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Chapter 1 Orientation to Pharmacology Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Pharmacology A science that draws on information from multiple disciplines, including: Anatomy Physiology Psychology Chemistry Microbiology Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 2 Four Basic Terms Drug Any chemical that can affect living processes Pharmacology Study of drugs and their interactions with living systems Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 3 Four Basic Terms Clinical pharmacology Study of drugs in humans Therapeutics A.k.a. pharmacotherapeutics The use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy Primary concern studied in this text Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 4 Orientation to Pharmacology Properties of an ideal drug The therapeutic objective Factors that determine the intensity of drug responses Therapeutics Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 5 Three Most Important Properties of an Ideal Drug 1. Effectiveness 2. Safety 3. Selectivity Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 6 Additional Properties of an Ideal Drug Reversible action Predictability Ease of administration Freedom from drug interactions Low cost Chemical stability Simple generic name But because no drug is ideal… Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 7 Therapeutic Objective of Drug Therapy To provide maximum benefit with minimum harm Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 8 Factors That Determine the Intensity of Drug Responses Administration Pharmacokinetics Pharmacodynamics Sources of individual variation Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 9 Fig. 1-1. The four basic pharmacokinetic processes. Dotted lines represent membranes that must be crossed as drugs move throughout the body. Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 10 Administration Important determinants of drug responses: dosage size, route, timing Medication errors Patient adherence Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 11 Pharmacokinetics Determining how much of administered dose gets to its sites of action Impact of the body on drugs Four major pharmacokinetic processes Drug absorption Drug distribution Drug metabolism Drug excretion Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 12 Pharmacodynamics Impact of drugs on the body Drug-receptor interaction Patient’s functional state Binding of the drug to its receptor Influences pharmacodynamic processes Placebo effects Also help determine the responses a drug elicits Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 13 Sources of Individual Variation Physiologic variables Pathologic variables Diminished function of kidneys and liver Genetic variables Age, gender, weight Can alter metabolism of drugs and predispose patient to unique interactions Drug interactions Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. 14