Pharmacology for sports medicine students

1. Introduction of Pharmacology
Dr Lokendra Sharma
Professor of Pharmacology
9414048334
drlokendra29@gmail.com
Dr LOKENDRA SHARMA

2. Dr LOKENDRA SHARMA

3. Welcome to Pharmacology
张岫美
山东大学医学院
药理学研究所
Welcome to Pharmacology

4. Pharmacology ?
Pharmacology
The study or science of drugs
Dr LOKENDRA SHARMA

5. Drug ?
Any chemical that affects the processes of
a living organism
Dr LOKENDRA SHARMA

6. Dr LOKENDRA SHARMA

7. Subdivision of Pharmacology ?
Dr LOKENDRA SHARMA

8. Subdivision of Pharmacology ?
Dr LOKENDRA SHARMA

9. Pharmaceutics
 The study of how various drug forms influence
pharmacokinetic and pharmacodynamic activities
Dr LOKENDRA SHARMA

10. Pharmacokinetics
The study of what the body does to the drug:
–Absorption
–Distribution
–Metabolism
–Excretion
Dr LOKENDRA SHARMA

11. Pharmacodynamics
The study of what the drug does to the body:
–The mechanism of drug actions in living
tissues
Dr LOKENDRA SHARMA

12. Pharmacotherapeutics
The use of drugs and the clinical indications
for drugs to prevent and treat diseases
Dr LOKENDRA SHARMA

13. Pharmacognosy
 The study of natural (plant and animal) drug sources
Dr LOKENDRA SHARMA

14. Drug Absorption of Various
Oral Preparations
Liquids, elixirs, syrups Fastest
Suspension solutions 
Powders 
Capsules 
Tablets 
Coated tablets 
Enteric-coated tablets Slowest
Dr LOKENDRA SHARMA

15. Pharmacokinetics: Absorption
The rate at which a drug leaves its site of
administration, and the extent to which
absorption occurs.
– Bioavailability
– Bioequivalent
Dr LOKENDRA SHARMA

16. Pharmacokinetics: Metabolism
(also known as Biotransformation)
The biologic transformation of a drug into an
inactive metabolite, a more soluble
compound, or a more potent metabolite.
 Liver (main organ)
 Kidneys
 Lungs
 Plasma
 Intestinal mucosa
Dr LOKENDRA SHARMA

17. Pharmacokinetics: Metabolism
Factors that decrease metabolism:
 Cardiovascular dysfunction
 Renal insufficiency
 Starvation
 Obstructive jaundice
 Slow acetylator
 Erythromycin or ketoconazole drug therapy
Dr LOKENDRA SHARMA

18. Pharmacokinetics: Metabolism
Factors that increase metabolism:
 Fast acetylator
 Barbiturates
 Rifampin therapy
Dr LOKENDRA SHARMA

19. Pharmacokinetics: Metabolism
Delayed drug metabolism results in:
 Accumulation of drugs
 Prolonged action of the effects of the drugs
Stimulating drug metabolism causes:
 Diminished pharmacologic effects
Dr LOKENDRA SHARMA

20. Pharmacokinetics: Excretion
The elimination of drugs from the body
 Kidneys (main organ)
 Liver
 Bowel
– Biliary excretion
– Enterohepatic circulation
Dr LOKENDRA SHARMA

21. Pharmacokinetics
Half-Life
 The time it takes for one half of the original amount
of a drug in the body to be removed.
 A measure of the rate at which drugs are removed
from the body.
Dr LOKENDRA SHARMA

22. Pharmacodynamics
Drug actions:
 The cellular processes involved in the drug and
cell interaction
Drug effect:
 The physiologic reaction of the body to the drug
Dr LOKENDRA SHARMA

23. Pharmacodynamics
Onset
 The time it takes for the drug to elicit a
therapeutic response
Peak
 The time it takes for a drug to reach its maximum
therapeutic response
Duration
 The time a drug concentration is sufficient to elicit
a therapeutic response
Dr LOKENDRA SHARMA

24. Pharmacodynamics:
Mechanisms of Action
The ways by which drugs can produce
therapeutic effects:
 Once the drug is at the site of action, it can modify
the rate (increase or decrease) at which the cells or
tissues function.
 A drug cannot make a cell or tissue perform a
function it was not designed to perform.
Dr LOKENDRA SHARMA

25. Pharmacotherapeutics: Monitoring
The effectiveness of the drug therapy must be
evaluated.
One must be familiar with the drug’s
intended therapeutic action (beneficial)
The drug’s unintended but potential side
effects (predictable, adverse drug reactions).
Dr LOKENDRA SHARMA

26. Pharmacotherapeutics: Monitoring
Therapeutic index
Drug concentration
Patient’s condition
Tolerance and dependence
Interactions
Side effects/adverse drug effects
Dr LOKENDRA SHARMA

27. Pharmacotherapeutics: Monitoring
Therapeutic Index
 The ratio between a drug’s therapeutic benefits
and its toxic effects
Dr LOKENDRA SHARMA

28. Pharmacotherapeutics: Monitoring
Tolerance
 A decreasing response to repetitive drug doses
Dr LOKENDRA SHARMA

29. Pharmacotherapeutics: Monitoring
Dependence
 A physiologic or psychological need for a drug
Dr LOKENDRA SHARMA

30. Pharmacotherapeutics: Monitoring
Interactions may occur with other drugs or food
 Drug interactions: the alteration of action of
a drug by:
– Other prescribed drugs
– Over-the-counter medications
– Herbal therapies
Dr LOKENDRA SHARMA

31. Pharmacotherapeutics: Monitoring
Interactions
 Additive effect
 Synergistic effect
 Antagonistic effect
 Incompatibility
Dr LOKENDRA SHARMA

32. Pharmacotherapeutics: Monitoring
Medication Misadventures
Adverse drug events
 ALL are preventable
 Medication errors that result in patient harm
Adverse drug reactions
 Inherent, not preventable event occurring in the
normal therapeutic use of a drug
 Any reaction that is unexpected, undesirable, and
occurs at doses normally used
Dr LOKENDRA SHARMA

33. Pharmacotherapeutics: Monitoring
Some adverse drug reactions are classified as
side effects.
 Expected, well-known reactions that result in little
or no change in patient management
 Predictable frequency
 The effect’s intensity and occurrence is related to
the size of the dose
Dr LOKENDRA SHARMA

34. Dr LOKENDRA SHARMA

35. Dr LOKENDRA SHARMA

36. Dr LOKENDRA SHARMA

37. Dr L K Sharma
Oral
• Disadvantages
– Sometimes inefficient - only part of the drug may
be absorbed
– First-pass effect - drugs absorbed orally are initially
transported to the liver via the portal vein
– irritation to gastric mucosa - nausea and vomiting

38. Dr L K Sharma
Oral
• Disadvantages cont.
– destruction of drugs by gastric acid and digestive
juices
– effect too slow for emergencies
– unpleasant taste of some drugs
– unable to use in unconscious patient

39. Dr L K Sharma
First-pass Effect
• The first-pass effect is the term used for the hepatic
metabolism of a pharmacological agent when it is
absorbed from the gut and delivered to the liver via
the portal circulation. The greater the
first-pass effect, the less the agent will
reach the systemic circulation when the agent is
administered orally

40. Dr L K Sharma
First-pass Effect cont.
Magnitude of first pass hepatic effect:
Extraction ratio (ER)
ER = CL liver / Q ; where Q is hepatic
blood flow (usually about 90 L per hour.
Systemic drug bioavailability (F) may be
determined from the extent of absorption
(f) and the extraction ratio (ER):
F = f x (1 -ER)

41. Dr L K Sharma
First-pass Effect

42. Dr L K Sharma
1. unconscious patients and children
2. if patient is nauseous or vomiting
3. easy to terminate exposure
4. absorption may be variable
5. good for drugs affecting the bowel such
as laxatives
6. irritating drugs contraindicated
Rectal

43. Dr L K Sharma
Parenteral Routes
– Intravascular (IV, IA)- placing a drug directly into
the blood stream
– Intramuscular (IM) - drug injected into skeletal
muscle
– Subcutaneous - Absorption of drugs from the
subcutaneous tissues
– Inhalation - Absorption through the lungs

44. Adrenaline and Cardiac Massage ?

45. Defibrillator ?

46. What is septic shock ?

47. What is PVD ?

48. Epistaxis ?

49. Narcolepsy ?

50. Nasal Decongestants ?

51. Anorectics ?

57. Thanks
Dr LOKENDRA SHARMA