This document provides an introduction to pharmacology. It discusses that pharmacology is the study of drugs and their interaction with living systems. The two main divisions of pharmacology are pharmacodynamics, which refers to what the drug does to the body, and pharmacokinetics, which refers to what the body does to the drug. It also discusses key concepts in pharmacology including the essential drug concept, clinical pharmacology, and how pharmacology relates to other fields like pharmacy, toxicology, and biotechnology.
in this presentation we are going to study introduction to pharmacology and scope of pharmacology.
i.e. meaning and definition of pharmacology along with branches of pharmacology and scope of pharmacology.
Introduction of Veterinary pharmacology Somaliland Dr.Osman Abdulahi FarahQaline Giigii
This course was prepared by Dr.Osman Abdulahi Farah
Cismaan shiine Lecturer of Gollis University Faculty of Agriculture and Veterinary Medicine 2014
The main content of this course including introduction of Veterinary Pharmacology, division of pharmacology and list of terms of terminology about veterinay pharmacology
in this presentation we are going to study introduction to pharmacology and scope of pharmacology.
i.e. meaning and definition of pharmacology along with branches of pharmacology and scope of pharmacology.
Introduction of Veterinary pharmacology Somaliland Dr.Osman Abdulahi FarahQaline Giigii
This course was prepared by Dr.Osman Abdulahi Farah
Cismaan shiine Lecturer of Gollis University Faculty of Agriculture and Veterinary Medicine 2014
The main content of this course including introduction of Veterinary Pharmacology, division of pharmacology and list of terms of terminology about veterinay pharmacology
It will provide you a complete journey through the routes of drug administration, with all the basics covered I hope this presentation will make your fundamentals crystal clear.
chap no 1 INTRODUCTION TO PHARMACOLOGY 1.pptxMahnoorFatima92
I am Mahnoor Fatima ,I am nursing personnel and currently working as an instructor in Pakistan ,Most of the time when i search of qualitative or HEC based course ,i get disappointed so then i tried myself to make my own nursing concerned HEC based content presentation. I hope it would be help full to all nursing undergraduates, Thank You!!
as nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. It includes the promotion of health, the prevention of illness, and the care of ill, disabled and dying people. So, it's important to have a vast knowledge about different disciplines. While I discuss about the Pharmacology which is the scientific study of the effects of drugs and chemicals on living organisms where a drug can be broadly defined as any chemical substance, natural or synthetic, which affects a biological system. Pharmacology in nursing is important to know because nurses have to deal the patient in IU,WARDS by the administration of accurate doses.
definitions that are related to pharmacology are given in detailed in this ppt. it covers definition of Pharmacokinetics pharmacodynamics toxicology chemotherapy and effects of drugs idiosyncrapcy sideeffect and all
Introduction to essential Pharmacology for Advanced EMT and Paramedic Students. A bit long but a good lecture. Does not goo into individual drugs, that is later. This is JUST the introduction.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. PHARMACOLOGY
( Greek : Pharmacon – drug; logos – a study or
discourse in)
Pharmacology is the science of drugs. In a
broad sense, it deals with interaction of
exogenously administered chemical molecules (
drugs) with living systems.
It encompasses all aspects of
knowledge about drugs, but most importantly
those that are relevant to effective and safe use
for medicinal purposes.
3. THE TWO MAIN DIVISIONS OF
PHARMACOLOGY
PHARMACODYNAMICS PHARMACOKINETICS
4. PHARMACODYNAMICS
( Greek : dynamis – power)
What the drug does to the body is called
Pharmacodynamics.
This includes
- Physiological and biochemical effects of drugs and
- their mechanism of action at cellular and organ system
levels.
5. PHARMACOKINETICS
(Greek : Kinesis – movement )
What the body does to the drug is called
Pharmacokinetics. This refers to movement
of the drug and its alteration within the
body, including
Route of administration,
Absorption,
Distribution,
Biotransformation and Excretion
6. RELATIONSHIP BETWEEN BODY AND DRUG
BODYDRUG
What the BODY does to the DRUG (pharmacokinetics)
What the DRUG does to the BODY (pharmacodynamics)
7. DRUG ( French: Drogue – a dry herb)
“It is the single active chemical entity present in a medicine
that is used for diagnosis, prevention, treatment or cure of a disease”.
This disease oriented definition of drug does not include
contraceptives.
WHO (1966) has given a more comprehensive definition :–
“Drug is any substance or product
that is used or is intended to be used
to modify or explore
physiological systems or pathological states
for the benefit of the recipient ”.
8. The benefits of the recipient (human or an
animal) include:-
1. Diagnosis
2. Prevention
3. Control (suppression)
4. Cure of the disease.
9. DIAGNOSIS
means the determination of the nature of a case of a disease
or the distinguishing of one disease from another.
It is based on signs, symptoms and laboratory findings
e.g. Barium sulfate ( a radio-opaque substance) is
usually used to fill the GIT so that the defects can be
exposed for X-ray.
Here barium sulfate is the drug used for the diagnosis
of the disease.
10. PREVENTION ( prophylaxis)
In primary prevention the person does not
have the disease and is to be prevented from getting
it, for e.g. vaccinations to prevent occurrence of
infection in the body, e.g. Poliovaccine is used for
the prophylaxis of poliomyelitis.
In secondary prevention the patient has the
disease and the objective is to reduce risk factors and
to retard progression of disease. (e.g. lipid-lowering
drugs in atherosclerosis ).
11. CONTROL (SUPPRESSION)
When a drug is used
continuously or intermittently
to maintain health without attaining cure
as in hypertension, diabetes mellitus, asthma
Or to control symptoms, such as pain & cough,
while awaiting recovery from the causative disease,
it is called control or suppression of disease or symptoms,
for e.g. use of analgesic to suppress pain while awaiting healing of
fracture.
12. CURE OF THE DISEASE
It implies the therapy that eliminates
the disease completely and then the drug is
withdrawn afterwards, for e.g. in bacterial and
parasites infections.
Metronidazole is commonly used for the
treatment of amebiasis with the purpose to cure
the disease.
However a single drug may not fulfill all the
purposes like diagnosis, prevention, control or
cure of a disease.
13. Drugs
Drugs can be defined as chemical agents that
uniquely interact with specific target molecules in
the body, thereby producing a biological effect.
Drugs can be
stimulatory or
inhibitory
14. Drugs
• Drugs, as well as hormones, neurotransmitter,
autacoids and toxins can make possible the
transfer of information to cells by interaction
with specific receptive molecules called
“receptors”.
Receptor
DRUG
15. Drugs
• Drugs interact with biological systems in ways that
mimic, resemble or otherwise affect the natural
chemicals of the body.
• Drugs can produce effects by virtue of their acidic or
basic properties (e.g. antacids, protamine), surfactant
properties (amphotericin), ability to denature proteins
(astringents), osmotic properties (laxatives, diuretics),
or physicochemical interactions with membrane lipids
(general and local anesthetics).
16. PHARMACO-THERAPEUTICS
It is the application of pharmacological information together with knowledge of the
disease for its prevention, mitigation or cure.
For e.g. if we take aspirin in fever, it lowers the temperature.
When atenolol is used it reduces the blood pressure.
When glibenclamide is taken it reduces the blood sugar level.
That is, lowering body temperature, reducing blood pressure or blood sugar levels
are all considered as drug effects or therapeutic actions of drugs.
SITE OF DRUG ACTION
Now the question is where and how the effect is produced. For e.g atenolol on the
heart to reduce cardiac output and peripheral resistance i.e. to reduce high blood
pressure,
glibenclamide on the beta cells of the islets of Langerhans of the pancreas to release
insulin.
Here, heart, blood vessels and beta cells of islets of Langerhans of pancreas are the
sites of drug action.
17. PHARMACOLOGICAL EFFECTS
Pharmacological effects may be defined as the physiological
and/or biochemical changes in the body produced by a drug in therapeutic
concentrations. No drug has single pharmacologic effect rather it usually
produces several pharmacological effects.
The pharmacologic effects of a drug may be classified as
desired and undesired effects even when used in usual dose. Undesired effects
are further classified as beneficial, harmful and harmless effects.
PHARMACOLOGICAL EFFECTS
DESIRED EFFECTS UNDESIRED EFFECTS
BENIFICIAL HARMFUL HARMLESS
18. PLASMA CONCENTRATION OF DRUG
The effectiveness, ineffectiveness or toxicity of a drug depends on
its concentration in plasma.
For example, therapeutic effect is unlikely if the plasma
concentration of digoxin is less than 1nmol/L. Beneficial effect with
a low risk of toxicity is obtained when its concentration ranges
between 1 to 3.8nmol/L. But the risk of its toxicity is increased
considerably when its plasma concentration increases above
3.8nmol/L.
A barbiturate can be taken as another example, which in
lower doses produces sedation but when its concentration is
increased it can develop hypnosis. Even coma and death may occur
with further increase in concentration.
19. CLINICAL PHARMACOLOGY
It is the scientific study of drugs in man. It includes,
Pharmacodynamic and pharmacokinetic investigation in healthy
volunteers and in patients;
Evaluation of efficacy and safety of drugs and comparative trials
with other forms of treatment;
Surveillance of drug use, adverse effects, etc.
The aim of clinical pharmacology is to generate data for optimum use of
drugs.
CHEMOTHERAPY
It is the treatment of systemic infection or malignancy with
specific drugs that have selective toxicity for the infecting organism or
malignant cells with no or minimal effects on the host cells.
20. PHARMACY
It is the art and science of compounding and
dispensing drugs or preparing suitable dosage forms for
administration of dugs in man or animals.
It includes collection, purification, isolation,
synthesis, standardization and quality control of medicinal
substances.
The large scale manufacture of drugs is called
Pharmaceutics. It is primarily a technological science.
21. TOXICOLOGY
It is study of poisonous effects of drugs and other
chemicals (house–hold and environmental pollutants,
industrial and agricultural chemicals) with emphasis on
detection, prevention and treatment of poisoning.
It also includes the study of adverse effects of drugs,
since same substance can be a drug or a poison, depending
on its dose.
22. ESSENTIAL DRUG CONCEPT
The WHO has defined Essential Drugs as ‘ those that satisfy the healthcare needs of
majority of the population; they should therefore be available at all times in
adequate amounts and in appropriate dosage forms’.
It has been realized that only a handful of drugs out of the multitude available can meet
the health care needs of majority of the people in any country, and that many well
tested and cheaper drugs are equally ( or more) efficacious and safe as their newer
more expensive congeners. For optimum utilization of resources, government
should concentrate on these drugs by identifying them as Essential Drugs.
The WHO has laid down criteria to guide selection of an essential drug. Some of
its important points are as follows:
i. Adequate data on drug’s efficacy and safety should be available from clinical
studies. It should be available in a form.
ii. In case of two or more similar drugs, choice should be made on the basis of their
relative efficacy, safety, quality, price and availability . Cost benefit ratio should
be a major consideration.
iii. Selection of essential drugs should be a continuous process which should take into
account the changing priorities for public health planning, epidemiological
conditions, availability of better drugs & progress in pharmacological knowledge.
23. PHARMACOLOGY TODAY
As with other biomedical disciplines, the boundaries
of pharmacology are not sharply defined nor are they constant.
Its exponents are, as befits pragmatists, ever ready to poach on
the territory and techniques of other disciplines.
If it ever had a conceptual and technical core that it
could really call its own, this has now dwindled almost to the
point of extinction, and the subject is defined by its purpose, to
understand what drugs do to living organisms and more
particularly how their effects can be applied to therapeutics.
Figure in next slide shows the structure of pharmacology as it
appears today.
24.
25. BIOTECHNOLOGY
Originally , this was the production of drugs or other useful products
by biological means e.g. antibiotic production from microorganisms.
Currently in the biomedical sphere, biotechnology refers mainly to the
use of recombinant DNA technology for a wide variety of purposes, including
the manufacture of therapeutic proteins, diagnostics , genotyping, etc.
There are also many non-medical applications including agricultural,
forensic , environmental sciences and etc.
PHARMACOGENETICS
This is the study of genetic influences on responses to drugs.
Originally , pharmacogenetics focused on familial idiosyncratic drug reactions,
where affected individuals show an abnormal, usually adverse, response to a
class of drug.
26. PHARMACOGENOMICS
This recent term overlaps with pharmacogenetics,
describing the use of genetic information to guide the choice of
drug therapy on an individual basis. The underlying assumption
is that differences between individuals in their response to
therapeutic drugs can be predicted from their genetic makeup.
On this principal, discovering which specific gene
variations are associated with a good or poor therapeutic
response to a particular drug should enable individual tailoring
of therapeutic choices on the basis of an individual’s genotype.
So far, the concept is largely theoretical, but if it
proves valid, the consequences for therapeutics will be far
reaching.
27. PHARMACOEPIDEMIOLOGY
This is the study of drug effects at the population
level. It is concerned with the variability of drug effects between
individuals in a population, and between populations.
It is an increasingly important topic in the eyes of
the regulatory authorities who decide whether or not new drugs
can be licensed for therapeutic use.
Pharmacoepidemiological studies also take into
account patient compliance and other factors that apply when the
drug is used under real – life conditions.
28. PHARMACOECONOMICS
This branch of health economics aims to quantify in
economics terms the cost and benefit of drugs used
therapeutically.
It arose from the concern of many governments to
provide for healthcare from tax revenues, raising questions of
what therapeutic procedures represent the best value for money.
This, of course raises fierce controversy, since it ultimately
comes down to putting monetary value on health and longevity.
As with Pharmacoepidemiology, regulatory authorities are
increasingly requiring economic analysis, as well as evidence of
individual benefit, when making decisions on licensing.
29. CONSIDERATIONS BEFORE TREATING PATIENTS
Before treating any patient with drugs, doctors should have made up their
minds on 8 points :
i. Whether they should interfere with the patient at all and if so;
ii. What alteration in the patient’s condition they hope to achieve
iii. That the drug they intend to use is best capable of bringing this about.
iv. How they will know when it has been brought about
v. That they can administer the drug in such a way that the right concentration
will be attained in the right place at the right time and for the right
duration.
vi. What other effects the drug may have and whether these may be harmful
vii. How they will decide to stop the drug.
viii. Whether the likelihood of benefit, and its importance, outweighs the
likelihood of damage, and its importance, i.e. to consider benefit verses
risk, or efficacy in relation to safety.
30. FACTORS INFLUENCING DRUG
RESPONSES
When a patient is given a drug the responses are the resultant of
numerous factors :
- The pharmacodynamic effect of the drug and interactions with
any other drugs the patient may be taking.
- The pharmacokinetics of the drug and its modification in the
individual due to genetic influences or disease.
- The act of medication , including the route of administration.
- What the doctor has told to patient.
- The patient’s past experience of doctors.
- The social environment , e.g. whether supportive or dispiriting
The relative importance of these factors varies according to
circumstances.
31. DRUG HISTORY
The reasons for taking a drug history from patients are :
- Drugs can be cause of disease. Withdrawal of drugs can also cause
disease,
- Drugs can conceal disease,
- Drugs can give diagnostic clues, e.g. ampicillin and Amoxycillin
causing urticaria in infectious mononucleosis – a diagnostic adverse
effect.
- Drugs can cause false results in clinical chemistry test.
- Drugs history can assist choice of drugs in the future.
32. WARNINGS AND CONSENT
Doctors have a professional duty to inform and to warn,
so that patients, who are increasingly informed and educated, may make
meaningful personal choices which it is their right to do ( unless they opt
to leave the choice to the doctor, which is also their right to do ).
KINDS OF WARNINGS TO PATIENTS
- Warnings that will affect the patient’s choice to accept or reject the
treatment.
&
- Warnings that will affect the safety of the treatment once it has begun,
e.g. risk of stopping treatment, occurrence of drug toxicity.
33. PATIENT’S COMPLIANCE
Patient compliance is the extent to which the actual behaviour of the
patient coincides with medical advice and instructions : it may be
complete, partial, erratic, nil or there may be over-compliance.
PRIME FACTORS FOR POOR PATIENT’S COMPLIANCE
- Patient dissatisfaction with the doctor, poor patient – doctor
relationship
- Lack of motivation
- Forgetfulness ( Unintentional noncompliance)
- Deliberate intention
- Lack of information
- Frequency and complexity of drug regimen
34. DOCTOR’S COMPLIANCE
Doctor compliance is the extent to which the behaviour of
doctor fulfills their professional duty :
- Not to be ignorant.
- To adopt new advances when they are sufficiently proved.
- To prescribe accurately.
- To refrain from inappropriate prescription.
-To tell patients what they need to know.
35. SELF MEDICATION
Self medication is appropriate for :
- Short term relief of symptoms where accurate diagnosis is
unnecessary.
- Uncomplicated cases of some chronic and recurrent
diseases ( where a medical diagnosis & prescription would
have already been made)