Professional Documents
Culture Documents
Identified glycerin
Invented new methods of preparing calomel and benzoic acid
Friedrich Sertuner
Isolation of morphine from opium
Joseph Caventou and Joseph Pelletier
Isolated quinine and cinchonine from chinchona
Isolated strychnine and brucine from nux vomica
Joseph Pelletier and Pierre Robiquet
Isolated caffeine
Pierre Robiquet
Separated codeine from opium
[Drug Standards]
The United States Pharmacopeia and the National Formulary
Pharmacopeia
Pharmakon: drug
Poiein: make
Any recipe or formula or other standars required to make or prepare
drug
Lititz Pharmacopeia
First American pharmacopeia
Published in 1778 at Lititz, Pennsylvania
32-page booklet, 84 internal and 16 external drugs and preaparations
Lyman Spalding
Father of USP
Proposed for a convention in 4 geographic districts
United States Pharmacopeial Convention
Revise USP every 10 years
1940 meeting: revise the USP every 5 years
1830 and 1840: pharmacists were invited
1850: full membership of pharmacists
USP
First published on December 15, 1820 in English and Latin
217 drugs
American Pharmaceutical Association (APhA)
1852
National Formulary of Unofficial Preparations
Formulary containing many f the popular drugs and formulas denied
administration to the USP
Changed to National Formulary on June 30, 1906 when President
Theodore Roosevelt signed into law
USP XX and NF XV
USP: volume; NF: sections
USP 23-NF 18
o Became official in 1995
USP Pharmacists Pharmacopeia
To address the needs of pharmacist practioners
Products
Manufactured drugs
Preparations
Compounded drugs
USP and NF Monographs
Adopt standards for drug substances, pharmaceutical ingredients and
dosage forms reflecting the best in the current practices of medicine
and pharmacy
Official parts of a monograph
o Official title (generic or nonproprietary name)
o Graphic or structural formula
o Empirical formula
o Molecular weight
o Established chemical names
o Chemical Abstracts Service (CAS) registry number
USP Drug Research and Testing Laboratory
o Provides direct laboratory assistance to the USP and NF
o Main functions: evaluation of USP reference standards and
evaluation and development of analytical methods
Other Pharmacopeias
Homeopathic Pharmacopeia of the United States (HPUS)
Used by law enforcement agencies that must ensure the quality of
homeopathic drugs
Homeopathy
o Coined by Samuel Hahnemann
o Homoios = similar
o Pathos = disease
o Law of similars, like cures like
International Pharmacopeia (IP)
Published by WHO
Intended as a recommendation to a national pharmacopeial revision
committees to modify their pharmacopeias
International Organization for Standardization
International consortium of representative bodies constituted to
develop and promote uniform or harmonized international standards
Quality assurance (QA), quality control (QC), detectin of defective
products, quality management (WM)
[Drug Regulation Control]
Food and Drug Act of 1906
First federal law in the US designed to regulate drug products
Required drugs marketed interstate to comply with their caimed
standards
[The Federal Food, Drug and Cosmetic Act of 1938]
Prohibits the distribution and use of any new drug or drug product
without prior filing of a new drug application (NDA) and approval of the
FDA
Required drugs to be safe for human use but did not require it to be
efficacious
Durham-Humphrey Amendment of 1952
Prescriptions for legend drugs may not be refilled without the consent
of the prescriber
Refill status was further regulated with the passage of the Drug Abuse
Amendments of 1965 and Comprehensive Drug Abuse Prevention and
Control of 1970
Kefauver-Harris Amendments of 1962
To ensure a grater degree of safety for approved drugs and
manufacturers were now required to prove a drug to be both safe and
effective
Sponsor of a new drug is now required to file an investigational newdrug application (IND) before it can be tested on humans
Comprehensive Drug Abuse Prevention and Control Act of 1970
To consolidate and codify authority over drugs of abuse in a single
statue
Schedule I
o Drugs with no accepted medical use
o Substances with high potential of abuse
o Heroin, LSD, mescaline, peyote, methaqualone, marijuana
Schedule II
o Drugs with accepted medical uses and a high potential for
abuse, may lead to severe psychologic or physical
dependence
o Morphine, cocaine, methamphetamine, amobarbital
Schedule III
o If abused, it may lead to moderate psychologic or physical
dependence
o Specified quantities of codeine, hydrocodone
Schedule IV
o Low potential for abuse, may lead to low psychologic or
physical dependence
o Specified quantities of diphenoxin, diazepam, oxazepam
Schedule V
o Specified quantities of dihydrocodeine, diphenoxylate
FDA Pregnancy Categories
Category X
Strongest
May be implicated as a teratogen and the risk benefit ratio does not
support the use of the drug
Category A
No risk in to the fetus
Category B
No risk to animal reproduction studies
No adequate and well-controlled studies in pregnant women
Category C
Animal reproduction studies have shown an adverse effect on the
fetus
Category D
There is positive evidence of human fetal risk
Black Box Warning
Strongest labeling requirements for high-risk medicines
AT CG
Gene Therapy
Medical intervention base on the modification of the genetic material of
living cells
Ex vivo: outside the body
In vivo: within in the body
Goal Drug
Would produce the specifically desired effect, be administered by the
most desired dosage route
Methods of Drug Discovery
Random/Untargeted Screening
Testing of large number of synthetic organic compounds or
substances of natural origin
Used initially to detect an unknown activity of the test compound or
substance
Non-random/Targeted Screens
Determine the specific activity or a compound/substance
Biostaysis
Used to differenciate the effect and potency of the test agent
High-throughput Screening
Capable of examining 15,000 chemical compounds a week
Molecular Modification
Chemical alteration of a known and previously characterized organic
compound for the purpose of enhancing its usefulness as a drug
Mechanism-based drug design
Molecular modification to design a drug that interferes specifically with
the known or suspected biochemical pathway or mechanism of a
disease process
Enalaprilat (enalapril), ranitidine, sertraline (for depression)
Molecular graphics
Use of computer graphics to represent or manipulate the structure of
the drug molecule
Lead Compound
Prototype chemical compound that has a fundamental desired biologic
or pharmacologic activity
Finasteride
Prodrugs
A compound that requires metabolic biotransformation after
administration to produce the desired pharmacologically active
compound
Conversion of an inactive prodrug to an active compound occurs
through enzymatic biological cleavage
May be designed for solubility, absorption, biostability and prolonged
release
o Absorption: a drug may be made more water or lipid soluble
o Biostability: could result in site-specific action
(dopamine&levodopa)
o Prolonged release: may extend therapeutic activity
Sponsor of a new drug must file an IND before the drug may be given
to human subjects
Sponsor must delay the use of drug in human subject for not less than
30 days
Clinical hold is issued when there is concern that human subjects will
be exposed to unreasonable and significant risk of illness or injury
The Clinical Protocol
Purpose and objectives of the study
Estimate number of patients involved
Approval of the authorized IRB
1994: National Institue of Health (NIH) issued its policy that women
and minorities be included in all NIH-supported research
Purpose of IRB: to protct the safety of human subjects by assessing a
proposed clinical protocol, evaluate the benefits against risks, and
ensuring that the plan includes all needed measures for subject
protection
Pre-IND Meetings
May include advice on the adequacy of data to support an
investigational plan, the design of a clinical trial
FDA Review of an IND Application
Objecttives
o Protect the safety and rights of the human subjects
o Help ensure that the study allows the evaluation of the drugs
safety and effectiveness
o Stamped then sent to the Center for Drug Evaluation
Research (CDER) or the Center for Biologics Evaluation and
Research (CBER) for review
FDA Drug Classification
By chemical type of therapeutic potential
Phases of a Clinical Investigation
Phase 1
Initial introduction of the investigational drugs into humans for the
purpose of assessing safety
20 to 100 subjects
Initial dose is one tenth of the highest no-effect dose
Designed to determine the human pharmacology of the drug,
structure-activity relationships, side effects associated with increasing
doses and early evidences of effectiveness
Rate of absorption, concentration of drug in blood over time, rate of
mechanism
Phase 2
Controlled clinical studies to evaluate the effectiveness of a drug in
patients with the condition
Asses side effects and risks that may be revealed
Additional date on the drugs pharmacokinetics and dose-response
and dose ranging (Phase 2a studies)
Dose determination studies (Phase 2b)
Drug product is refined
Phase 3
Include several hundred to several thousand patients in controlled and
uncontrolled trials
Objective is to determine the usefulness of the drug in an expanded
patient base
Completed studies (Phase 3a)
Additional studies (Phase 3b)
Clinical Study Controls and Designs
Blinded studies
Identity of the investigational drug and the control are not revealed
Single blind studies
Patient is unaware of the agent administered
Double blind studies
Neither the patient nor the clinician is aware or the agent administered
Parallel designs
Applicable to most clinical trials
Crossover designs
Useful in comparing different treatments within individuals
Drug Dosage and Terminology
Minimum effective concentration (MEC)
An average blood serum concentration that can be expected to
produce the drug's desired effects
Minimum toxic concentration (MTC)
Second level of serum concentration
Median effective dose
Amount that will produce the desired intensity of effect in 50% of the
individuals tested
Therapeutic index
Relationship between the desired and undesired effects of the drug
Defined as the ratio between a drugs median toxic dose and its
median effective dose (TD50/ED50)
Age
Pharmacogenetics
Body weight
BSA
Sex
Pathologic state
Tolerance
Ability to endure the influence of a drug, particularly during continued
use
Concomitant drug therapy
Effects of a drug may be modified by the prior or concurrent
administration of another drug
Time and conditions of administration
Dosage form and route of administration
Treatment IND
Nmt 48 hours
(Refrigerated) nmt 14 days
Medium-risk at room temp
Nmt 30 hrs
(Refrigerated) nmt 9 days
High-risk preparations at room temp
Nmt 24 hours
(Refrigerated) nmt 3 days
Low, Medium, High-risk s (-25 - -10 degrees C)
45 days in solid state
Low-risk and medium-risk compounding
Involves sterile products an equipment
Food and Drug Modernization Act of 1997
To ensure patients access to individualized drug therapy and prevent
unnecessary FDA regulation of health professional practice
A compounded product is exempt if the drug product is compounded
for an individual patient
Mtdland decision: compounded preparations are not new drugs
National Association of Boards of Pharmacy
Subpart (A), General Provisions
Compounding means the preparation of Components into a Drug
Manufacturing means the production, preparation, propagation,
conversion, or processing of a Drug or Devices
Subpart (B), Organization and Personnel
Discusses the responsibilities of pharmacists and other personnel
engaged in compounding.
Stresses that only personnel authorized by the responsible pharmacist
shall be in the immediate vicinity of the drug compounding operation
Subpart (C), Drug Compounding Facilities
Describes the areas that should be set aside for compounding, either
sterile or not
Subpart (D), Equipment
States that equipment used must be of appropriate design, adequate
size, and suitably located to facilitate operation for its intended use
Subpart (E), Control of Components and Drug Product Containers and
Closures
Describes the packaging requirements for compounded products.
Subpart (F), Drug Compounding Controls
Discusses the written procedures to ensure that the finished products
are of the proper identity, strength, quality, and purity, as labeled.
Subpart (G), Labeling Control of Excess Products and Records and Reports
Describes the various records and reports that are required under
these guidelines.
[Packaging, Labeling and Storage of Pharmaceuticals]
Containers
That which hold the article and is or may be in direct contact with the
article at all rimes
Well-closed container
8-15 degrees C
Warm
30-40 degrees C
DOSAGE FORM DESIGN: PHARMACEUTICAL FORMULATION
CONSIDERATIONS
Pharmaceutical ingredients
Nonmedicinal agents
[The Need for Dosage Forms]
To protect the drug substance from the destructive influences of
atmospheric oxygen or humidity (coated tablets, sealed ampules)
To protect the drug substance from the destructive influence of gastric
acid after oral administration (enteric-coated tablets)
To conceal the bitter, salty, or offensive taste or odor of a drug
substance (capsules, coated tablets, flavored syrups)
To provide liquid preparations of substances that are either insoluble
or unstable in the desired vehicle (suspensions)
To provide clear liquid dosage forms of substances (syrups, solutions)
To provide rate-controlled drug action (various controlled-release
tablets, capsules, and suspensions)
To provide optimal drug action from topical administration sites
(ointments, creams, transdermal patches, and ophthalmic, ear, and
nasal preparations)
To provide for insertion of a drug into one of the bodys orifices (rectal
or vaginal suppositories)
To provide for placement of drugs directly in the bloodstream or body
tissues (injections)
To provide for optimal drug action through inhalation therapy
(inhalants and inhalation aerosols)
[General Considerations in Dosage Form Design]
Master formula
Formulation that best meets the goals for the product
Systemic use: oral administration
Preformulation Studies
Provides the framework for the drugs combination with
pharmaceutical ingredients in the fabrication of a dosage form
Physical Description
Particle size, crystalline structure, melting point and solubility
Microscopic Examination
Gives an indication of particle size and size range of the raw material
along with the crystal structure
Heat of Vaporization
The amount of heat absorbed when 1g of a liquid vaporizes
Measured in calories
Melting Point Depression
Characteristic of a pure substance
Temperature at which the pure liquid and solid exist in equilibrium
relationship between drug blood levels and clinical efficacy and toxicity
[Routes of Drug Administration]
Local effects: direct contact of the drug to the site of action
Systemic effect: entrance of the drug into the circulatory system and
transport to the cellular site of its action
Bioavailability is lowest for drugs that undergo a significant first-pass
effect
Oral Route
Systemic drug effects
Most natural, uncomplicated, convenient and safe means of
administering drugs
Disadvantages: slow drug response, destruction of certain drugs by
the acid reaction of the stomach
Dosage forms applicable
Tablets
o Prepared by compression or molding that contains medicinal
substances
o Diluents are fillers used to prepare tablets
o Disintegrants are used for the breakup or separation
o Enteric coatings: safe passage through the acid environment
Capsules
o Enclosed in either a hard or soft shell, generally composed of
gelatin
Suspension
o Finely divided drugs in a suitable fluid vehicle
o Drug particles must be suspended in an insoluble vehicle
o Useful means to administer large amounts of solid drugs
Solution
Elixir
o Solutions in a sweetened hydroalcoholic vehicle
Syrups
o Use sucrose solution
Absorption
Sublingual: with nitroglycerin and certain steroid sex hormones
Tetracycline drugs must not be taken with milk
Rectal Route
Suppositories
o Promotion of laxation, soothing of inflamed tissues, promotion
of systemic effcts
Parenteral Route
Para = beside
Enteron = intestine
Dosage Forms Applicable
Slow absorption = prolonged drug action; subcutaneous or IM: depot
or repository injection
Subcutaneous (Hypodermic) Injections
Injection through the skin into the loose subcutaneous tissue
Insulin