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PHARMACOLOGY MIND MAPS CHAPTER 1

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 1
Definitions, drug nomenclature,
and sources of drugs

1.1 DEFINITIONS

Pharmacology – Deals with effects of Movement of drug within the body

drugs on living system

Drug – Any substance or product

that is used or intended to be
Includes process of absorption (A), distribution (D),
used to modify or explore physiological
metabolism (M), and excretion (E)
system or pathological states
for the benefit of recipient (WHO)

Pharmacokinetics Means “what the body does to the drug”

Study of drugs, their mechanism of action,

pharmacological actions, and their adverse effects
Pharmacodynamics

Means “what drug does to body”

Science that deals with preparation, preservation,

Pharmacy standardization, compounding, dispensing
and proper utilization of drugs

Definitions
Therapeutics Concerned with treatment of diseases

Toxicology Study of poisons, their actions, detection,

prevention and treatment of poisoning

Chemotherapy Deals with treatment of

infectious diseases/cancer

Clinical pharmacology Study of drug in man, both healthy volunteers

and patients, by comparative clinical trials

Satisfy the health care needs of

majority of population
Essential drugs
Should be available at all times, in adequate amounts,
and in appropriate dosage forms (WHO)

Used for diagnosis, treatment or prevention

Orphan drug
of rare diseases

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 Definitions, drug nomenclature, and sources of drugs  3

1.2  DRUG NOMENCLATURE

e.g. Acetylsalicylic acid

Chemical name
Not suitable for use in
prescription

e.g. Aspirin

Also called as generic

name

Non-proprietary name

Drug nomenclature Same worldwide

Assigned by U.S. Adopted

Name (USAN) council

e.g. Dispirin

Also called brand name

Proprietary name
Given by pharmaceutical
manufacturers

A drug may have many

brand names

1.3  SOURCES OF DRUGS

i. Alkaloids – morphine,
atropine, quinine

a. Plants

ii. Glycosides – digoxin,

digitoxin

b. Animals Insulin, thyroxine

1. Natural
Ferrous sulfate, magnesium
c. Minerals
Sources of drugs sulfate

2. Synthetic: Aspirin,
paracetamol
d. Microorganisms Penicillin, streptomycin

e. Genetic engineering Human insulin, hepatitis B

(recombinant DNAtechnology) vaccine

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 2
Routes of drug administration

2.1  FACTORS DETERMINING ROUTES OF DRUG ADMINISTRATION

Drug characteristics

Type of use –
emergency/routine

Patient condition –
unconscious, vomiting,
diarrhea
Factors determining route
of administration

Age

Co-morbid diseases

Patient/doctor choice

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 Routes of drug administration  5

2.2  LOCAL ROUTE

One of simplest route

Local route Given at site of desired action

Minimal side effects

Drug applied to skin/mucous

membrane for local actions

e.g. Clotrimazole troche

a. Oral cavity
for oral conditions

As non-absorbable tablet

b. GIT

e.g. Neomycin for gut

sterilization before surgery

Liquid drug is administered

in rectum

e.g. Soap water enema; soap

As evacuant enema
acts as lubricant and water
for bowel evacuation
stimulates the rectum
c. Rectum and anal canal

e.g. Methylpredinisolone
1. Topical Retention enema
in ulcerative colitis

Solid dosage form drug is e.g. Bisacodyl for

Suppository
inserted in rectum bowel evacuation

As drops, ointments,
sprays, etc.
d. Eye, ear, and nose
For allergic or infective
conditions of
eye, ear, and nose

e.g. Salbutamol inhalation for

bronchial asthma, and
e. Bronchi As inhalation
COPD (chronic obstructive
pulmonary disease)

f. Vagina As tablet, cream, pessary For vaginal candidiasis

g. Urethra As jelly e.g. Lignocaine

2. Deeper areas are reached e.g. Infiltration of

by using syringe and needle local anesthesia

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 6  Pharmacology mind maps for medical students and allied health professionals

2.3  SYSTEMIC ROUTE

Drug reaches blood and Oral, sublingual,

Systemic route i.e. Enteral route
produces systemic effects and rectal route

Most common and accepted e.g. Tablets, capsules, syrups, etc.

Safe

Cheap

Advantages Painless

Convenient for repeat and

long-term use

Self-administered

Slow onset, not used in

emergency

Unpalatable, highly irritant

drugs cannot be given

Unabsorbable drugs cannot

be given (e.g. neomycin)
1. Oral route Drugs destroyed by digestive
Disadvantages
juices cannot be given (e.g. insulin)

Drugs with high first-pass metabolism

cannot be given (e.g. lignocaine)
Cannot be given in unconscious/
uncooperative/unreliable patients

Cannot be given in patients with

vomiting or diarrhea

Prevents gastric irritation

Protects drug from gastric acid

Retards drug absorption and

↑ its duration of action

Done by cellulose, acetate, etc.

Sustained/controlled release
formulation
Enteric-coating of tablets
Consists of different coatings
dissolving at different time intervals

↑ Duration of action

↓ Dosing frequency

↑ Patient compliance

e.g. Sustained-release nifedipine

(Continued)

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 Routes of drug administration  7

2.3  SYSTEMIC ROUTE (Continued)

Drug is kept under

tongue

Absorbed through
the buccal mucosa

Enters systemic
circulation

Bypasses first-pass
liver metabolism
Rapid onset
e.g. Nitroglycerin,
buprenorphine
Action can be
2. Sublingual route terminated by
spitting out drug
Advantages
Bypasses first-pass
liver metabolism

Self-administration
is possible

Irritant and lipid-

insoluble drugs
cannot be given

Unpalatable drugs
Disadvantages with bad smell
cannot be given

Cannot be used
in children

i.e. Retention enema e.g. Methylprednisolone

For
local effect

Solids and liquid Evacuant enema e.g. Soapy water

3. Rectal route i. Enema
dosage forms used

e.g. Diazepam for

For
febrile convulsions
systemic effect
in children

(Continued)

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 8  Pharmacology mind maps for medical students and allied health professionals

2.3  SYSTEMIC ROUTE (Continued)

Administered other than Injection, inhalation, and

enteral route transdermal route

Rapid onset, and can be used in

emergency

Also be used in unconscious/unco-

operative/unreliable patients

Used in presence of vomiting and

diarrhea

Advantages Suitable for irritant drugs

Drugs with high first-pass metabolism

B. Parenteral route
can be given by this route

Drugs that are not absorbed orally

also can be given

Drugs destroyed by digestive juices

can be administerd by this route

Require sterilization and aseptic

conditions

Invasive technique, painful

Can cause local tissue injury;

Disadvantages
e.g. nerves, vessels, etc.

Requires technical experts, hence

cannot be self-administered

Expensive

(Continued)

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 Routes of drug administration  9

2.3  SYSTEMIC ROUTE (Continued)

Volatile liquids and gases are

e.g. General anesthetics
administered by this route

Rapid onset

Lower dose is required,

1. Inhalation Advantages
fewer systemic side effects

Dose regulation is possible

Local irritation can cause ↑ respiratory

Disadvantages
secretions and bronchospasm

Scopolamine for motion

sickness
Patches deliver drug into
circulation for systemic effects
Nitroglycerin for angina

e.g.
Estrogen for hormone
replacement therapy (HRT)

Fentanyl for analgesia

Self-administered

Good patient compliance

2. Transdermal route
(adhesive patches)

Advantages Prolonged action

Minimal side effects

Constant plasma concentration

Expensive

Disadvantages Local irritation (itching, dermatitis)

Patch may fall off without

being noticed

(Continued)

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 10  Pharmacology mind maps for medical students and allied health professionals

2.3  SYSTEMIC ROUTE (Continued)

e.g. BCG vaccination, drug sensitivity

a. Intradermal Injected into dermal layer of skin
testing

Injected into subcutaneous tissue e.g. Insulin, adrenaline

Self-administered; e.g. insulin

Advantages

Depot preparations can be used;

e.g. norplant for contraception
b. Subcutaneous
Disadvantages

3. Injection
Unsuitable for irritant drugs

Slow onset, unsuitable

for emergency

Deltoid, gluteus maximum, lateral

Injected into large muscles
aspect of thigh in children

Rapid onset compared to oral route

Advantages
Depot preparations (used to prolong
drug action), mild irritants, soluble
c. Intramuscular substances and suspensions can be given

Requires aseptic condition

Painful, may lead to abscess

Disadvantages

Self-administration is not possible

Local tissue injury can occur; e.g. nerves

(Continued)

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 Routes of drug administration  11

2.3  SYSTEMIC ROUTE (Continued)

Bolus administration – single, large dose

e.g. Furosemide
rapidly/slowly injected as single unit

Direct injection of drug

Slow IV injection e.g. Morphine
into vein

IV infusion – addition of drug into a e.g. Dopamine infusion in

bottle containing dextrose/saline cardiogenic shock

100% bioavailability

Rapid onset, suitable for

emergencies

Large volume of fluid can be

given (IV dextrose)
Advantages
Highly irritant drugs can be
given (e.g. anticancer drugs)

Hypertonic solutions can be

given (20% mannitol)

Constant plasma levels can be maintained

(dopamine in cardiogenic shock)
d. Intravenous

Once drug is injected, drugs

action cannot be stopped

Local irritation, thrombophlebitis

Strict aseptic conditions are

mandatory
Disadvantages
Self-administration is not
possible

Drug extravasation cause

necrosis, slougting

Depot preparations cannot be given

Administer drugs slowly,

otherwise toxicity
Caution

Ensure tip of needle is in vein

(Continued)

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 12  Pharmacology mind maps for medical students and allied health professionals

2.3  SYSTEMIC ROUTE (Continued)

Rarely used now

e. Intra-arterial Used diagnostically e.g. Coronary angiography

Sometimes anticancer
drugs can be given

Injection of drug in e.g. Spinal anesthesia (lignocaine),

f. Intra-thecal
subarachnoid space antibiotics (in meningitis)

Direct injection of drug e.g. Hydrocortisone for

into joint space rheumatoid arthritis

g. Intra-articular Requires strict aseptic

condition

Repeated use can

damage cartilage

2.4  SPECIALIZED DRUG DELIVERY

Kept beneath lower eyelid e.g. Pilocarpine in glaucoma

1. Ocusert
Single application releases
drug for 1 wk

Intrauterine contraceptive
device
2. Progestasert
Releases progesterone
C. Specialized drug delivery
for 1 yr

Drug incorporated in minute e.g. Liposomal amphotericin

3. Liposomes
phospholipid vesicles for fungal infection

Immunoglobulins react with

specific antigen
4. Monoclonal antibiotics

Used for targeted delivery e.g. Anticancer drugs

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