clinical_pharmacy_maulik

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INTRODUCTION to Clinical Pharmacy:

INTRODUCTION to Clinical Pharmacy Aim: imp definitions related to pharmacology . different types of uses of drugs. various categories of drugs defined by drug regulatory authorities. drug nomenclature with examples . different ways of dose expression, especially using metric system. Latin abbreviations used for drug therapy.

PHARMACOLOGY:

PHARMACOLOGY word is derived from two Greek words, “ PHARMACON ” meaning a drug and “ LOGOS ” meaning science. It is the science that deals with detailed study of drugs .

DRUG::

DRUG: According to WHO , “a drug is any substance or product, which is used or intended to be used to modify or explore physiological system or pathological state for the benefit of the recipient”. French Word “ DROGUE ” means a dry herb.

Aims of Drug Usage::

Aims of Drug Usage: To cure the disease e.g. ceftriaxone to cure typhoid( s.typhi infection) Chloroquine to cure malaria. To suppress the disease e.g. atenolol for hypertension, glipizide for diabetes mellitus To treat symptoms like pain, fever etc. e.g. paracetamol for fever Diclofenac for pain Prevention of disease, e.g. chloroquine to prevent malaria, BCG vaccine to prevent tuberculosis. Thus, drug is an agent used for prevention, diagnosis or treatment of disease.

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CLINICAL PHARMACOLOGY: Clinical Pharmacology deals with all aspects of scientific study of drugs in man . It provides for the scientific basis for: (1) rational drug therapy, (2) drug therapy of individual diseases and (3) introduction of new medicines. THERAPEUTICS : The branch of medicine concerned with the cure of disease or relief of symptoms. It also includes drug treatment ( Pharmacotherapy ).

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PHARMACOPOEIA : It is an official code containing medicinal preparations with descriptions of their physical properties and tests for their identification, purity and potency. It defines the standards which these preparations must meet and their average doses for an adult. we have Indian Pharmacopoeia (I.P.), published by Government of India. Likewise, there are British Pharmacopoeia (B.P.) and United States Pharmacopoeia (U.S.P.). OFFICIAL DRUGS : Official Drugs are those, which are described in the official publications like Pharmacopoeia, Pharmaceutical Codex or Formularies

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DRUG REGULATIONS: Drug Controller General of India (DCGI) and Food and Drug Administrations (FDA) are the regulatory bodies, which govern the approval of new drugs as well as sale and dispensing of drugs. Some of the categories into which the drugs have been classified in the Drugs & Cosmetics Act, 1940 and Rules, 1945 are: OVER THE COUNTER (O.T.C.) DRUGS : Certain drugs which are relatively safe are available without prescription . Such preparations are called “Over the Counter” drugs, e.g. aspirin, paracetamol for treatment of common ailments like headache, bodyache, common cold etc. SCHEDULE ‘H’ DRUGS : Under regulations of FDA, certain drugs are made available to the patient only on the prescription of a qualified doctor. These are called Schedule ‘H’ Drugs.

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SCHEDULE ‘C’ & ‘C 1’ DRUGS: This includes biological and special products, e.g. sera, vaccines for parenteral injection, insulin etc. Sterile disposable devices for single use also fall in this category. SCHEDULE ‘F 1’ DRUGS : Bacterial vaccines. SCHEDULE ‘X’ DRUGS : Some psychotropic substances and dangerous drugs like opioids , barbiturates and amphetamine are liable to cause drug abuse . Such drugs are put under this schedule. There is restriction on sale of such drugs. They must to be prescribed in three copies. The doctor retains one copy, other remains with the pharmacist/drug store and third one is for the patient.

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Drug Nomenclature (Drug Names): Drugs are known by: Chemical name : It denotes the chemical structure e.g paracetamol is N-Acetyl para-aminophenol Nonproprietary name (Generic Name ) : It is the name chosen by the official bodies . It is usually suggestive of the drug group/class to which the drug belongs e.g. sulfadiazine is a member of sulfonamide group while ampicillin is a member of penicillin group of drugs. If the drug is an official drug then it is called its OFFICIAL NAME. INN- International Nonproprietary Name is the name given to a drug by WHO. Use of INN ensures uniformity in prescribing any drug all over the world. Proprietary (Brand name) : It is the name chosen by the companies manufacturing or marketing the particular drug. Thus if the drug is marketed by more than one company, it can have several proprietary names, e.g. paracetamol is marketed as Crocin, Calpol, Metacin, etc.

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PHARMACY: It is a science, which deals with preparation, standardization, compounding and dispensing of drugs. PHARMACEUTICS : Manufacturing of various drug formulations ( dosage forms) on a large scale is called PHARMACEUTICS o r Manufacturing Pharmacy . Dosage form (Formulation): For administration to the patients, the drugs are prepared and supplied in variety of pharmaceutical forms known as Dosage Forms [Formulations] e.g. tablet, capsule, injection etc. Dispensing Pharmacy : Preparing simple dosage forms like mixtures, powders, lotions, etc. on a small scale for immediate dispensing is called Dispensing Pharmacy . It is usually meant for an individual patient according to the physician’s prescription. Nowadays, with the availability of the various drug formulations in the market, the dispensing pharmacy has a limited value . CLINICAL PHARMACY : It involves cooperation of the pharmacist with the physician in educating the patient about compliance, counseling him on how to take the medication and monitoring the errors in drug therapy.

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DOSE : It is the amount of the drug given at a time, which may be repeated to get optimum therapeutic effect. POSOLOGY : It is the science related to doses of drugs. DOSE EXPRESSION: Solids are mentioned in microgram (µg), milligram (mg) or gram (g) and liquids in milliliter (ml) or litre (L). Dose can be mentioned in various ways as follows: (1) Absolute Dose: irrespective of body weight E.g. 500 mg three times a day. (2) On the basis of body weight: E.g. 50 mg/kg / day in three divided doses (3) On the basis of body surface area: e.g. 10 mg /sq. meter /day. (4) Doses for i.v. infusion may be expressed as rate of infusion: e.g. 15 mg/kg. per hr, 60 drops per minute.

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METROLOGY: It is the science of weights and measures. It is divided in to 3 systems: (1) Imperial System - it is discarded and replaced by metric system. weight is ‘pound’ or ‘lb’ and volume is ‘gallon’. (2) Metric System – It is the official system and is used in prescriptions and scientific investigation. It is based on decimal system. So calculations are easier. Solids are weighed and liquids are measured. Unit of Weight is ‘g’ and Unit of Volume is ‘L’ or ‘ml.’ 1 kg. = 1000 g. 1mcg. = 1000 nanogram (ng) 1 g = 1000 mg. 1ng. = 1000 picogram (pg) 1 mg. = 1000 microgram (µg.) 1 L = 1000 ml. (3) Domestic System - It uses rough measures and commonly used in household. 1 teaspoonful (tsf) = 4 to 5 ml . 1 teacupful = 120 ml. 1 dessertspoonful = 8 or 10 ml. 1 glassful = 240 ml. 1 tablespoonful = 15 ml . 1 ml. = 16/20 drops .

IMPERIAL SYSTEM & ITS METRIC EQUIVALENTS::

IMPERIAL SYSTEM & ITS METRIC EQUIVALENTS: 1 Pint* = 500 ml. 1 quart = 1000 ml. 1 fluid ounce = 30 ml. 2.2 lb. = 1 kg. 1 grain = 65 mg. * The word ‘pint’ is commonly used to indicate one ‘container’ of intravenous fluid the quantity of which may vary from product to product

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LATIN ABBREVIATIONS used in the era when Latin was the international language of medicine.. These abbreviations if not correctly interpreted may lead to medication errors. ABBREVIATION LATIN WORD ENGLISH WORD p.c. post cibum After Food a.c. ante cibum Before Food h.s. hora somni At bed time o.d. omni die Once daily b.i.d. bis in die Twice daily t.i.d. ter in die Thrice daily. t.d.s. ter die sumendum To be taken thrice daily q.i.d. quarter in die Four times a day. q.d.s. quarter die sumendum To be taken four times daily q.h. quaque hora Every hour. q.4.h. quaque quarta hora Every four hour. nocta noct At night. S.O.S. Si opus Sit If necessary. ocul. oculantum Eye Ointment. ung. unguentum Skin Ointment. stat Immediately, At once. non rep Do not repeat.

Assignment::

Assignment: Define ‘Drug’. Give two examples of preventive use of drugs. What is a Pharmacopoeia? What is Official Drug? What is Generic name and what is its importance? What are OTC drugs? Give two examples. Explain – Schedule H drugs, Schedule X drugs Explain the following instructions: Tab. Ferrous sulphate 300 mg. b.d. p.c. Tab. Diazepam 5 mg. h.s. Tab. Paracetamol 500 mg. s.o.s. Fill in the Blanks: 15 ml. = 1 ____________ful. 1ml. = ________ drops 1 glassful = ________ ml.

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