FUNDAMENTAL CONCEPTS OF PHARMACOLOGY

Course Code NCM 106 Week/Day Week 2

Course Description Pharmacology Duration 1 week
Lesson/ Topic FUNDAMENTAL CONCEPTS Lesson No. 2
OF PHARMACOLOGY

Learning Outcome/s At the end of lesson students can

1. Identify drug names
2. Outline the drug development

Value Integration Commitment

Reference/s Basic Pharmacology for Nurses (Clayton, Stock, Cooper)
Course Coach Ma. Vida Joy M. Mangubat, RM, RN

Welcome to chapter one of nursing pharmacology. This chapter will introduce you to history of
pharmacology and drug names. Please take the pre-test to evaluate your prior knowledge of the
topic.

I. Activation of Prior Knowledge.

Briefly differentiate between drugs and medicine in your own words and perception. Use a
minimum of 50 words. Please write your answer on the answer sheet provided.

II. Engagement in Relevant Content and Appropriate Learning Activity/Activities.

Take time to read this brief history of drugs to gain appreciation of their discovery process and
importance to society.

First, let us know the meaning of the word drugs.

 DRUGS= came from the DUTCH WORD “DROOGS” meaning DRY.

Why dry? Because plants were dried long time ago to be used as medicine.

And what are drugs? They are chemical substances that have an effect on living organisms.

Where drugs do came from?

 Natural- comes from nature such as

aspirin from willow bark tree or Iron
from minerals.
 Endogenous- from within the body.
Example: Hepatitis B
Immunoglobulin
 Synthetic drugs are created using
man-made chemicals rather than
natural ingredients. They aim to
mimic the effect of existing prohibited drugs such as cannabis and cocaine. Common
synthetic drugs include LSD, methamphetamine and ecstasy, which all are prohibited drugs.
PHARMACOLOGY
 GREEK WORD “PHARMACON” = DRUGS
 LOGOS= STUDY

If you combine PHARMACON+ LOGOS= PHARMACOLOGY!

Thus, pharmacology is the study of drugs and also their actions on living organisms 1such as
humans and animals.

 Therapeutic drugs a.k.a medicine – drugs used in the prevention or treatment of diseases.
Or, substance administered for the diagnosis, cure, treatment, or relief of a symptom or
for prevention of disease. To put it simply, a medication is a drug intended for therapeutic
benefit.

 And we also have drugs that does not prevent or treat disease but used mainly because of
its side effect which is to induce euphoria or feeling of completeness and joy. These drugs
are called recreational drugs and as you know mostly are prohibited.

ACTIVITY # 1: READING

BRIEF HISTORY OF MEDICINE

Pharmacology began since
ancient times and herbal plants
were commonly used in treating
various illness. The medicinal plants
and their uses were documented
and gathered in books called
pharmacopoeias. It was on mid- 19th
century that pharmacology
developed as part of science under
biomedicine. It was at this time
where drugs are studied using
scientific principles of
experimentation. However, before
that age most people rely on herbal
medicines and other natural sources.

Pharmacology developed in the 19th century as a biomedical science that applied the
principles of scientific experimentation to therapeutic contexts. The advancement of research
techniques propelled pharmacological research and understanding. The development of the organ
bath preparation, where tissue samples are connected to recording devices, such as a myograph,
and physiological responses are recorded after drug application, allowed analysis of drugs' effects
on tissues. The development of the ligand binding assay in 1945 allowed quantification of the
binding affinity of drugs at chemical targets.

Modern pharmacologists use techniques from genetics, molecular biology, biochemistry,

and other advanced tools to transform information about molecular mechanisms and targets into
therapies directed against disease, defects or pathogens, and create methods for preventative care,
diagnostics, and ultimately personalized medicine.
 In summary, medicines were first discovered by ancient people through the use of
substances available in nature such as plants and were later developed further through scientific
experiments and advancement in research process. So you see, research is the real deal!

PS. On modern definition, pharmacopeia is a book containing lists of products used in

medicine, with descriptions of the product, chemical tests conducted formulas and prescriptions.

ACTIVITY # 2: VIDEO LESSON

Watch the following videos on YouTube to gain deeper understanding on history of medicine and
its importance in the society.

How aspirin was discovered- Krishna Sudhir( TED-ED)

How we conquered the deadly smallpox virus (TED ED)- This video provides an insight on how
vaccines are made and how does it work. As a nurse, you should have an understanding of how
traditionally vaccines work, i hope this video helps you in understanding the COVID vaccine and
other vaccines in general.
ACTIVITY # 3: READING
DRUG NAMES and CLASSIFICATIONS
GENERIC AND BRAND NAME

You may have noticed on medicine packages that there are 2 names on it. One on top and one
below. But, which is which? The answer is both! Both are drug names. Though one is the generic
and the other one is the brand name.

The one that is usually seen above is called the

generic name. It is given before a drug becomes an officially approved medication. Generic name
may be used in any country by any manufacturer freely, thus, they are also called non-proprietary
or common name.

Proprietary means one holds exclusive right to something, in this case, the name of the drug.

Generic name is non- proprietary so you will not have copyright issues if pharmaceuticals print
its name along with their brand name. No issues whatsoever because no one has exclusive right on
its name usage! With that, generic name are widely common and popular.

TRIVIA! One can easily identify brand name with generic name as generic names are usually not
capitalized. Like this example!

The name below is called the brand name or trademark, which is the proprietary name meaning
only the manufacturing company can use its name and cannot be copied like your answers in exam.
It’s their name and their right!

TRIVIA! Brand names are usually identified as they have these cute ® logo after the brand name. R
simply means registered. Like this example!

CHEMICAL NAME AND OFFICIAL NAME

Now, let us learn 2 more drug names. But first, try to look for the drug literature of medicine
packages you have at home. Drug literature is simply the paper found inside the package which
contains all the information about the medicine. There, you can also see the chemical name and
official name of the drug. Alright, now let us distinguish the two!

CHEMICAL NAME is the chemical composition of the

drug. Remember your chemistry? So this name is the
most meaningful to the chemist.

Example of this:

Chemical Name of ampicillin- 4- Thia-1-azabicyclo

(3.2.0) heptane 2 etc.
The next is OFFICIAL NAME. It is the name of the drug listed under Food and Drug
Administration (FDA). Meaning the drug is registered and has passed the FDA standards.

◦ Example: ampicillin, USP (United States Pharmacopeia)

But who is FDA? They are the agency authorized by law to name drugs for human use. We will get
to know him later on, okay.

So, after getting to know drug names, let us advance further by knowing the different classifications
of drugs.

DRUG CLASSIFICATIONS

Drugs are classified according to

1. Body System- it may be drugs for renal, cardiovascular, integumentary or etc.

2. Therapeutic use or clinical indications- this is based on specific symptoms that these
drugs exert an effect. For example, the symptom of inflammation is relieved by drugs under
the classification of anti- inflammatory. Equally, pain symptom is relieved by drugs under
the classification of analgesics.

As a beginning nurse, familiarizing this is essential as most drug packages indicate the
therapeutic use of it. Thus, making it easier for you to identify what the drug is for and quite
handy when you are unfamiliar with the brand name or generic name and your instructor
asked you for what is it for.

3. Physiologic or chemical action- some drugs are classified based on their physiologic effect
on specific cells in the body. For example, drugs that block the calcium channel in the
myocardial cells are classified under calcium channel blockers. Other examples are beta-
blockers, cholinergic and anti- cholinergic.

4. Prescription drugs- prescriptions are specific instructions provided by doctors regarding

medicine treatment. Some drugs require written prescription by doctor to be bought from
the pharmacy as they are usually regulated and harmful if taken indiscriminately like
antibiotics and narcotics.
5. Non- prescription or over- the- counter drugs- these are drugs that does not need
written prescription by doctor’s to be obtained and is usually bought on most pharmacies
easily.
6. Illicit or recreational drugs- you know what are they, but let us have an in depth look on it
on unit

Drug Classifications

Alpha- Blockers Dilation of peripheral blood vessels, lowering

of peripheral resistance and the lowering of
blood pressure.
Antacids Neutralize gastric acidity.
Antianginals An antianginal is a medication which is used to
treat angina, a form of chest pain which
develops when the supply of blood to the
heart becomes restricted. The purpose of an
antianginal is to either increase the supply of
blood to the heart, or to decrease the heart's
 demand for oxygen
Anticholinergics Anticholinergics relax and enlarge (dilate) the
airways in the lungs, making breathing easier
(bronchodilators). They may protect the
airways from spasms that can suddenly cause
the airway to become narrower
(bronchospasm). They also may reduce the
amount of mucus produced by the airways.
Anticonvulsants Anticonvulsants are drugs that prevent or
reduce the severity and frequency of seizures.
Antidepressants Antidepressants are a class of drugs that
reduce symptoms of depressive disorders by
correcting chemical imbalances of
neurotransmitters in the brain. Chemical
imbalances may be responsible for changes in
mood and behavior. Antidepressants are
further divided into MAOIs, tricyclics, and
others.
Antidysrhythmics Antidysrhythmics are used for the treatment
of cardiac dysrhythmia, which is any change
from the normal heartbeat rhythm. Cardiac
dysrhythmia includes not only bradycardia but
also tachycardia.
Antihistamines Antihistamines work well to relieve symptoms
of different types of allergies, including
seasonal (hay fever), indoor, and food
allergies. Antihistamines come in different
forms, including tablets, capsules, liquids,
nasal sprays, and eye drops. Some are only
available by prescription. Others can be
bought over the counter (OTC).
Anti-infectives Anti-infective medications are used to treat a
wide variety of bacterial infections. They
inhibit the growth of bacteria by interfering
with the production of certain biochemicals
necessary to sustain the bacteria's life or by
interfering with the bacteria's ability to use
nutrients. The body's defenses then have a
much easier time eliminating the infection.
Antineoplastics Antineoplastics or Anticancer drugs are the
drugs that prevent or inhibit the maturation
and proliferation of neoplasms. Antineoplastic
agents travel the body and destroy cancer
cells. Many of the side effects associated with
antineoplastic agents occur because
treatment destroys the body's normal cells in
 addition to cancerous cells.
Antipsychotic and Neuroleptic Agents The antipsychotics have the capacity to
sedate, tranquilize, blunt emotional
expression, attenuate aggressive and
impulsive behavior, and cause disinterest in
the environment and lack of initiative. Unique
features of the drugs are that higher
intellectual functions are left relatively intact
and yet they act to specifically ameliorate the
agitation and bizarre behavior and thinking of
psychotic patients
Antitussives and Expectorants These medications are used to treat cough
and congestion such as with the common cold.
Antivirals Antivirals are used to treat infections caused
by viruses. Unlike antibacterial drugs, which
may cover a wide range of pathogens, antiviral
agents tend to be narrow in spectrum, and
have limited efficacy.

Please read the other drug classifications I have attached in the Learning Resources Secction
in our Google classroom.

LEGAL ASPECT OF DRUG ADMINISTRATION

Remember this future nurses, UNDER THE LAW, YOU ARE RESPONSIBLE FOR YOUR OWN ACTION
OF WETHER THERE IS A WRITTEN ORDER. Thus, always be careful when administering
medications even with doctor’s order.

For example, a doctor ordered Demerol 500 mg instead of 50 mg and you happened to be the nurse
who would administer it. If you have not been able to spot the mistake and proceeded to give the
medication, then, YOU ARE RESPONSIBLE as well as the physician.
On this kind of scenario, you should question a doctor’s order that appears unreasonable and do not
give the medication until it is clarified. DO NOT FOLLOW ORDERS BLINDLY!

Given all those, now you know that as a nurse, it is important to:

1. Know your roles, responsibilities and limitations as a nurse

2. Recognize the limit of your own knowledge and skills

Other thing to consider is the administration of controlled substance in the hospital. This is
strictly regulated by the government so you should be knowledgeable about this.

What are controlled substances?

A controlled substance is generally a drug or chemical whose manufacture, possession, or use is

regulated by a government, such as illicitly used drugs or prescription medications that are
designated by law.
It is enforced by Philippine Drug Enforcement Agency in the Philippines and categorizes controlled
substances and limits how often a prescription can be filled. These controlled substances are
classified into 5 schedules which will be discussed later.

Wait a minute. Why are they controlled? Simply because these drugs causes drug dependence and
drug dependence is bad as it is the state of being addicted to it. Ahh. We don’t want our patients to
get addicted to it, right?

How do we administer controlled substance in the hospital?

1. Controlled substances are kept in a locked drawer, cupboard, medicine cart or computer
controlled dispensing system. Why? To prevent the nurse, or someone from trying it out for
themselves.

2. At the end of the shift, there is always an inventory of controlled substances used and wasted
using a special form. Like this example below. Inventories are done by tallying the total count of
controlled substance of the previous shift then subtract it with
the number used on your shift.

What would you do if they do not tally?

It must be reported to the nurse manager, nurse supervisor and pharmacy according to agency
policy.
3. Hospitals also require verification of 2 nurses before removing a controlled substance with the
number actually available with the number indicated on the inventory record.

Food and Drug Administration of the

Philippines (FDA) – is under DOH and which
has the authority to license, monitor, and
regulate the flow of food, drugs, cosmetics and
medical devices and household hazardous
waste.
Medical devices- radiation devices and health
related devices, health products- food, drugs,
cosmetics, biological, vaccine,
etc.

Thinking point! So guys, whenever you buy that new hyped skincare product, be sure to check it
out first on FDA website to see if it is registered under them to make sure that it is safe and
effective. Products should be FDA approved to make sure that it is safe for you.

5 CLASSIFICATIONS OR SCHEDULES OF CONTROLLED SUBSTANCES

SCHEDULE I DRUGS
 High potential for abuse
 Not accepted for medical use
 Examples: lysergic acid diethylamide (LSD)
 Marijuana, Peyote, Heroin
 Prescription: None allowed in the US and Philippines

SCHEDULE II DRUGS
 High potential for abuse
 Medically accepted
 Abuse potential may lead to severe dependence
Examples: Morphine, amphetamines, meperidine, secobarbital, pentobarbital, percodan
Prescription: May be directly dispensed by practitioner to user or with a written prescription.
(Some limitedemergency situations allow for oral prescription). No refills are allowed and
prescriptions must be retained but practitioners may provide a patient with multiple prescriptions
for the same controlled substance to allow the patient to receive a 90-day supply for legitimate
medical purpose, but each prescription must indicate the earliest date by which
it can be filled.

SCHEDULE III DRUGS

 High potential for abuse but less than I and II
 Medically accepted
 Abuse potential may lead to moderate or low dependence
Examples: Tylenol with Codeine, Empirin with Codeine
Prescription: May be directly dispensed by practitioner to user or with written or oral prescription,
with a 6-month or 5- refill limitation without renewal by practitioner.

SCHEDULE IV DRUGS
 Low potential for abuse compared with III
 Medically accepted
 Abuse potential may lead to limited dependence compared with III
Examples: Phenobarbital, diazepam, chlordiazepoxide, chloral hydrate
Prescription: May be directly dispensed by practitioner to user or with written or oral prescription,
with a 6-month or 5- refill limitation without renewal by practitioner.

SCHEDULE V DRUGS
 Low potential for abuse compared with IV
 Medically accepted
 Abuse potential low, some may need no prescription
Examples: Lomotil, Robitussin AC
Prescription: For medical purposes only.

Videolink: 10 Drug Schedules & Controlled Substances – Medical Video

https://youtu.be/YUEkwU-PtOM

DRUG DEVELOPMENT
FROM LABORATORY TO SHELF
Now that we have known FDA, how do you think does a drug become registered under
FDA and sold?
Well, it’s an awfully long process that may take an average of 8- 15 years and 1 $ Billion
before a drug can be sold to the market. Moreover, only 1 out of 10,000 chemicals
investigated are actually brought to the pharmacist’s shelf! These long processes are broken down
into 4 stages of drug development.

1st Stage: PRE- CLINICAL RESEARCH

 Discovery, synthesis and purification of the drug (laboratory studies)
 Animal Testing
 May reach 1 to 3 years
 Manufacturer submits an Investigational New Drug (IND) application to FDA

2nd Stage: CLINICAL RESEARCH

 Aka IND Stage
 Human Testing
 May lasts 2 to 10 years
 Divided into 3 phases of clinical research or clinical trial
 Trivia! Only 1 out of 5 drugs that enter clinical trial makes it to the marketplace
Clinical Trial- according to WHO, they are type of research that studies new tests and treatments
and evaluates their
effect on human health outcomes.

3 Phases of Clinical Research

Phase 1
 Determines drug pharmacodynamics, pharmacokinetics, potential toxicity and safe routes of
administration
 2 Study Population: normal volunteers and with intended treatment population
 20 to 100 subjects treated for 4 to 6 weeks

Phase 2
 Smaller intended patient population
 Only given to intended patients or for those patients with whom the drugs are created for such
as to those with cancer or hypertension.
 Determines success rate of drug or the likelihood that the drug can treat, cure or prevent the
disease.

Phase 3
 Larger intended patient population
 Only given to intended patients
 Ensure statistical significance of drug or does the drug works for larger number of patients

3rd Stage: NEW DRUG APPLICATION (NDA) REVIEW

 Drug safe and effective
 investigator formally request approval by the FDA
 submits NEW DRUG APPLICATION (NDA)
 (NDA) data will be reviewed by team of experts, then recommends to DFA for approval and use

4th Stage: POST- MARKETING SURVEILLANCE

 Product is already in the market and is taken already by people
 Ongoing review of adverse effects
 Refining doses
 Exploring potential drug interactions*
 Medwatch- program which reviews safety of medicines,
“black box warnings” very serious, potentially life-threatening side- effects of drugs that may occur
Drug interaction- a reaction between two (or more) drugs or between a drug and a food or
supplement. An existing medical condition can also cause a drug interaction. A drug interaction can
decrease or increase the action of the drug(s) or cause adverse effects.

Thalidomide incident

Please watch these short videos on phases of drug development:

 (https://youtu.be/DhxD6sVQEYc) or simply type Drug discovery process by PhRMAPress.

 https://www.youtube.com/watch?v=w3ykU52K-Hw, GCSE Biology- Drug development and

Testing- Clinical Trials # 33 by Cognito
III. REFLECTION AND RESPONSE/ACTION
1. Lifesaving lessons for future nurses from the real life cases of medication
administration. Open this link and summarize key lifesaving lessons on each 5
scenarios. https://www.berxi.com/resources/articles/medication-errors-in-nursing/

2. Provide 3 photo evidence of products that are sold online and or in the marketplace
and review if the product is FDA approved.

1. Product Name

Photo of the Screenshot of

Product the FDA list

Example:

1. Brilliant Skin