PHARMACOLOGY

AND BASIC
CONCEPT OF DRUGS
Agni Laili Perdani, MS

STIKEP PPNI JAWA BARAT

ALPINE SKI HOUSE

 What topics we will discuss?

1. History and development of Pharmacology

2. Pharmacology scope
3. Medical Terms in Pharmacology
4. Pharmacokinetics
5. Pharmacodynamics
6. Concept of drugs
7. Drugs Administration
8. Drugs Form
9. Drugs Law
10.Role of Nurses ALPINE SKI HOUSE 2
 Pharmacology
• Pharmacology is a branch of science that deals with the study of drugs
and their actions on living systems
• The study of how drugs work in the body (drug actions).
• What a drug is, how it affects our physical, emotional and
psychological wellbeing, the type of drug being used, the modes of
administration, how the drug is absorbed and the characteristics of the
person taking the drug
 Pharmacology scope (1/2)
1. Farmakognosi : Ilmu yang mempelajari pengetahuan dan juga
pengenalan obat yang berasal dari tanaman serta zat-zat aktifnya
yang berasal dari mineral dan juga hewan.
2. Farmasi : Bidang profesional kesehatan yang merupakan sebuah
kombinasi dari ilmu kesehatan dan juga ilmu kimia bertanggung
jawab memastikan efektivitas serta juga keamanan penggunaan
obat. Profesional bidang farmasi disebut dengan sebutan farmasi
atau apoteker.
3. Farmakologi klinik : Ilmu farmakologi yang mempelajari pengaruh
kondisi klinis pasien terhadap efikasi obat, contohnya kondisi hamil
dan juga menyusui, neonatus serta anak, geriatrik, inefisiensi ginjal
dan juga hepar.
 Pharmacology scope (2/2)
4. Farmakoterapi : Subilmu yang mempelajari mengenai penanganan
penyakit dengan melalui penggunaan obat-obatan yang digunakan
untuk dapat membuat diagnosis, mencegah timbulnya, serta juga
cara menyembuhkan suatu penyakit dan juga mempelajari khasiat
obat pada berbagai penyakit, bahaya yang dikandungnya,
kontraindikasi obat, pemberian obat yang tepat.
5. Toksikologi : Pemahaman mengenai pengaruh-pengaruh dari bahan
kimia yang merugikan bagi organisme hidup.
6. Farmakokinetik
7. Farmakodinamik
 Pharmacokinetics

• Definition : Farmokinetik adalah proses

pergerakan obat untuk mencapai kerja
obat
• Pharmacokinetics, which refers to the
administration,
bioavailability/absorption,
distribution, metabolism, and
excretion of drugs
Pharmacokinetics: Administration

• Administration is factors relating to

dosing and adherence
• Administration of the drug by the
chosen route requires a treatment
plan, formulated in a prescription,
adherence to that plan and
description of the conditions of
administration
 Pharmacokinetics: Absorption
• Proses pergerakan partikel-partikel obat dari saluran gastrointestinal
ke dalam cairan tubuh melalui absorpsi pasif, absorpsi aktif atau
pinositosis
• Bioavailability is the fraction of administered drug entering the
systemic circulation [Rowland and Tozer, 2011].
• The rate of drug entering the systemic circulation determines the
maximum concentration and the time at which this occurs, but it does
not affect steady-state concentration or determine maintenance
dose.
 Pharmacokinetics : Distribution
• Distribution of the drug to its site of action is the description of the
differential distribution of the drug within the body.
• Distribution is easier to consider after bioavailability and clearance
have defined steady-state concentration in the systemic circulation.
• The concentration gradient between the systemic circulation and the
site of action is often determined by transport processes. Although
drug transport is important to bioavailability and clearance, it sits
more comfortably under the heading of distribution.
• The rate of distribution is particularly relevant to bolus dosing, but in
continuous dosing, rate is best considered after extent
 Pharmacokinetics : Metobolism

• Clearance is composed of metabolism and excretion of the active

drug.
• Clearance withextent of bioavailability, determines average steady-
state concentration and hence maintenance dose.
• The clearance of the pharmacologically active drug moieties is the
clinically relevant quantifier of drug leaving the systemic circulation.
 Pharmacokinetics : Excretion (1/2)
The kidney is the most important organ for the excretion. Some
compounds are also excreted via bile, sweat, saliva, exhaled air, or milk
(source of unwanted exposure in nursing infants). Drug excretion may
involve one or more of the following processes.
A. Renal Glomerular Filtration
Glomeruli permit the passage of most drug molecules, but restrict the
passage of protein-bound drugs. Changes in glomerular filtration rate
affect the rate of elimination of drugs which are primarily eliminated by
filtration (e.g., digoxin, kanamycin)
B. Renal Tubular Secretion
The kidney can actively transport some drugs (e.g., dicloxacillin) against
a concentration gradient, even if the drugs are protein-bound. Only free
drug is transported, but the protein-drug complex rapidly dissociates
 Pharmacokinetics : Excretion (2/2)
C. Renal Tubular Reabsorption
Reabsorption is influenced by the same physicochemical factors that
influence gastrointestinal absorption
D. Biliary Excretion
Many drugs and metabolites are passed into the small intestine via bile
and may undergo enterohepatic cycling
Pharmacodynamics : Cara Obat Mempengaruhi Tubuh
• Farmakodinamika adalah ilmu pengetahuan yang mempelajari tentang
interaksi antara komponen kimia dari sistem yang hidup dan zat kimia
asing, termasuk obat, yang memasuki sistem tersebut.
• Pharmacodynamics refers to the molecular, biochemical, and
physiological effects of drugs, including drug mechanism of actio
• Respon obat dapat menyebabkan efek fisiologis primer atau sekunder
atau kedua-duanya. E
• Efek primer adalah efek yang diinginkan dan efek sekunder adalah efek
yang bisa diinginkan atau tidak diinginkan. Ex : Difenhidramin (Benadryl) :
antihistamin. Efek primer untuk mengatasi gejala alergi, efek sekunder
adalah penekanan susunan saraf pusat yang menyebabkan rasa kantuk,
Kerja Obat
1. Mengganti atau bekerja sebagai pengganti zat kimia yang hilang
2. Meningkatkan atau menstimulasi aktivitas selular tertentu
3. Menekan atau memperlambat aktivitas selular
4. Menganggu fungi sel asing, seperti mikroorganisme atau neoplasma
(agens kemoterapi)
The time course of drug action depends on
1. Drug dose, route of administration, rate and extent of absorption,
distribution rate (particularly to site of action) and rate of
elimination.
2. The minimum effective concentration and concentration-effect
relationship. Consideration of the time course of drug action is
important since usually it is necessary to maintain a certain
concentration of drug at its site of action for a finite period of time.
Definisi Obat
• Obat adalah bahan atau panduan bahan-bahan yang siap
digunakan untuk mempengaruhi atau menyelidiki sistem
fisiologi atau keadaan patologi dalam rangka penetapan
diagnosis, pencegahan, penyembuhan, pemulihan,
peningkatan kesehatan dan kontrasepsi (Undang-Undang Kesehatan
No. 23 tahun 1992)
 Different Types of Dosage Forms

1.Solids : Tablets, Capsules, Pills

2.Liquids : Suspension, Emulsion
3.Ointments
4.Lotions
5.Spray
6.Inhalations
 Solids : Tablets (1/2)
• Tablets are solid dosage forms prepared by compression on
molding.
• Contain : suitable diluents, disintegrants, coatings, colorants,
flavors, and sweeteners.
• These ingredients are necessary in preparing tablets of the
proper size, consistency, proper disintegration, flow of powders,
taste, and sweetness.
• Various coatings are placed upon tablets to permit safe passage
through the acid stomach environment where the acidity or
enzymes can destroy the drug or to protect drugs from
destructive environmental influences such as moisture, light, and
air during storage.
• Coatings can also conceal a bad or bitter taste of the drug from
the patient.
• Commercial tablets have distinctive colors, shapes, monograms,
and code numbers to facilitate their identification and serve as
added protection to the public.
Solids : Capsules (1/2)
• Capsules are solid dosage forms in a gelatin shell as fillers, antioxidants, flow enhancers,
and surfactants are enclosed.
• A “hard” gelatin capsule is composed of gelatin, glycerin, sugar, and water, whereas a
“soft” gelatin capsule is composed of only gelatin, glycerin, and water.
• Capsules vary in size from 000 to 5. The number increases the capsule size becomes
smaller.
• The sizes provide a convenient container for the amount of drug to be administered and
can be of distinctive shapes and colors when produced commercially.
• Drugs are released from capsules faster than from tablets because the powdered drug
has not been compressed and can dissolve at faster rates.
• The gelatin (a protein) is acted upon rapidly by the enzymes of the GI tract, permits
gastric juices to penetrate and reach the contents to promote dissolution.
Liquids : Suspension (1/2)
This dosage form contains distributed dissolved drug particles
1. Ready-to-use: A product that is already dispersed
throughout a liquid vehicle with or without stabilizers and
other pharmaceutical additives

2. Dry Powders for suspension in liquid : A powder mixture

containing the drug and suitable suspending and dispersing
agents, which upon dilution and agitation with a specified
quantity (usually purified water) results in the formation of
the final suspension suitable for administration.
Liquids : Suspension (1/2)
There are several reasons for preparing an oral suspension :
1. Certain drugs are chemically unstable when in solution but stable
when in suspension.
2. The liquid form is preferred over the solid forms (tablets and
capsules) due to ease of swallowing.
3. A greater flexibility in dose administration especially for
exceedingly large doses.
4. Safety and convenience of liquid doses for infants and children.
 Liquids : Emulsion
• Emulsions are dispersions in dispersed phase
(internal phase) is composed of small globules of a
liquid distributed throughout a liquid vehicle
(external or continuous phase)
• Emulsions having an oleagenous internal phase and
an aqueous external phase are designated oil-
inwater emulsions
• The emulsion can be diluted with water.
• The reduced particle size of the oil globules may
render the oil more digestible and therefore more
readily absorbed.
Other (1/2)
1. Liniment Liquid forms of drug that are applied by rubbing into the skin contain anodyne
compound to alleviate pain and a rubifacient, which reddens the skin e.g. by causing dilation
of the capillaries and an increase in blood circulation.
2. Ointments. These drug forms are often semi-solid preparations in which the drug is
incorporated into a base material. Ointment bases fall into four general classes:
a)hydrocarbon bases (oleaginous ointment bases) - these keep medicaments in prolonged
contact with the skin, act as occlusive dressings, and are used chiefly for emollient effects
b)absorption bases that either permit the incorporation of aqueous solutions with the
formation of a water-in-oil emulsions, or are water-in-oil emulsions that permit the
incorporation of additional quantities of aqueous solutions; such bases permit better
absorption of some medicaments and are useful as emollients
c)water-removable bases (creams) – these are oil-in-water emulsions containing petrolatum
(petroleum jelly), anhydrous lanolin, or waxes; they may be washed from the skin with
water and are thus more acceptable for cosmetic reasons; they favour absorption of serous
discharges in dermatologic conditions
d)water-soluble bases (greaseless ointment bases) containing only water-soluble substances
Other (2/2)
3. Lotions. Lotions are liquid forms, which are applied to the skin to protect, cool,
cleanse, act as emollient and even provide antipruritic treatment.
4. Paste : ointment-like type of form where drugs and other solid substances (e.g.,
zinc oxide) are mixed together with an adhesive fatty base (e.g., petroleum jelly).
Pastes are semi-solid preparations intended for topical application affected areas
of the skin. Usually they are thick (contain 25% of solids by weight) and do not
melt at normal temperature. Remain on the area for longer duration than
ointments and are therefore generally more effective.
5. Suppositories. A form where drugs are mixed together and molded into the
desired shape to be inserted into the body cavity.
6. Sprays. Sprays contain drugs in liquid form and are administered using an atomizer.
7. Inhalants. These devices contain drugs and are administered by inhaling the
vapour sent out from the inhalant and directly to the patient’s nasal passage
DRUG ADMINISTRATION : ENTERAL ROUTES (1/2)

1.Sublingual (buccal) : Usually for nitrates and certain hormones

Certain drugs are best given beneath the tongue or retained in the cheek
pouch and are absorbed from these regions into the local circulation. Ideal for
lipid-soluble drugs that would be metabolized in the gut or liver, since the
blood vessels in the mouth bypass the liver (do not undergo first pass liver
metabolism), and drain directly into the systemic circulation.
2. Oral solution > suspension > capsule > tablet > coated tablet
The most common route. The passage of drug from the gut into the blood is
influenced by biologic and physicochemical factors and by the dosage form.
For most drugs, two- to five-fold differences in the rate or extent of
gastrointestinal absorption can occur, depending on the dosage form. These
two characteristics, rate and completeness of absorption, comprise
bioavailability.
DRUG ADMINISTRATION : ENTERAL ROUTES (2/2)

3. Rectal
The administration of suppositories is
usually reserved for situations in which oral
administration is difficult. This route is more
frequently used in small children. The
rectum is devoid of villi, thus absorption is
often slow.
DRUG ADMINISTRATION : PARENTERAL ROUTES
(1/4)
1. Intravenous injection :
• Used when a rapid clinical response is necessary
(ex: acute asthmatic episode).
• This route allows one to achieve relatively precise
drug concentrations in the plasma, since
bioavailability is not a concern.
• Most drugs should be injected over 1-2 minutes in
order to prevent the occurrence of very high drug
concentrations in the injected vein, possibly causing
adverse effects.
• Some drugs, particularly those with narrow
therapeutic indices or short half-lives, are best
administered as a slow IV infusion or drip.
DRUG ADMINISTRATION : PARENTERAL ROUTES
(2/4)
2. Intra-arterial injection:
Used in certain special situations, notably with
anticancer drugs, in an effort to deliver a high
concentration of drug to a particular tissue. The
injected artery leads directly to the target organ.
3. Intrathecal injection
The blood-brain barrier limits the entry of many
drugs into cerebrospinal fluid. In life-threatening,
antibiotics, antifungals and anticancer drugs are
given via lumbar puncture and injection into the
subarachnoid space.
DRUG ADMINISTRATION : PARENTERAL ROUTES
(3/4)
4. Intramuscular injection
• Drugs may be injected into the arm (deltoid), thigh
(vastus lateralis) or buttocks (gluteus maximus).
• Because the differences in vascularity, the rates of
absorption : arm > thigh > buttocks
• Drug absorption may be slow and erratic. The volume
of injection, osmolality of the solution, lipid solubility
and degree of ionization influence absorption.
DRUG ADMINISTRATION : PARENTERAL ROUTES
(4/4)
5. Subcutaneous injection
• Some drugs (ex: insulin) are routinely administered SC.
• Drug absorption is generally slower SC than IM, due to poorer
vascularity.
• Absorption can be facilitated by heat, massage or vasodilators.
6. Inhalation
• Volatile anesthetics affect pulmonary function administered as
aerosols.
• Examples : nicotine and tetrahydrocannabinol (THC) absorbed
following inhalation of tobacco or marijuana smoke.
• The large alveolar area and blood supply lead to rapid
absorption into the blood.
• Drugs administered via this route are not subject to first-pass
liver metabolism
 Drugs Law in Indonesia (1/2)
1. Ordonansi Obat Keras (Staatsblad Nomor 419 Tahun 1949);
2. UU Nomor 5 Tahun 1997 : Psikotropika (Lembaran Negara Republik Indonesia Tahun 1997
Nomor 10, Tambahan Lembaran Negara Republik Indonesia Nomor 3671)
3. UU Nomor 35 Tahun 2009 : Narkotika (Lembaran Negara Republik Indonesia Tahun 2009
Nomor 143, Tambahan Lembaran Negara Republik Indonesia Nomor 5062)
4. PP Nomor 72 Tahun 1998 : Pengamanan Sediaan Farmasi dan Alat Kesehatan (Lembaran
Negara Republik Indonesia Tahun 1998 Nomor 138, Tambahan Lembaran Negara Republik
Indonesia Nomor 3781)
5. PP Nomor 51 Tahun 2009 : Pekerjaan Kefarmasian (Lembaran Negara Republik Indonesia
Tahun 2009 Nomor 124, Tambahan Lembaran Negara Republik Indonesia Nomor 5044);
6. PP Nomor 40 Tahun 2013 : Pelaksanaan Undang-undang Nomor 35 Tahun 2009 tentang
Narkotika (Lembaran Negara Republik Indonesia Tahun 2013 Nomor 96, Tambahan Lembaran
Negara Republik Indonesia Nomor 5419)
7. Peraturan Menteri Kesehatan Nomor 1148/MENKES/PER/IV/2011 tentang Pedagang Besar
Farmasi (Berita Negara Republik Indonesia Tahun 2011 Nomor 370) sebagaimana telah
diubah dengan Peraturan Menteri Kesehatan Nomor 34 Tahun 2014 tentang Perubahan atas
Peraturan Menteri Kesehatan Nomor
Drugs Classification
Drugs can be classified as :
1. Uses (medicinal or recreational)
2. Effect on the body (the specific effect on the central nervous system)
3. Source of the substance (synthetic or plant)
4. Legal status (legal/illegal)
5. Risk status (dangerous/safe)
 Drugs Classification : Uses (1/3)
1. Generic Drugs
• A generic drug is a medication created to be the same as an
already marketed brand-name drug in dosage form, safety,
strength, route of administration, quality, performance
characteristics, and intended use.
• These similarities help to demonstrate bioequivalence a generic
medicine works in the same way and provides the same clinical
benefit as its brand-name version.
• Ex : One used for diabetes is metformin. Brand name :
Glucophage. Used for hypertension is metoprolol. Brand name is
Lopresso
Drugs Classification : Uses (2/3)
2. Orphan Drugs : Drugs developed specifically to treat a rare medical
condition. Drugs that are not developed by the pharmaceutical industry
for economic reasons but respond to public health need
Drugs Classification : Uses (2/3)
3. Obat bebas
Obat yang dijual bebas di pasaran dan dapat dibeli tanpa resep dokter. Contoh : Parasetamol
4. Obat bebas terbatas adalah obat yang sebenarnya termasuk obat keras tetapi masih dapat
dijual/ dibeli bebas tanpa resep dokter, dan disertai dengan tanda peringatan. Contoh : CTM
5. Obat keras adalah obat yang hanya dapat dibeli di apotek dengan resep dokter. Obat
psikotropika adalah obat keras (alamiah maupun sintetis) bukan narkotik berkhasiat psikoaktif
melalui pengaruh selektif pada susunan saraf pusat yang menyebabkan perubahan khas pada
aktivitas mental dan perilaku (Diazepam, Phenobarbital)
6. Obat narkotika adalah obat yang berasal dari tanaman atau bukan tanaman baik sintetis
maupun semi sintetis yang dapat menyebabkan penurunan atau perubahan kesadaran,
hilangnya rasa, mengurangi sampai menghilangkan rasa nyeri dan menimbulkan
ketergantungan (Morfin, Petidin)
 2. Drugs Classification: Effect on the body (CNS)

1. Stimulants : Tend to speed up the activity of a person's central nervous

system (CNS) including the brain. These drugs often result in the user
feeling more alert and more energetic. Examples : Amphetamines Cocaine,
Pseudoephidrine (found in medications such as Sudafed, Codral Cold and
Flu), Nicotine Caffeine
2. Depressants (also known as relaxants) : Tend to slow down the activity of
the CNS, the user feeling less pain, more relaxed and sleepy. These
symptoms may be noticeable when a drug is taken in large amounts.
Depressant is the effect on the CNS, not mood and more likely to result in
euphoria than depression. Examples : Alcohol. Major tranquillisers,
Benzodiazepines (e.g. Valium, Temazepam) Opioids (heroin, morphine),
Volatile substances (can also be classified as 'other' (glue, petrol, and paint)
 2. Drugs Classification: Effect on the body (CNS)

3. Hallucinogens
Have the ability to alter a user's sensory perceptions by distorting
the messages carried in the CNS. Hallucinogens alter one's
perceptions and states of consciousness. Examples :LSD, Psilocybin
(magic mushrooms), Mescaline (peyote cactus)
4. Other
Includes psycho-active drugs that do not fit neatly into one of the
other categories, but clearly psycho-active, such as antidepressants
(e.g. Zoloft) and mood stabilisers (e.g. Lithium).Examples :MDMA
(ecstasy), Cannabis, Volatile substances (petrol, glue, paint)
Drugs Classification: Legal status
(legal/illegal)
• The Controlled Substances Act (CSA) places all substances regulated
under existing federal law into one of five schedules based upon the
substance’s medical use, potential for abuse, and safety or
dependence liability.  
1. Schedule I Controlled Substances
2. Schedule II/IIN Controlled Substances (2/2N)
3. Schedule III/IIIN Controlled Substances (3/3N)
4. Schedule IV Controlled Substances
5. Schedule V Controlled Substances
 Drugs Classification : Schedule I Controlled Substances

• A lack of accepted safety for use under medical supervision and a high
potential for abuse.
• Some examples : heroin, lysergic acid diethylamide (LSD), marijuana
(cannabis), peyote (mescaline), methaqualone (Quaalude), 3,4-
methylenedioxymethamphetamine (“ecstasy”) and “bath salts.
 Drugs Classification :
Schedule II/IIN Controlled Substances (2/2N)

• Have a high potential for abuse which may lead to severe

psychological or physical dependence.
• Examples of narcotics: hydromorphone (Dilaudid), methadone
(Dolophine), meperidine (Demerol), oxycodone (OxyContin, Percocet),
and fentanyl (Sublimaze, Duragesic), opiates morphine, opium, and
codeine.
• Examples of IIN (tN for non-narcotic) stimulants include:
amphetamine (Dexedrine, Adderall), methamphetamine (Desoxyn),
and methylphenidate (Ritalin).
• Other : amobarbital, glutethimide, and pentobarbital.
 Drugs Classification :
Schedule III/IIIN Controlled Substances (3/3N)

• Less than substances in Schedules I or II and abuse may lead to

moderate or low physical dependence or high psychological
dependence.
• Examples of narcotics: combination products containing less than 15
milligrams of hydrocodone per dosage unit (Vicodin), products
containing not more than 90 milligrams of codeine per dosage unit
(Tylenol with codeine), and buprenorphine (Suboxone).
• Examples of non-narcotics include: benzphetamine (Didrex),
phendimetrazine, ketamine, and anabolic steroids such as Depo-
Testosterone
 Drugs Classification :
Schedule IV Controlled Substances
• Have a low potential for abuse relative to substances in Schedule III.
• Examples o: alprazolam (Xanax), carisoprodol (Soma), clonazepam
(Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam
(Ativan), midazolam (Versed), temazepam (Restoril), and triazolam
(Halcion).
 Drugs Classification :
Schedule V Controlled Substances

• Have a low potential for abuse relative to substances listed in

Schedule IV and consist primarily of preparations containing limited
quantities of certain narcotics.
• Examples of : cough preparations containing not more than 200
milligrams of codeine per 100 milliliters or per 100 grams (Robitussin
AC, Phenergan with Codeine), and ezogabine.
Factors to determine schedule drugs
1. Its actual or relative potential for abuse.
2. Scientific evidence of its pharmacological effect, if known.
3. The state of current scientific knowledge regarding the drug or other
substance.
4. Its history and current pattern of abuse.
5. The scope, duration, and significance of abuse.
6. What, if any, risk there is to the public health.
7. Its psychic or physiological dependence liability.
8. Whether the substance is an immediate precursor of a substance already
controlled under this subchapter.
 Six Right Medication
1. Right medication
2. Right dose
3. Right time
4. Right route
5. Right client
6. Right documentation
Peran dan tanggung jawab perawat
1. Memberikan obat
2. Mengkaji efek obat
3. Melakukan intervensi agar program pengobatan tersebut dapat
lebih ditoleransi
4. Memberikan penyuluhan kepada pasien tentang obat-obatan dan
program pengobatan

(
 Homework
History of Pharmacology
Medical Terms in Pharmacology
http://pio.binfar.depkes.go.id/
http://apps.who.int/medicinedocs/documents/s19469en/s19469en.pdf

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