Áiáëiîòåêà ñòóäåíòà-ìåäèêà Medical Student’s Library GENERAL PHARMACOLOGY GENERAL PHARMACOLOGY ОДЕСЬКИЙ МЕДУНІВЕРСИТЕТ Medical Student’s Library Initiated in 1999 to mark the Centenary of the Odessa State Medical University (1900 — 2000) Edited and Published by V. M. ZAPOROZHAN, the State Prize-Winner of Ukraine, Academician of the Academy of Medical Sciences of Ukraine CHIEF EDITORIAL BOARD V. M. ZAPOROZHAN, (Chief Editor), Yu. I. BAZHORA, I. S. VITENKO, V. Y. KRESYUN (Vice Chief Editor), O. O. MARDASHKO, V. K. NAPKHANYUK, G. I. KHANDRIKOVA(Senior Secretary), P. M. TCHUYEV The Odessa State Medical University Dear Reader, When in 1999 the lecturers and researchers of the Odessa State Medi- cal University started issuing a series of books united by the collection en- titled “Medical Student’s Library” they had several aims before them. Firstly, they wanted to add new books to the Ukrainian library of med- ical literature that would be written in Ukrainian, the native language of the country. These books should contain both classical information on med- icine and the latest information on the state of the art, as well as reflect extensive experience of our best professionals. Secondly, our lecturers and specialists wanted to write such books which reflected the newest subjects and courses that have recently been introduced into the curricula, and in general there have been no textbooks on these subjects and courses at that time. These two aims have successfully been coped with. Some dozens of text- books and workbooks published in these years have become a good con- tribution of their authors and publishers to the development and making of the Ukrainian national educational literature. The next step that we decided to undertake was to issue a unique series of books in foreign languages. The foreign students taking their medical ed- ucation in the Ukraine, our University included, are expecting such books to be published. Other countries are also waiting for them as the Odessa State Medical University is a Fellow Member of the International and European Association of Universities. Our Medical University is over a hundred years old and has long since become a center of various original medical schools and trends. These are headed by well-know medical professionals whose competence is acknowledged not only in this country, but abroad as well. Valery ZAPOROZHAN, Editor-in-Chief of the Series “Medical Student’s Library” the State Prize-Winner of Ukraine, Academician of the Academy of Medical Sciences of Ukraine GENERAL PHARMACÎLÎGY COURSE OF LECTURES Odessa The Odessa State Medical University 2005 UDC 615:378.16=20 BBC 52.81Я93 Authors: V. Y. Kresyun, D. Yu. Andronov, K. F. Shemonaeva, V. V. Godovan, G. G. Vidavska, P. B. Antonenko Reviewers: Professor V. D. Lukyanchuk, M.D., the Chair of the Pharmacology Department of the Lugansk State Medical University, Ukraine Professor V. I. Mamchur, M.D., the Chair of the Pharmacology Department of the Dnepropetrovsk Medical Academy, Ukraine The lectures are designed according to pharmacological drug groups due to their ef- fects on particular body systems and intended for the 3rd year students of medical facul- ty. Information is organized according to the sequence used in many International and Ukrainian pharmacology courses. The textbook is intended for students of higher medi- cal institutions. Загальна фармакологія: Курс лекцій: Навч. посібник / В. Й. Кресюн, Д. Ю. Андронов, К. Ф. Шемонаєва та ін. — Одеса: Одес. держ. мед. ун-т, 2005. — 215 с. — (Б-ка студента-медика). — Мова англ. ISBN 966-7733-80-7 Курс лекцій для студентів 3-го курсу медичного факультету складається з розділів, упорядкованих за фармакологічними групами ліків згідно з їх ефектами на специфічні системи органів. Матеріал викладено у послідовності, використову- ваній у багатьох міжнародних й українських виданнях з фармакології. Для студентів вищих навчальних медичних закладів. Іл. 30. Табл. 15. Бібліогр.: 37 назв. ББК 52.81Я93 Рекомендовано до видання Центральною координаційно-методичною радою Одеського державного медичного університету Протокол № 5 від 18.05.2005 © В. Й. Кресюн, Д. Ю. Андронов, К. Ф. Шемонаєва, ISBN 966-7733-47-5 В. В. Годован, Г. Г. Відавська, П. Б. Антоненко, 2005 ISBN 966-7733-80-7 © Одеський державний медичний університет, 2005 6 PREFACE The lectures are designed to provide a complete, Other lectures within each section emphasize up-to-date and readable pharmacology text for the 3rd therapeutic classes of drugs and prototypical or year students of medical faculty. Planned to be used commonly used individual drugs, those used to treat during the 2 semesters, the text focuses on the major common disorders, and those likely to be encoun- principles of pharmacology with the clinical ap- tered in clinical practice. Lecture’s content is pre- plication of drugs. It also offers special features that sented in a consistent format and includes a descrip- make it useful to practicing clinicians. tion of a condition for which a drug group is used; The content of Lectures is organized in 10 sec- a general description of a drug group, including a tions, primarily by therapeutic drug groups and their small historic review, mechanism(s) of action, indi- effects on particular body systems. This approach cations for use, and contraindications; adverse drug helps the student make logical connections between effects and descriptions of individual drugs, with major drug groups and the conditions for which they recommended dosages and routes of administration. are used. It also provides a foundation for learning The lectures in these sections include drug names, about new drugs, most of which fit into known groups. classifications, prototypes, drug approval process- Information is organized according to the sequence es. Some lectures include initial parts that reviews used in many pharmacology courses: common pharma- the physiology of body systems. The reviews are de- cology; autonomic drugs; neurotropic agents; cardio- signed to facilitate understanding of drug effects on vascular drugs; endocrine and vitamin drugs; anti- a body system. Each section includes examination microbial agents; drugs used to treat diseases of the questions with detailed answers to help students test blood; and special topics. The first lecture contains their knowledge of the covered material. Appendi- knowledge required to understand the main principles ces contain information about main international and rules of medical prescription. Lecture 2 consists pharmacological abbreviations and examples of of common pharmacological information, including: combination drugs. All of this made the Lectures cellular physiology, drug transport, pharmacokinetic book comprehensive but not exhaustive, and accu- processes, the receptor theory of drug action, types of rate — a text that supplies both students and uni- drug interactions, and factors that influence drug ef- versity faculties. fects on body tissues, dosage forms, routes and meth- These lectures are created at the Department of ods of accurate drug administration and general prin- general and clinical pharmacology of the Odessa State ciples of drug therapy. Medical University. 7 MEDICAL PRESCRIPTION Lecture 1 ument, because it is observed when the correctness of treatment is doubtful. INTRODUCTION TO THE MEDICAL PRESCRIPTION RULES PARTS OF PRESCRIPTION OF PRESCRIPTION WRITING 1. Inscriptio — tells official data about the hospital Prescription is a part of pharmacology. It is divid- (title and address), the physician, who writes prescrip- ed into pharmaceutical prescription, which studies tion (surname, initials), and the patient (surname, ini- rules of drug’s production, and medical prescription tials, age). It is written in national language. that studies rules of prescription writing. 2. Prepositio — consisting of the word recipe, take, Drug substances have different sources. They can or its sign, “Rp.:” be obtained from the plants, animals, minerals, bacte- 3. Designatio materiarum (list of agents) is the main ria, and fungi. Drugs, produced from the plants by sim- part of the prescription, containing the names and ple processing (drying and mixing), are called simple. amounts of the drugs ordered. Each drug substance is They are used seldom. Composite drugs are produced written in own line from a capital letter, in genitive from plant origin by more complex processing. For ex- case, and in Latin. Words can not to be shortened and ample, Galen’s and neo-Galen’s drugs. They are both broken. Doses are written by figures. If ingredient is containing sum of plant’s active substances. Galen’s only one, receipt is simple, if many — complex. drug is obtained by spirit or another kind of extrac- Drug substances are divided according to their im- tion from a plant, e.g. tinctures, extracts; usually it portance. contains ballast or non-active substances. However, a. Remedium cardinale (s.basis) — a drug sub- neo-Galen’s drug is subjected to more composite stance, which carries the main treating effect. processing; it is more pure and can be used parenter- b. Remedium adjuvants are substances with an ad- ally. ditive action. Drug form is a shape that is given to the drug sub- c. Remedium constituents — a shape-making sub- stance. According to their condition drug forms are di- stance. A constituent is to be indifferent (non-active). vided into solid, (powders, capsules, tablets, dragee, d. Remedium corrigens — substances bettering granules), liquid (infusions, decoctions, mixtures, tinc- taste, smell, type. Corrigens are usually sugar, ether tures, fluid extracts, solutions), and soft (ointments, flu- oils, syrups. id ointments, pasts, suppositories, plasters). Also drug 4. Subscriptio — directions for mixing of the in- forms can be dosed, they usually act after reaching the gredients and designation of the form (pill, powder, bloodstream, and non-dosed, which as a rule act topi- solution, etc.) in which the drug is to be made, e.g. be- cally. Drug substance is a chemical compound that pro- ginning with the word, misce, mix, or its abbreviation, vides drug’s action. Drug is a drug substance, produced M., fiat, make, or its abbreviation, f., and the name of in a concrete drug form.