HISTORY OF HISTORY OF PHARMACOLOGYPHARMACOLOGY

Prepared By: Ana Maria M. Pingol RN MSNPrepared By: Ana Maria M. Pingol RN MSN

PharmacologyPharmacology

• Is the scientific study of the origin, nature, Is the scientific study of the origin, nature, chemistry, effects, and uses of drugschemistry, effects, and uses of drugs

• Pharmacology is not synonymous with Pharmacology is not synonymous with pharmacy. Pharmacology deals with how drugs interact within biological systems to affect function, while pharmacy is a medical science concerned with the safe and effective use of medicines.

Brief History of PharmacologyBrief History of Pharmacology

Primitive PeriodPrimitive Period

– Primitive people uses drugs for mystical or Primitive people uses drugs for mystical or magic powers rather than their physiologic magic powers rather than their physiologic effecteffect

– They believed that evil spirits caused They believed that evil spirits caused diseasesdiseases

– Alcohol and opium were one of the first Alcohol and opium were one of the first medicinal plantsmedicinal plants

– EgyptEgypt- cradle of civilization- cradle of civilization

oldest phase of medicineoldest phase of medicine

– Ebers Papyrus-Ebers Papyrus- written 3,000 years ago, an written 3,000 years ago, an Egyptian medical source that listed 700 Egyptian medical source that listed 700 different remedies to treat specific ailments. It different remedies to treat specific ailments. It covers different prayers in driving away covers different prayers in driving away diseases and specific recipes for drugs (e.g. diseases and specific recipes for drugs (e.g. aloe, oil, opium, peppermint, and vinegar)aloe, oil, opium, peppermint, and vinegar)

Ancient PeriodAncient Period

• Greece- pharmaceutical history begins Greece- pharmaceutical history begins with legends of gods and goddesseswith legends of gods and goddesses

• AesculapiusAesculapius- god of healing- god of healing

• HippocratesHippocrates- father of medicine- father of medicine

• DioscoridesDioscorides- Greek physician who wrote the - Greek physician who wrote the Materia Medica, Materia Medica, which specifically described 600 which specifically described 600 different plants and classified them by substance different plants and classified them by substance rather than by the disease they intend to treat. This rather than by the disease they intend to treat. This became the main source of pharmaceutical became the main source of pharmaceutical knowledge up to the 16knowledge up to the 16thth century century

• Rome- after the Roman conquest of Rome- after the Roman conquest of Greece, Greek medicine migrates to Greece, Greek medicine migrates to RomeRome

GalenGalen- a Greek - a Greek physician who physician who established a established a system of medicine system of medicine and pharmacyand pharmacy

-he was the first to -he was the first to prepare the prepare the cold cold cream and cream and rose water rose water ointmentointment

Medieval PeriodMedieval Period

• There was a spread in Christianity There was a spread in Christianity and the establishment of the and the establishment of the Venerable Bede-Venerable Bede- a medieval a medieval monastery where monks monastery where monks preserved their works on preserved their works on pharmacy and medicine on pharmacy and medicine on manuscriptsmanuscripts

• Dark Age- Dark Age- a period of about 600 years, a period of about 600 years, characterized by the destruction of old civilization characterized by the destruction of old civilization and little progress in learningand little progress in learning

Medieval PeriodMedieval Period

• Arabian Influence- establishment of schools and Arabian Influence- establishment of schools and hospitals and discovery of many new drugs. hospitals and discovery of many new drugs. Arabs are the originator of syrups, alcohol, and Arabs are the originator of syrups, alcohol, and aromatic water. They produced the first aromatic water. They produced the first pharmaceutical formula or set of standards pharmaceutical formula or set of standards (Apothecary System)(Apothecary System)

• GeberGeber- the first great Mohammedan and reputed - the first great Mohammedan and reputed discoverer of nitric acid, sulfuric acid, and discoverer of nitric acid, sulfuric acid, and nitrohydrochloric acidnitrohydrochloric acid

GeberGeber- - “Father of “Father of Arab Chemistry”Arab Chemistry”

1616thth Century Century• Paracelsus- “Father of Pharmacology”Paracelsus- “Father of Pharmacology”

»Swiss scientist that first advocated the Swiss scientist that first advocated the use of a single drug rather than use of a single drug rather than mixtures and potions (advantage: the mixtures and potions (advantage: the dosage of a single dose can be dosage of a single dose can be regulated more precisely than that of regulated more precisely than that of complex mixturescomplex mixtures

» Improved pharmacy and therapeutics, Improved pharmacy and therapeutics, introducing new remedies and introducing new remedies and compounds and reducing overdosingcompounds and reducing overdosing

1717thth Century Century

• - Great interest was displayed in - Great interest was displayed in chemistry and pharmacy and many chemistry and pharmacy and many preparations are in use.preparations are in use.

• Ex.Ex. Cinchona bark – Cinchona bark – discovered by discovered by the Indians; used in treating and the Indians; used in treating and preventing malaria.preventing malaria.

• Syrup of ipecac – Syrup of ipecac – discovered by discovered by the natives of Brazil; used for amoebic the natives of Brazil; used for amoebic dysenterydysentery

• William Harvey – William Harvey – explained how drugs exert explained how drugs exert beneficial or harmful effects. He also demonstrated beneficial or harmful effects. He also demonstrated the circulation of blood in the body and introduced the circulation of blood in the body and introduced a new way of administering drug – a new way of administering drug – IntravenouslyIntravenously

1818thth Century Century

• Edward Jenner – Edward Jenner – an English an English physician who made the first physician who made the first public inoculation of smallpox public inoculation of smallpox vaccine in 1756vaccine in 1756

William Withering – William Withering – an Englishman who introduced the an Englishman who introduced the infusion digitalis for the treatment of heart disease.infusion digitalis for the treatment of heart disease.

1919thth Century Century

• Friedrich Serturner – Friedrich Serturner – a German pharmacist a German pharmacist who discovered who discovered alkaloid morphine substance.alkaloid morphine substance.

• Francois Magendie & Claude Bernard – Francois Magendie & Claude Bernard – with with the use of purified drug, they demonstrated that the use of purified drug, they demonstrated that certain drugs work at specific sites of action certain drugs work at specific sites of action within the body.within the body.

• The French Codex The French Codex was the first important was the first important pharmacology book to be produced in 1818.pharmacology book to be produced in 1818.

• Ether and Chloroform Ether and Chloroform were first used as were first used as general anesthesia in the 1840s.general anesthesia in the 1840s.

2020thth Century Century

• Important legislation was instituted to control the Important legislation was instituted to control the manufacture and sales of drugs. These include the Food manufacture and sales of drugs. These include the Food and Drug Act of 1906 & 1938 and the Harrison Narcotic and Drug Act of 1906 & 1938 and the Harrison Narcotic Drug Act of 1914 & Controlled Substance Act of 1970.Drug Act of 1914 & Controlled Substance Act of 1970.

• Lister & Semmelweis – Lister & Semmelweis – introduced the use of introduced the use of antiseptics to prevent infection during surgeryantiseptics to prevent infection during surgery

• Two early landmarks in the 20th century:Two early landmarks in the 20th century:– Ehrlich – Ehrlich – introduced Salvarsan for treating syphilis introduced Salvarsan for treating syphilis

and responsible for the introduction of and responsible for the introduction of antibioticsantibiotics– Banting & BestBanting & Best’s discover of insulin in treating ’s discover of insulin in treating

diabetes.diabetes.

Definition of TermsDefinition of Terms

• Drugs – Drugs – a.k.a. medicationsa.k.a. medications• any chemical substance which affects living any chemical substance which affects living

systemssystems• chemical and medicinal compounds used for chemical and medicinal compounds used for

treatment of disease, for the prevention of illness treatment of disease, for the prevention of illness of pathologic states and for diagnosing disease of pathologic states and for diagnosing disease condition.condition.

• Pharmacology – Pharmacology – science concerned with the science concerned with the history, sources, physical and chemical properties history, sources, physical and chemical properties of drugs as well as the ways in which drug affects of drugs as well as the ways in which drug affects the living systemthe living system

• a branch of knowledge that has to do with the a branch of knowledge that has to do with the chemicals that have biological effect.chemicals that have biological effect.

Subdivisions/ Brances of PharmacologySubdivisions/ Brances of Pharmacology• Pharmacognosy – Pharmacognosy – the branch of pharmacology dealing with the the branch of pharmacology dealing with the

economic, biological and chemical aspects of natural drugs and their economic, biological and chemical aspects of natural drugs and their constituents. The study of the sources of drugs and the physical constituents. The study of the sources of drugs and the physical characteristics of crude or unrefined drugs. Study of drugs derived characteristics of crude or unrefined drugs. Study of drugs derived from herbal and other natural sources and how the body reacts to from herbal and other natural sources and how the body reacts to them.them.

• Pharmacokinetic –Pharmacokinetic – deals with the absorption, distribution, deals with the absorption, distribution, biotransformation, and excretion of drugs and/or its chemical biotransformation, and excretion of drugs and/or its chemical byproducts in various body sites as well as the time required for these byproducts in various body sites as well as the time required for these drug concentration to develop and/or change.drug concentration to develop and/or change.– Absorption – Absorption – movement of drug particles from the GI tract to movement of drug particles from the GI tract to

body fluids by passive absorption, active absorption.body fluids by passive absorption, active absorption.– Distribution –Distribution – is the process by which the drug becomes is the process by which the drug becomes

available to body fluids and body tissue or the drug is carried from available to body fluids and body tissue or the drug is carried from its site of absorption to its site of action.its site of absorption to its site of action.

– Metabolism/Biotransformation –Metabolism/Biotransformation – when drugs are inactivated by when drugs are inactivated by liver enzymes and are then converted or transformed by hepatic liver enzymes and are then converted or transformed by hepatic enzymes to inactive metabolites or water-soluble substance for enzymes to inactive metabolites or water-soluble substance for excretion. Process of energy and transformation in all living cells.excretion. Process of energy and transformation in all living cells.

– Excretion –Excretion – elimination of drugs or its chemical byproducts in elimination of drugs or its chemical byproducts in various body sites (i.e. bile, feces, lungs, saliva, sweat, breast various body sites (i.e. bile, feces, lungs, saliva, sweat, breast milk). The site by which the drug is excreted.milk). The site by which the drug is excreted.

• Pharmacodynamics – Pharmacodynamics – study of the biochemical and study of the biochemical and physiological effects of drugs as well as their mechanism of physiological effects of drugs as well as their mechanism of action.action.– Pharmacologist – Pharmacologist – is a scientist who specializes in the study is a scientist who specializes in the study

of pharmacodynamics, employing all kinds of biochemical, of pharmacodynamics, employing all kinds of biochemical, physiological, and other techniques.physiological, and other techniques.

• Pharmacotherapeutics – Pharmacotherapeutics – study of how drug may be used in study of how drug may be used in the treatment of disease, that is, which among the drugs would the treatment of disease, that is, which among the drugs would be most effective or appropriate for a specific disorder or what be most effective or appropriate for a specific disorder or what dose would be required.dose would be required.

• Pharmacy – Pharmacy – the study of techniques involved in the the study of techniques involved in the preparation, compounding, dispensing, preservation and preparation, compounding, dispensing, preservation and storage of the drugs for medical use.storage of the drugs for medical use.– Pharmacist – Pharmacist – one who is qualified and licensed to prepare one who is qualified and licensed to prepare

and dispense drugs; responsible for the manufacture of the and dispense drugs; responsible for the manufacture of the dosage form of drugs (e.g. tablets, capsules, etc)dosage form of drugs (e.g. tablets, capsules, etc)

• Pharmacogenetics – Pharmacogenetics – the study of genetically-determined the study of genetically-determined reactions of drugs in the human body.reactions of drugs in the human body.

• Toxicology – Toxicology – study of poisonous effects of drugsstudy of poisonous effects of drugs• Drug therapy –Drug therapy – the proper administration of drugs used to treat the proper administration of drugs used to treat

diseasedisease

Drug Standards and LegislationDrug Standards and Legislation• Drug StandardsDrug Standards

– The United Pharmacopoeia National Formulary (USP NF)The United Pharmacopoeia National Formulary (USP NF)• the current authoritative source for drug standards (revised the current authoritative source for drug standards (revised

every 5 years by a group of experts in nursing: pharmaceutics, every 5 years by a group of experts in nursing: pharmaceutics, pharmacology, chemistry, and microbiology)pharmacology, chemistry, and microbiology)

• Drugs included in the USP-NF have the standards for:Drugs included in the USP-NF have the standards for:– therapeutic usetherapeutic use– client safetyclient safety– QualityQuality– puritypurity– strengthstrength– packagingpackaging– dosage formdosage form

– International Pharmacopoeia – International Pharmacopoeia – first published in 1951 by WHOfirst published in 1951 by WHO• provides basis for standards in strength and composition of provides basis for standards in strength and composition of

drugs worldwidedrugs worldwide• published in English, Spanish, and French (revised every 5 published in English, Spanish, and French (revised every 5

years)years)

• FEDERAL LEGISLATIONFEDERAL LEGISLATION– Purpose – Purpose – to ensure safety (drugs that are impure, toxic, ineffective, to ensure safety (drugs that are impure, toxic, ineffective,

or not tested before public sale)or not tested before public sale)– do not include drug effectiveness and drug safetydo not include drug effectiveness and drug safety

• 1938: Food, Drug, and Cosmetic Act1938: Food, Drug, and Cosmetic Act– empowered a governing body—the Food and Drug Administration empowered a governing body—the Food and Drug Administration

(FDA) and Cosmetic Act of 1938(FDA) and Cosmetic Act of 1938– Purpose: to monitor and regulate the manufacture and marketing of Purpose: to monitor and regulate the manufacture and marketing of

drugsdrugs– FDA’s responsibility is to ensure that all drugs are tested for harmful FDA’s responsibility is to ensure that all drugs are tested for harmful

effects, have labels with accurate information, drug literature that effects, have labels with accurate information, drug literature that explains adverse effectsexplains adverse effects

• 1952: Durham-Humphrey Amendment1952: Durham-Humphrey Amendment– amendment to the FDA and Cosmetic Act of 1938amendment to the FDA and Cosmetic Act of 1938– distinguished between drugs that be sold with or without prescription distinguished between drugs that be sold with or without prescription

and those that should not be refilled without a new prescription (ex. and those that should not be refilled without a new prescription (ex. Narcotics, hypnotics, or tranquilizers; must be labeled)Narcotics, hypnotics, or tranquilizers; must be labeled)

– It also specified that all other drugs are approved for use to be It also specified that all other drugs are approved for use to be considered non-prescription drugsconsidered non-prescription drugs

• 1962: Kefauver-Harris Amendment1962: Kefauver-Harris Amendment– tightened controls on drug safety, especially experimental drugs, and required tightened controls on drug safety, especially experimental drugs, and required

that adverse reactions and contraindications must be labeled and included in that adverse reactions and contraindications must be labeled and included in the literaturethe literature

– it added requirements that both prescription and non-prescription drugs be it added requirements that both prescription and non-prescription drugs be shown to be effective as well as safeshown to be effective as well as safe

– thalidomide tragedy1950 – thalidomide tragedy1950 – pregnant European women who took the sedative-pregnant European women who took the sedative-hypnotic thalidomide during their first trimester of pregnancy gave birth to infants hypnotic thalidomide during their first trimester of pregnancy gave birth to infants with extreme limb deformities.with extreme limb deformities.

• 1970: The Controlled Substance Act1970: The Controlled Substance Act– the Controlled Substance Act of the Comprehensive Drug Abuse Prevention the Controlled Substance Act of the Comprehensive Drug Abuse Prevention

and Control Act, title II, was passed by the congress.and Control Act, title II, was passed by the congress.– Provision:Provision:

• The promotion of drug education and research into the prevention and The promotion of drug education and research into the prevention and treatment of drug dependencytreatment of drug dependency

• The strengthening of enforcement authorityThe strengthening of enforcement authority• The establishment of treatment and rehabilitation facilitiesThe establishment of treatment and rehabilitation facilities• The designation of schedules, or categories of controlled substances The designation of schedules, or categories of controlled substances

according to abuse liabilityaccording to abuse liability

• Drug Enforcement Administration (DEA)Drug Enforcement Administration (DEA)– charged with the role of being the Nation’s sole legal drug enforcement agencycharged with the role of being the Nation’s sole legal drug enforcement agency– Bureau of Narcotics and Dangerous Drugs was closed before DEA took placeBureau of Narcotics and Dangerous Drugs was closed before DEA took place

A German pharmaceutical company, Chemie Grünenthal at Stolberg, synthesized thalidomide in West Germany in 1953. It had accidentally been discovered during a search for cheap antibiotics, but was soon marketed with little evidence as a sedative.In 1961 the drug was found to be harmful to the unborn children of pregnant women

• 1978: Drug Regulation Reform Act1978: Drug Regulation Reform Act• This reform act shortened the time in which new drugs could be This reform act shortened the time in which new drugs could be

developed and marketed.developed and marketed.• 1992: Drug Relations Act1992: Drug Relations Act• The regulations were changed to increase the approval rates of drugs The regulations were changed to increase the approval rates of drugs

used to treat AIDS and cancerused to treat AIDS and cancer• The pharmaceuticals pay a users fee at the time they file the The pharmaceuticals pay a users fee at the time they file the

application for the new drugs (for FDA approval process)application for the new drugs (for FDA approval process)..• 1997: The Food and Drug Administration Modernization Act1997: The Food and Drug Administration Modernization Act

5 Provisions included in this act:5 Provisions included in this act:

• Review and use of new drugs is accelerated.Review and use of new drugs is accelerated.• Drugs can be tested in children before marketing.Drugs can be tested in children before marketing.• Clinical trial data is necessary for experimental drug for serious or life-Clinical trial data is necessary for experimental drug for serious or life-

threatening health conditions.threatening health conditions.• Drug companies are required to give information on “off-label” drugs Drug companies are required to give information on “off-label” drugs

(non-FDA approved drugs) and their uses and costs(non-FDA approved drugs) and their uses and costs• Drug companies that plan to discontinue drug must inform health Drug companies that plan to discontinue drug must inform health

professionals and clients at least 6 months before stopping drug professionals and clients at least 6 months before stopping drug productionproduction

Drug Pregnancy CategoriesDrug Pregnancy Categories• CATEGORY A: CATEGORY A: No risk to fetus. Studies have not shown No risk to fetus. Studies have not shown

evidence for fetal harm.evidence for fetal harm.

• CATEGORY B: CATEGORY B: No risk in animal studies, and well-controlled No risk in animal studies, and well-controlled studies in pregnant women are not available. It is assumed there studies in pregnant women are not available. It is assumed there is little to no risk in pregnant women.is little to no risk in pregnant women.

• CATEGORY CCATEGORY C: Animal studies indicate a risk to the fetus. : Animal studies indicate a risk to the fetus. Controlled studies on pregnant women are not available. Risk Controlled studies on pregnant women are not available. Risk versus benefit of the drug must be determined.versus benefit of the drug must be determined.

• CATEGORY D: CATEGORY D: A risk to the human fetus has been proven. Risk A risk to the human fetus has been proven. Risk versus benefit of the drug must be determined. It could be used in versus benefit of the drug must be determined. It could be used in life-threatening conditions.life-threatening conditions.

• CATEGORY X: CATEGORY X: A risk to the human fetus has been proven. Risk A risk to the human fetus has been proven. Risk outweighs the benefits and drug should be avoided during outweighs the benefits and drug should be avoided during pregnancy.pregnancy.

Drug NamesDrug Names

• Chemical Name – Chemical Name – describes the drug’s chemical structuredescribes the drug’s chemical structure

• Generic Name – Generic Name – the official or non-proprietary name for the official or non-proprietary name for the drug the drug

• this name is not owned by any pharmaceutical (drug) this name is not owned by any pharmaceutical (drug) company and is universally acceptedcompany and is universally accepted

• Brand Name or Trade Name – Brand Name or Trade Name – also known as proprietary also known as proprietary namename

• also chosen by the drug company and is usually a also chosen by the drug company and is usually a registered trademark owned by that specific registered trademark owned by that specific manufacturermanufacturer

Drug UsesDrug Uses

• The most common drug use is symptomatic The most common drug use is symptomatic treatment. Many drugs are used to relieve treatment. Many drugs are used to relieve disease symptoms.disease symptoms.

• Preventive drug helps the body avoid diseasePreventive drug helps the body avoid disease• Diagnostic drugs help the physician determine Diagnostic drugs help the physician determine

whether a disease is presentwhether a disease is present• Curative drugs eliminate the disease.Curative drugs eliminate the disease.• Health maintenance drugs help the body to Health maintenance drugs help the body to

function normally.function normally.• Contraceptive drugs prevent pregnancy.Contraceptive drugs prevent pregnancy.