For Health Science Students - Carter Center

LECTURE NOTES

For Health Science Students

Pharmacology

Teferra Abula, Srinivasa A.Rao, Amare Mengistu,

Solomomon Worku, Eshetu Legesse, Musie Aberra, Dawit

University of Gondar

In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center,

the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education

2004

Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00.

Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter

Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education.

Important Guidelines for Printing and Photocopying

Limited permission is granted free of charge to print or photocopy all pages of this

publication for educational, not-for-profit use by health care workers, students or

faculty. All copies must retain all author credits and copyright notices included in the

original document. Under no circumstances is it permissible to sell or distribute on a

commercial basis, or to claim authorship of, copies of material reproduced from this

publication.

?2004 by Teferra Abula, Srinivasa A.Rao, Amare Mengistu,

Solomomon Worku, Eshetu Legesse, Musie Aberra, Dawit

All rights reserved. Except as expressly provided above, no part of this publication may

be reproduced or transmitted in any form or by any means, electronic or mechanical,

including photocopying, recording, or by any information storage and retrieval system,

without written permission of the author or authors.

This material is intended for educational use only by practicing health care workers or

students and faculty in a health care field.

ACKNOWLEDGMENT

The authors would like to thank the Carter Center for the initiation and financial support of the

preparation of this material.

Ato Getu Degu¡¯s role in coordinating this work is greatly acknowledged.

Finally, we thank the department heads and the faculty heads of the health institutions for their

cooperation to participate in the preparation of the lecture note.

i

INTRODUCTION

Pharmacology is a medical science that forms a backbone of the medical profession as drugs

form the corner stone of therapy in human diseases. Therefore, it is of utmost importance to

describe the pharmacological basis of therapeutics in order to maximize the benefits and

minimize the risks of drugs to recipients. This lecture note on pharmacology is primarily a note

for undergraduate health science students such as health officer, nursing, midwifery and

laboratory technology students. However, other health professionals whose career involves

drug therapy or related aspects should also find much of the material relevant.

The goal is to empower the practitioner through an understanding of the fundamental scientific

principles of pharmacology. The effects of prototypical drugs on physiological and

pathophysiological processes are clearly explained to promote understanding. Other related

drugs are touched briefly. The selection of the drugs is based on the national drugs list for

Ethiopia and on the accumulated experience of teaching pharmacology to many health

profession students.

The chapters open with a list of objectives to guide the reader, and most end with questions

which challenge the reader¡¯s understanding of the concepts covered with in the chapter. Most

sections have an introduction that provides an overview of the material to be covered.

Readers are encouraged to refer the references mentioned for further information and we hope

that this material will be a valuable companion in our pursuit of a fundamental understanding in

a most fascinating area of clinical knowledge, pharmacology.

The Authors

April 2004:

ii

Table of Contents

Acknowledgment ...................................................................................................................

i

Introduction ..........................................................................................................................

ii

Table of Contents ..................................................................................................................

iii

Abbreviation ..........................................................................................................................

vi

Chapter one: General pharmacology ...................................................................................

Learning objectives .....................................................................................

Introduction .................................................................................................

Pharmacodynamics.....................................................................................

Pharmacokinetics ........................................................................................

Theoretical pharmacokinetics .....................................................................

Drug safety and effectiveness.....................................................................

Development and evaluation of new drugs .................................................

Exercise ......................................................................................................

1

1

1

2

5

17

19

26

29

Chapter two: Drugs acting on autonomic nervous system .................................................

Learning objectives .....................................................................................

Introduction .................................................................................................

Autonomic drugs .........................................................................................

Cholinergic drugs ........................................................................................

Anticholinergics ...........................................................................................

Adrenergic drugs .........................................................................................

Adrenergic blockers ....................................................................................

Exercise .....................................................................................................

30

30

30

35

36

40

42

47

50

Chapter three: Cardiovascular-renal drugs ..........................................................................

Learning objectives .....................................................................................

Introduction .................................................................................................

Antihypertensive drugs ...............................................................................

Drugs used in heart failure ..........................................................................

Pharmacotherapy of angina pectoris ..........................................................

Anti-arrhythmics ..........................................................................................

Diuretics ......................................................................................................

Drugs used in hypotensive states and shock .............................................

Exercise .....................................................................................................

51

51

51

51

57

60

62

64

66

68

Chapter four: Autacoids and their antagonists ....................................................................

Learning objectives .....................................................................................

Introduction ................................................................................................

Hisamine .....................................................................................................

69

69

69

69

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