1. Introduction to general pharmacology.

2. Pharmacology
Science that studies interactions of drugs with organism on different levels (subcellular, cellular, organ, systemic)
Studies:
relationship between chemical structure and biologic activity
site of effect localisation
mechanism of action
fate of drug in organism
evaluation of relationship between dose and biologic effect

3. Clinical pharmacology
is the science of drugs and clinical use of drugs
branches:
pharmacodynamics
pharmacokinetics
rational prescribing
adverse drug effects
drug interactions
toxicology
drug development

4. Pharmacogenetics and Pharmacogenomics
study of genetic variation which cause different response to drugs
is taking into consideration one or only a few genes
Pharmacogenomics
investigation in variation in DNA and RNA characteristics related to drug response

5. Genetic variations and pharmacokinetics
„Slow-acetylators“ have higher blood concentrations, better response, but greater risk of toxicity to isoniazid than „fast- acetylators“
Many polymorphism in a number of cytochrome P450 isoenzymes
Polymorphism in butyrylcholinesterase, alcohol dehydrogenase
Polymorphism that alter the elimination pathways

6. Pharmacovigilance
science of collecting, monitoring and evaluating information of the adverse effects of medications, biological products, herbalism and other medicines
from Greek pharmacon = drug
Latin vigilare = to keep alert

7. Pharmacoeconomics
study that evaluates the cost and effects of a drug or drug therapy
examples of pharmacoeconomic evaluation types:
cost – benefit analysis
cost – minimization analysis

8. Drug discovery
Most medicines were botanical or zoological origin (most had dubious therapeutic value)
Plant-derived drugs (morphine, cardiac glycosides, acetylsalicylic acid)
During 20th century – advances in chemistry allowing the synthesis and purification of small organic molecules (sulphonamides, penicillins)
„biologic drugs“(advances in molecular biology)
Advantages of modern drugs is their ability to act selectively

9. Drug discovery
Synthesis of novel chemicals not previously synthetised (in vivo, in vitro)
Synthesis of chemical analogues and modifications of existing medicines
Synthesis of a naturally occuring substance, its precursor or antagonist
Development of compounds that can mimic or interfere with the activity of the gene product

10. Drug approval
All medicines licensed for sale have to pass a rigorous evaluation of:
SAFETY
QUALITY
EFFICACY
In the European Union (EMA – European Medicines Agency)
In the USA (FDA – Food and Drug Administration)

11. Basic principles of drug prescription.

12. Prescription information
over-the-counter drugs can be obtained without a prescription (pharmacy medicines (P), which may be sold by a pharmacist without prescription, general sales list (GSL) medicines that may be sold without a prescription in any shop)
prescription medication is a drug that requires a medical prescription to be dispensed
brand name drug, generic drugs and biosimilars

13. Prescription – basic terms
Prescription Drug Time and Dosage Limit Laws
Prescription limitation
Indication limitation
Co-payment
Different in many countries, just know the meaning of these terms

14. What you should know about the drug?
Non-proprietary (generic) drug name (not necessary to know proprietary (trade name))
The class to which the drug belongs
Mechanism of action
Indications, contraindications
adverse drug reactions, interactions
Pharmacokinetic parameters (especially the ones characteristic for the drug)
Non-pharmacological treatments that are effective alternatives or complementary to pharmacotherapy

15. Sources of Information in Pharmacology

16. Primary literature
source of information for the development of secondary and tertiary literature
research studies, case reports, editorials
New England Journal of Medicine, Journal of the American Medical Association, Lancet,... (suitable for research, physicians)
Advantages of primary literature: current, original
Disadvantages of primary literature: may lead to inaccurate conclusions, price

17. Secondary literature
compiled by indexing and abstracting services that can be used to systematically locate various types of published literature
PubMed (Medline), Scopus, ...(suitable for research, physicians)
Advantages: quick access to the primary literature. broad information on specific topics, the journal sources are peer reviewed
Disadvantages: the number of journals indexed by each system depends upon the scope of the database, large amount of information can prolong the searching for specific topic, price

18. Tertiary literature
is core knowledge established via primary literature or accepted as standard of practice within the medical community (FDA, EMA)
textbooks on various drug or disease topics (e.g. Pharmacotherapy), compendia or online, full-text databases
textbooks, encyclopedia articles, guidebooks, and handbooks (suitable for students, physicians)
Advantages: convenient and accessible, drug information references may be divided into specific subjects, usually the information contained in tertiary literature is well accepted in medical practice
Disadvantages: time passes before the information is available, and more updated information may be available in a database, authors may emphasize limited information about a topic or drug (see the date of last edition)