WHAT IS PHARMACOLOGY ?

Etymology:
Pharmakon: medicine, drug - Logos: science

William Paton (1986)

“If physiology is concerned with the function, anatomy with the structure, and
biochemistry with the chemistry of the living body, then pharmacology is concerned
with the changes in function, structure, and chemical properties of the body brought
about by chemical substances”

Pharmacology, the science of drugs and their effects on the body.

 ANCIENT TIMES

• Ancient Civilizations: Early pharmacological practices date back to ancient

civilizations like the Egyptians, Chinese, Indians, Greeks, and Romans. They used plant,
animal, and mineral substances for therapeutic purposes.
• Hippocrates and Galen: In ancient Greece, Hippocrates (460-370 BCE) is often called
the "Father of Medicine." He emphasized the importance of diet and exercise in health.
Galen (130-200 CE) further advanced medical knowledge by conducting animal
dissections and creating detailed pharmaceutical preparations.
 MIDDLE AGES

• Islamic Golden Age: During the Islamic Golden Age, scholars like Avicenna (Ibn Sina
980 – June 1037 CE) and Al-Razi (865–925CE) made significant contributions to
pharmacology. Avicenna's "The Canon of Medicine" included detailed information on
pharmacology and medical treatments.
• Monastic Medicine: In Europe, monasteries became centers of medical knowledge,
where monks preserved and expanded upon classical texts.
 19TH CENTURY

• Advancements in Organic Chemistry: The 19th century saw significant progress in

organic chemistry, leading to the isolation and synthesis of drugs. Friedrich Sertürner
isolated morphine from opium in 1804, and Pierre-Joseph Pelletier and Joseph-
Bienaime Caventou isolated quinine from cinchona bark in 1820.
• Founding of Pharmacology as a Discipline: Pharmacology began to emerge as a
distinct scientific discipline. Oswald Schmiedeberg, a German pharmacologist, is often
regarded as the "Father of Pharmacology." He established one of the first
pharmacology laboratories and trained many future leaders in the field.
 20TH CENTURY

• Development of Modern Pharmaceuticals: The 20th century witnessed the

development of numerous important drugs, including antibiotics like penicillin,
discovered by Alexander Fleming in 1928, and sulfa drugs in the 1930s.
• Regulatory Agencies: Governments established regulatory agencies, such as the U.S.
Food and Drug Administration (FDA) in 1906, to oversee drug safety and efficacy.
• Pharmacokinetics and Pharmacodynamics: Advances in understanding how drugs
are absorbed, distributed, metabolized, and excreted (pharmacokinetics) and how they
exert their effects (pharmacodynamics) became central to pharmacology.
 21ST CENTURY

• Biotechnology and Personalized Medicine: The 21st century has seen the rise of
biotechnology, leading to the development of biologic drugs, gene therapies, and
personalized medicine. Pharmacogenomics, the study of how genes affect a person's
response to drugs, is becoming increasingly important.
• Emerging Challenges: Pharmacology continues to face challenges such as antibiotic
resistance, the development of new treatments for chronic diseases, and the need for
more effective and safer drugs.
 PURPOSE OF MEDICATION

• The primary purpose of medication is to prevent, diagnose, treat, or manage various

medical conditions and diseases. Medications achieve this by exerting specific effects
on the body or pathogens within the body.
• 1. Prevention
• Vaccines: Prevent infectious diseases by stimulating the immune system to recognize and
combat pathogens.
• Prophylactic Drugs: Prevent conditions, such as aspirin to prevent heart attacks or
anticoagulants to prevent blood clots.
• 2. Diagnosis
• Diagnostic Agents: Used in medical imaging and diagnostic tests, such as contrast dyes in X-
rays or MRI scans, and radioactive tracers in nuclear medicine.
 PURPOSE OF MEDICATION

• 3. Treatment
• Curative Medications: Aim to cure a disease, such as antibiotics for bacterial infections or
antiviral drugs for certain viral infections.
• Symptomatic Relief: Alleviate symptoms without necessarily curing the underlying
condition, such as pain relievers, antihistamines, and antipyretics (fever reducers).
• 4. Management
• Chronic Disease Management: Control and manage chronic conditions, such as insulin for
diabetes, antihypertensives for high blood pressure, and statins for high cholesterol.
• Replacement Therapy: Provide necessary substances that the body cannot produce in
sufficient quantities, such as hormone replacement therapy or thyroid supplements
 PURPOSE OF MEDICATION

• 5. Supportive Care
• Palliative Care: Improve the quality of life for patients with serious illnesses by
managing pain and other distressing symptoms.
• Adjunctive Therapy: Support primary treatments, such as antiemetics to reduce
nausea caused by chemotherapy or corticosteroids to reduce inflammation.
• 6. Psychiatric and Neurological Treatments
• Mental Health Medications: Treat psychiatric disorders, including antidepressants,
antipsychotics, anxiolytics, and mood stabilizers.
• Neurological Drugs: Manage neurological conditions, such as antiepileptics for
epilepsy, medications for Parkinson's disease, and Alzheimer's treatments.
 PURPOSE OF MEDICATION

• 7. Nutritional Supplements
• Vitamins and Minerals: Address deficiencies and support overall health, such as vitamin D
for bone health or iron supplements for anemia.
• 8. Immune System Modulation
• Immunosuppressants: Used to prevent organ transplant rejection and treat autoimmune
diseases.
• Immunostimulants: Enhance the immune response, such as certain cancer therapies.
• Medications are developed to target specific pathways or mechanisms within the body
to achieve these purposes, aiming to improve health outcomes and enhance the
quality of life for individuals.
 SOURCES OF MEDICATION

• Medications are derived from a variety of sources, each contributing to the diverse array of treatments
available in modern medicine.
• 1. Natural Sources
• Plants: Many drugs are derived from plants. Examples include:
• Morphine from the opium poppy (Papaver somniferum).
• Aspirin from willow bark (Salix spp.).
• Quinine from the cinchona tree (Cinchona spp.).
• Animals: Some medications are obtained from animal sources, such as:
• Insulin (historically derived from the pancreas of pigs or cows, though now often produced synthetically).
• Heparin, an anticoagulant, initially extracted from animal tissues like pig intestines or cow lungs.
• Minerals: Certain medications are derived from mineral sources, such as:
• Magnesium sulfate (Epsom salts) used as a laxative and to treat magnesium deficiency.
• Iron supplements for treating iron deficiency anemia
 SOURCES OF MEDICATION

• 2. Microorganisms
• Bacteria and Fungi: Some antibiotics and other drugs are derived from microorganisms.
Examples include:
• Penicillin from the Penicillium mold.
• Streptomycin from the bacterium Streptomyces griseus.
• Biotechnology and Genetic Engineering: Modern techniques involve using genetically
modified microorganisms to produce drugs, such as:
• Insulin produced by genetically engineered bacteria or yeast.
• Human growth hormone produced using recombinant DNA technology.
 SOURCES OF MEDICATION

• 3. Synthetic Sources
• Chemical Synthesis: Many drugs are created entirely through chemical synthesis in laboratories.
Examples include:
• Aspirin, initially derived from willow bark, is now synthesized chemically.
• Antihistamines, analgesics, antidepressants, and many other classes of medications.
• Semi-Synthetic Drugs: These drugs are chemically modified derivatives of naturally occurring
substances. Examples include:
• Amoxicillin, a semi-synthetic penicillin derived from naturally occurring penicillin.
• Oxycodone, derived from thebaine, an alkaloid found in the opium poppy.
 SOURCES OF MEDICATION

• 4. Biological Sources
• Biologics: These are complex medications derived from living organisms. Examples include:
• Monoclonal antibodies used in cancer treatment and autoimmune diseases.
• Vaccines developed from weakened or inactivated pathogens, or pieces of pathogens.
• Blood Products and Plasma Derivatives: These include medications derived from human blood
and plasma, such as:
• Clotting factors for hemophilia.
• Immunoglobulins for immune deficiencies and autoimmune conditions.
• 5. Marine Sources
• Marine Organisms: The ocean is a source of unique bioactive compounds used in medications,
such as:
• Ziconotide, a pain reliever derived from the venom of the cone snail (Conus magus).
 CLASSIFICATION OF DRUGS

• Drugs can be classified in various ways based on their different characteristics, such
as their therapeutic use, mechanism of action, chemical structure, legal status, and
potential for abuse. Here are some common classifications:
• 1. Therapeutic Classification
This system categorizes drugs based on their therapeutic use or the condition they treat.
• Analgesics: Relieve pain (e.g., ibuprofen, morphine).
• Antibiotics: Treat bacterial infections (e.g., penicillin, ciprofloxacin).
• Antidepressants: Treat depression (e.g., fluoxetine, sertraline).
• Antihypertensives: Lower blood pressure (e.g., lisinopril, amlodipine).
• Antipyretics: Reduce fever (e.g., acetaminophen, aspirin).
 CLASSIFICATION OF DRUGS

• 2. Mechanism of Action
Drugs can also be classified by how they work in the body, targeting specific biological pathways.
• Beta-Blockers: Block beta-adrenergic receptors (e.g., propranolol, metoprolol).
• ACE Inhibitors: Inhibit the angiotensin-converting enzyme (e.g., enalapril, ramipril).
• Proton Pump Inhibitors: Reduce stomach acid production (e.g., omeprazole, esomeprazole).
• Calcium Channel Blockers: Inhibit calcium ions from entering cardiac and smooth muscle cells (e.g.,
verapamil, diltiazem).
• 3. Chemical Structure
This classification groups drugs with similar chemical structures.
• Penicillins: A class of beta-lactam antibiotics (e.g., amoxicillin, penicillin).
• Benzodiazepines: Used for anxiety, insomnia, and seizures (e.g., diazepam, lorazepam).
• Statins: Lower cholesterol levels (e.g., atorvastatin, simvastatin).
 CLASSIFICATION OF DRUGS

• 4. Legal Classification
Drugs are also classified based on their legal status and potential for abuse and dependence.
• Prescription Drugs: Require a doctor's prescription (e.g., antibiotics, antidepressants).
• Over-the-Counter (OTC) Drugs: Can be purchased without a prescription (e.g., ibuprofen,
diphenhydramine).
• Controlled Substances: Regulated due to potential for abuse (e.g., opioids like oxycodone, stimulants like
amphetamines).
• 5. Source of Origin
This system classifies drugs based on their origin.
• Natural Drugs: Derived from natural sources like plants, animals, and minerals (e.g., digitalis from foxglove,
morphine from opium poppy).
• Synthetic Drugs: Created through chemical synthesis in laboratories (e.g., aspirin, paracetamol).
• Semi-Synthetic Drugs: Modified versions of naturally occurring substances (e.g., amoxicillin, oxycodone).
 CLASSIFICATION OF DRUGS

• 6. Dosage Form
Drugs can be classified based on their physical form or method of delivery.
• Tablets and Capsules: Oral solid forms (e.g., ibuprofen tablets, vitamin capsules).
• Injectables: Administered via injection (e.g., insulin, vaccines).
• Topicals: Applied to the skin (e.g., corticosteroid creams, antibiotic ointments).
• Inhalants: Delivered through inhalation (e.g., asthma inhalers, anesthetic gases).
• 7. Pharmacological Classification
This system groups drugs based on their pharmacological effects.
• Diuretics: Increase urine production (e.g., furosemide, hydrochlorothiazide).
• Antihistamines: Block histamine receptors to reduce allergy symptoms (e.g., loratadine,
cetirizine).
• Anticoagulants: Prevent blood clot formation (e.g., warfarin, heparin).
 DRUG SUPPLY SYSTEM

• The three main types of drug supply systems are the centralized system, decentralized system,
and hybrid system. Each has its own characteristics, advantages, and challenges in terms of
drug procurement, distribution, and management.
• 1. Centralized Drug Supply System
In a centralized drug supply system, the procurement, storage, and distribution of drugs are
managed from a central location, usually by a central authority such as a government agency, a
national health service.
• Characteristics:
• Centralized Procurement: Drugs are purchased in bulk by a central authority.
• Central Storage: All drugs are stored in a central warehouse.
• Distribution: Drugs are distributed from the central warehouse to regional or local health
facilities.
 DRUG SUPPLY SYSTEM

• Advantages:
• Economies of Scale: Bulk purchasing can lead to cost savings.
• Standardization: Ensures uniformity in drug quality and availability.
• Efficient Resource Allocation: Easier to manage stock levels and allocate resources based on
need.
• Challenges:
• Logistical Issues: Delays and inefficiencies in distribution can occur.
• Limited Flexibility: Less responsive to local needs and emergencies.
• Potential for Bureaucracy: Increased risk of administrative inefficiencies and corruption.
 DRUG SUPPLY SYSTEM

• 2. Decentralized Drug Supply System

In a decentralized drug supply system, the procurement, storage, and distribution of drugs are
managed at multiple levels, such as regional or local health facilities. Each facility or regional
office has more autonomy in managing its own drug supply.
• Characteristics:
• Localized Procurement: Regional or local health facilities procure their own drugs.
• Local Storage: Drugs are stored at regional or local warehouses.
• Local Distribution: Drugs are distributed directly to the health facilities in the region.
 DRUG SUPPLY SYSTEM

• Advantages:
• Increased Flexibility: More responsive to local needs and emergencies.
• Improved Accessibility: Reduces delays in drug availability at local levels.
• Empowerment of Local Facilities: Enhances local decision-making and
accountability.
• Challenges:
• Higher Costs: Lack of bulk purchasing may lead to higher drug costs.
• Variability in Quality: Potential for inconsistencies in drug quality and
availability.
• Resource Management: More complex coordination and management of
resources.
 DRUG SUPPLY SYSTEM

• 3. Hybrid Drug Supply System

A hybrid drug supply system combines elements of both centralized and decentralized systems. It seeks
to leverage the benefits of both approaches while mitigating their drawbacks.
• Characteristics:
• Mixed Procurement: Centralized procurement for some drugs and decentralized procurement for
others.
• Flexible Storage: Centralized storage for certain drugs, with regional or local storage for others.
• Tailored Distribution: Distribution strategies are customized based on the type of drug and regional
needs.
• Advantages:
• Balanced Approach: Combines the cost-efficiency of centralized procurement with the responsiveness
of decentralized distribution.
• Customization: Can be tailored to the specific needs of different regions or health systems.
 DRUG SUPPLY SYSTEM

• Challenges:
• Complex Management: Requires sophisticated coordination and
management systems.
• Integration Issues: Potential difficulties in integrating centralized and
decentralized components.
• Variable Implementation: Success depends on the effective implementation
of both centralized and decentralized elements.
 DRUG STANDARDS AND
LEGISLATION
• Drug standards and legislation are essential components of a healthcare system, ensuring the
safety, efficacy, and quality of medications. They involve establishing regulations, guidelines, and
oversight mechanisms to protect public health. Here’s a detailed discussion on drug standards and
legislation:
• Drug Standards
• Definition
Drug standards are scientifically established specifications and criteria that drugs must meet to ensure their
quality, safety, and efficacy. These standards are set by national and international organizations.
• Key Components
• Purity: Ensures the drug is free from contaminants and impurities.
• Strength: Specifies the concentration of the active ingredient.
• Quality: Includes parameters like manufacturing practices, stability, and packaging.
• Efficacy: Demonstrates the drug’s effectiveness for its intended use.
 DRUG STANDARDS AND
LEGISLATION

• Standard-Setting Organizations
• United States Pharmacopeia (USP): Sets standards for the quality, purity, strength,
and consistency of drugs in the United States.
• European Pharmacopoeia (Ph. Eur.): Establishes drug standards for the European
Union.
• International Organization for Standardization (ISO): Develops international
standards, including those for medical devices and pharmaceuticals.
• World Health Organization (WHO): Provides international guidelines and standards,
especially for developing countries.
 DRUG STANDARDS AND
LEGISLATION
• Drug Legislation
• Purpose
Drug legislation encompasses laws and regulations that govern the approval, manufacture, distribution,
marketing, and monitoring of drugs. These laws ensure that only safe and effective drugs reach the market
and are used appropriately.
• Key Legislative Areas
• Drug Approval: Processes and criteria for approving new drugs before they can be marketed.
• Manufacturing Practices: Regulations on good manufacturing practices (GMP) to ensure quality and
consistency.
• Distribution and Marketing: Rules for the distribution, advertising, and promotion of drugs.
• Post-Market Surveillance: Monitoring the safety and efficacy of drugs after they have been approved and
are in use.
• Controlled Substances: Regulations on drugs with potential for abuse and dependence, including
scheduling and restrictions on prescribing.
 DRUG STANDARDS AND
LEGISLATION

• Major Regulatory Bodies

• Drug Regulatory Authority of Pakistan (DRAP) : Established in 2012
• U.S. Food and Drug Administration (FDA): Oversees drug approval, manufacturing, and
post-market surveillance in the United States.
• European Medicines Agency (EMA): Regulates drug approval and monitoring in the European
Union.
• Medicines and Healthcare products Regulatory Agency (MHRA): Responsible for
regulating drugs and medical devices in the United Kingdom.
• Health Canada: Regulates pharmaceuticals and health products in Canada.
 DRUG STANDARDS AND
LEGISLATION

• Drug Approval Process

• Preclinical Testing: Laboratory and animal studies to assess safety and biological activity.
• Investigational New Drug Application (IND): Submission to regulatory authorities to begin
clinical trials.
• Clinical Trials: Conducted in three phases to assess safety, efficacy, dosage, and side effects.
• Phase I: Tests safety and dosage in a small group of healthy volunteers.
• Phase II: Explores efficacy and side effects in a larger group of patients.
• Phase III: Confirms efficacy and monitors adverse reactions in a large group of patients.
• New Drug Application (NDA): Comprehensive submission of data to regulatory authorities for
approval.
• Post-Market Surveillance: Ongoing monitoring of the drug’s safety and efficacy in the general
population.