Pharmacology

Introduction and Definitions

PHMM 112 MEC

Ntokozo TV Madlopha-Mathepa
March 2019
Part 1

Introduction to pharmacology
1. What is it?
2. Where do medicines / drugs come from?
3. How are drugs used in healthcare?
What is Pharmacology?

 The study of substances that interact with living systems through

chemical processes

 Aim is to achieve a beneficial therapeutic effect on processes

within the patient or for their toxic effect on regulatory processes
in parasites and micro-organisms that infect patients

 The science of substances used to prevent, diagnose, and treat

disease
Drug Nomenclature/ Drug Names
 Chemical name
◼ Gives the exact chemical name of a drug according to atoms or
molecular structure

 Non-proprietary name/Generic name

◼ A simplified form of the chemical name, usually shorter than the
chemical name
◼ Typically derived from the chemical name

 Proprietary name/Brand name

◼ Name registered by the manufacturer
◼ Usually the first letter of the name is Capitalized
◼ A single drug can have several trade names depending on the
country of manufacture or multiple manufactures producing
products of same composition
Drug Nomenclature/ Drug Names
continued…

 Chemical
◼ E.g. N-(4-hydroxyphenyl) ethanamide
 Non-proprietary name (generic name)
◼ Paracetamol
 Proprietary name (trade name)
◼ Panado
◼ Painamol
◼ Painblock
Sources of drugs
 Natural
◼ Plants (Morphine, Nicotine)
◼ Animals (Heparin, Insulin, Cod liver oil)
◼ Micro-organisms (Penicillin, Chloramphenicol)
◼ Minerals (ferrous sulphate, aluminium
hydroxide)
◼ Human (HCG)
 Synthetic
◼ Semi-synthetic (atropine bromide)
◼ Synthetic (co-trimoxazole)
Where do drugs come from / how
are they sourced?
 Plants
Example trade name Classification
Chinchona Bark Quinidine Anti-arrhythmic
Malaria

Purple Foxglove Digitalis Cardio-tonic

Poppy Plant Morphine Analgesic

Codiene Analgesic/
Anti-tussive
Where do drugs come from / how
are they sourced? Continued…
◼ Animals
Animal Drug
Leech Heparin
Insulin Pork and cow
pancreas
Thyroxin Thyroid
Vitamin B12 Liver extract
Pepsin Stomach of cow
Where do drugs come from / how
are they sourced? continued…
 Microorganisms
Microbe Drug
Penicilium notatum Penicillin
Streptomyces venezuelace Chloramphenicol
Penicillin grisofulivum Griseofluvin
Streptomyces griseus Streptomycin
Streptomyces fradiae Neomycin
Where do drugs come from / how
are they sourced? Continued…
 Minerals
Mineral Use
Ferrous sulphate Anaemia
Magnesium sulphate Laxative
Sodium bicarbonate Antacid
Zinc Sunscreen
Where do drugs come from / how
are they sourced? Continued…
 Human
Source Drug
HCG Pregnant women
Menotrophin Post-
menopausal
women’s urine
Urokinase Human kidney
cells
Where do drugs come from / how
are they sourced? Continued…
 Genetic engineering
◼ Use genetic manipulation techniques to
produce a drug from isolated genetic
material

◼ E.g. Insulin and Hepatitis-B vaccine

Drug preparations
 Crude drug preparations
◼ Prepared by drying plant or animal tissue
◼ Others by extracting substances from
natural products
◼ Includes many herbal medicines
 Pure drug compounds
◼ Isolation of drugs from natural sources
 E.g isolation of Insulin from the pancreas
Pharmaceutical preparations /
dosage forms
 Drug products suitable for
administration of specific dose of a
drug using a particular route of
administration
 Most are made from pure drug
compounds while others often called
herbal remedies are from crude
preparations
Pharmaceutical preparations /
dosage forms continued…
 Types
◼ Tablets and capsules
 Most suitable for oral administration
 Variations in the rate and extent of tablet
disintegration and dissolution creates
differences in oral bioavailability
◼ Enteric coatings
◼ Sustained release products (controlled diffusion
and dissolution)
◼ Hard capsules (enclose powdered drugs)
◼ Soft capsules (enclose a drug in solution)
Pharmaceutical preparations /
dosage forms continued…
 Solution and suspensions
 Formulated for the following routes of
administration:
 Oral
◼ Syrups - sweetened aqueous solutions
◼ Elixir - sweetened aqueous-alcoholic
solutions
 Parenteral
◼ Sterile solutions and suspensions andmistered with a
needle and syringe or intravenous infusion device
 Topical e.g. Bioscrub/Hibitane/Dettol
Pharmaceutical preparations /
dosage forms continued…
 Skin patches
◼ Suitable for drugs effective at low dosages and
with high lipid solubility
 Aerosols
◼ Administered by inhalation (nose and mouth)
 Ointments, creams, lotions, pessaries and
suppositories
◼ Semi-solid preparations for topical application to
skin or mucous membranes
Routes of drug administration
 Enteral
◼ Drug absorbed from the gastrointestinal
tract
 Sublingual (under tongue)
 Buccal (between cheek and gum)
 Oral (by mouth and swallowed)
 Rectal (inserted into the rectum)
Routes of drug administration
continued…
 Parenteral (administration with needle
and syringe)
◼ Intravenous
◼ Intramuscular
◼ Subcutaneous
◼ Intrathecal (through the meninges of the
spinal cord)
Routes of drug administration
continued…
 Transdermal
◼ Application of drugs to the skin for
absorption into the blood circulation
 E.g. Analgesic (e.g. Transact patches) and
contraceptive (e.g. Evra patches)
 Inhalation
◼ Used for localised (asthma pump) or
systemic effect (halothane used in
anaesthesiology)
Routes of drug administration
continued…
 Topical
◼ Application of drugs to the surface of the
body to produce a localised effect on the
following:
◼ Skin
◼ Eyes
◼ Nose
◼ Mouth
◼ Throat
◼ Rectum
◼ Vagina
Part 2
 Pharmacokinetics
◼ Absorption
◼ Distribution
◼ Biotransformation (drug elimination)
◼ Excretion (drug elimination)
 Pharmacodynamics
 Drug safety
◼ Adverse effects of drugs
◼ Drug interactions
Pharmacokinetics

 The relationship between the dose of a

particular drug and the concentration of
that drug in body fluids and tissues over
time
 It is determined by rates of
◼ Drug absorption
◼ Drug distribution
◼ Drug elimination (biotransformation and
excretion)
Drug absorption
 Passage of a drug from its site of
administration into the circulation
 Through one or more layers of cells
 GIT, lungs and skin drugs must first
be absorbed through a layer of
epithelial cells with tight junctions
 Drugs administered by parenteral
route by-pass the epithelial layer
Drug absorption after oral,
subcutaneous, and intramuscular
administration
 drug absorption cont…

 NB drugs face a greater barrier to

absorption after oral administration
compared to parenteral
administration
Processes of absorption
 Passive diffusion (rate proportional
to drug concentration and surface
area)
◼ Lipid diffusion (drug dissolves in the lipid
components of the cell membrane) (drug needs
to have high lipid solubility)
◼ Aqueous diffusion (drug passes through the
aqueous pores in cell membranes) (most drugs
are too large to be absorbed this way because
of MW>200)
Processes of absorption
 Facilitated diffusion/active
transport involves transporters
(dipeptides) located in intestinal cells
 The design of drugs can influence
absorption by utilizing such
transporters
Drug distribution
 Drugs are distributed to organs and
tissues through blood circulation
 Drugs are not uniformly distributed
 They can be restricted to the extra-
cellular fluid while those with
adequate lipid solubility can diffuse
into cells
 Other classes of drugs can be actively
transported into cells
Factors affecting drug distribution
 Organ blood flow
◼ The higher the organ/tissue perfusion the more
rapid the distribution of a drug
 Plasma protein binding
◼ Almost all drugs are bound to plasma protein,
primarily albumin
◼ Extent of binding depends on the affinity to
plasma protein-binding sites
◼ Plasma protein binding is saturable and a drug
can be displaced from binding sites by other
drugs with a higher affinity for binding sites
(e.g. Warfarin displaces by Aspirin)
Factors affecting drug distribution
cont…
 Molecular size
◼ Affects the distribution of extremely large
molecules (e.g. Heparin)
◼ the result is the drug being confined in the
plasma
 Lipid solubility
◼ Major factor affecting the extent of drug
distribution
◼ E.g. The BBB restricts penetration of polar and
ionised molecules (tight junctions between cell
and glial cells that surround brain blood vessels)
Drug Biotransformation/metabolism
 Enzyme catalysed conversion of drugs into
their metabolites
 Purpose: to inactivate and detoxify drugs
and other foreign compounds that can
harm the body
◼ Metabolism can convert drugs into active
metabolites (e.g. Diazepam)
◼ Prodrugs administered as inactive compounds
can be biotransformed to active metabolites (e.g
Enalapril)
 Result = reduced plasma drug
concentration over time
Drug Biotransformation/metabolism
cont…
 Most biotransformation takes place in
the liver
 However many drug-metabolising
enzymes are found in other tissues
and organs (e.g. gut, kidneys, brain,
lungs and skin)
First-Pass
Biotransformation/metabolism
 Drugs absorbed from the gut reach the
liver via the hepatic portal vein before
entering the systemic circulation
 Drugs extensively metabolised by liver after
oral administration have reduced
bioavailability (e.g. Felodipine) (i.e. first-
pass effect
 Sublingual and rectal administraton results
in reduced first-pass effect
 IV administration by-passes the liver and
therefore first-pass metabolism
First-pass drug biotransformation
Drug excretion
 Most drugs excreted in urine as the parent
compound or active/inactive metabolite
 Others (MW>300) are excreted in bile as
parent compound or active/inactive
metabolite. After the bile empties into the
intestines the drug may be reabsorbed back
into circulation (entero-hepatic cycling)
(e.g. oral contraceptives)
Entero-hepatic cycling
Pharmacodynamics
 The detailed mechanism of action by
which a drug produces its biochemical
and physiologic effects
 The relationship between the dose
(drug concentration) and the
magnitude of drug effect
Adverse effects of drugs
 Excessive pharmacologic effects
 Hypersenstivity reactions
 Adverse effects on organs
◼ Hematopoietic toxicity
◼ Hepatotoxicity
◼ Nephrotoxicity
◼ Cardiotoxicity
◼ Pulmonary toxicity
◼ Skin rashes
Factors affecting drug safety and
efficacy
 Age
 Disease
 Pregnancy and lactatiion
Part 3
 Definitions
 Abbreviations
 Drug storage conditions
 Calculations
Common definitions in
pharmacology
 *Antibiotics – a substance, produced by or derived from a
microorgansm, that destroys or inhibits the growth of other
microorganisms (ussually bacteria and fungi) e.g.
Amoxycillin
 *Antiseptic - a chemical that destroys or inhibits the
growth of disease causing bacteria and other
microorganisms and is sufficiently non-toxic to be applied to
the skin or mucous membranes to cleanse wounds and
prevent infections. E.g. Chlorhexidine (Hibitane),
Povidone-iodine (betadine)
 *Antipruritics – an agent that relieves itching e.g.
Calamine
 *Antispasmodic – a drug that relieves spasm (presenting
as abdominal/stomach pain) of the smooth muscles in the
gut. E.g. hyoscine butylbromide (Buscopan),
mebeverine (Colofac)
Common definitions in
pharmacology cont…
 *Analgesic – a drug that relieves pain e.g. aspirin
(Disprin), paracetamol (Panado), mefenamic
acid (Ponstan)
 *Antipyretic – a drug that reduces fever by lowering
the body temperature (several analgesic drugs have
antipyretic activity) e.g. aspirin (Disprin),
paracetamol (Panado), mefenamic acid
(Ponstan)
 *Orexigenic/appetite stimulant – a drug, hormone
or compound that increases appetite e.g.
Prednisone, Insulin, Dronabinol
 *Antiemetic – a drug that prevents vomitting e.g
cyclizine (medazine)
Common definitions in
pharmacology cont…
 *Antihelmetic – a drug that expels or destroys
parasitic worms e.g. Albendazole, Mebendazole,
Praziquantel
 *Astringent – a drug that causes cells to shrink by
precipitating proteins from their surfaces (used in
lotions to harden and protect the skin, make the skin
less oily and reduce bleeding from minor abrasions)
e.g. Calamine lotion
 Bronchodilators – a drug/agent that causes
widening of the airway passages by relaxing bronchial
smooth muscles e.g. Theophylline, Salbutamol,
Formoterol
 *Toxicology – the study of poisonous materials and
their effects on living organisms
Common definitions in
pharmacology cont…
 *Addiction – a state of dependence produced by the
habitual taking of drugs (both prescription, OTC and illegal
drugs)
 *Side effect – an unwanted effect produced by a drug in
addition to its desired therapeutic effects. (drowsiness
caused by antihistamines e.g. Chlorpheniramine Allergex
tablets)
 *Idiosyncrasy – an unusual and unexpected sensitivity
exhibited by an individual to a particular drug or food (the
standard dose of a drug causes an excessive effect, the
normal effect is produced by a small fraction of the
standard dose) e.g. Aspirin causing an asthmatic attack
 *Allergic reaction – a reaction in which the body becomes
hypersensitive to a particular antigen/allergen, which
provokes characteristic symptoms following inhalation,
ingestion, injection and even touch.
Common definitions in
pharmacology cont…
 Antihistamine – a drug that inhibits the action of histamine in the
body by blocking the receptors of histamine [stimulation of
histamine receptors (H1 receptors) may produce allergic reactions
such as fever, pruritis and urticaria) e.g. Chlorpheniramine
Allergex tablets)
 *Urticaria – an itchy rash resulting from the release of histamine
by mast cells. It may cause Angio-oedema when the swelling
involves lips, eyes or tongue which may swell alarmingly and
constitute a medical emergency. May be drug-induced and involve
anaphylaxis.
 *Carcinogen – any substance that, when exposed to living tissue,
may cause the production of cancer e.g Ionizing radiation,
chemicals from cigarette smoke
 *Teratogen – any substance, agent or process that induces the
formation of developmental abnormalities in a fetus. E.g. Alcohol,
German measles, cytomegalovirus, irradiation with X-rays and
other ionizing radiation
Common definitions in
pharmacology cont…
 *Placebo – a medicine that is ineffective but may
help to relieve a condition because the patient has
faith in its powers (usually has no pharmacologically
active substance)
 *Drug tolerance – an idividual’s reduced reaction to
a drug following its repeated use. The individual no
longer reacts to the drug the same way as when they
started using the drug i.e. it takes a higher dose to
achieve the same level of response achieved initially
(ussually involves opiods and drugs of abuse)
 Drug accumulation – the amount of a drug in the
body relative to the amount lost by elimination (ratio
of dose interval and T1/2)
Common definitions in
pharmacology cont…
 Vasodilator – a drug that causes widening
of the blood vessels resulting in increased
blood flow e.g. glyceryl trinitrate
 *Coagulant - any substance that converts
blood from liquid to a solid state (blood
clotting). (Production of Enzyme thrombin
converts fibrinogen to fibrin)
 *Anticoagulant – an agent that prevents
the clotting of blood e.g. Warfarin
 *Antifungal/antimycotic – a drug that
kills or inactivate fungi e.g. nystatin,
griseofulvin, terbinafine
Common definitions in
pharmacology cont…
 *Antiviral – a drug effective against
viruses that cause disease e.g. acyclovir,
didanosine, zidovudine
 *Diuretic – a drug that increases the
amount/volume of urine produced by
promoting the excretion of salts and water
from the kidneys, the result is reduced
water retention in tissues and reduced
blood pressure e.g. HCTZ, Furosimide
 Anti-hypertensive – drugs that are used
to treat hypertention/high blood pressure
Common definitions in
pharmacology cont…
 *Vitamins – any group of substances not produced in the
body, required in very small amounts for healthy growth
and development e.g. Vit C
 *Haematinics – drugs used to increase the haemoglobin
content of the blood e.g. iron, folic acid, Vit B12,
erythropoietin
 *Antacids – a substance used to neutralize and reduce
stomach acidity especially in the stomach e.g. Citro-soda
granules
 Beta-blocker – a drug that prevents stimulation of beta-
adrenergic receptors at the nerve endings of the
sympathetic nervous system e.g. Bisoprolol, propanolol,
timolol
 *Shelf-life – the period of time from the date of
manufacture, that a drug product is expected to remain
within its approved product specifcation while stored under
defined (manufacturer’s) conditons.
 paracetamol 500mg tab tds pc prn

 prednisone 5mg d pc 5/7

Common Pharmaceutical
abbreviations
 aa - of each
 AAA - apply to affected area
 *a.c. - before meals
 a.d. - right ear
 a.s. - left ear
 *ad lib. - as much as required
 *a.m. - morning, before noon
 *amp. - ampule
 amt. - amount
Common Pharmaceutical
abbreviations cont…
 *aq. - water
 ATC - around the clock
 a.u. - both ears
 bib. - drink
 *b.i.d/BD - twice a day
 BP - Blood pressure
 *bucc. - inside cheek
 cap. - capsule
 *UNG - ointment
 UEA - Aqueous cream
 *OTC - over the counter
 *p.c. - after meals
Common Pharmaceutical
abbreviations cont…
 *pm. - evening, afternoon
 *p.o. - by mouth, orally
 *p.r. - rectally
 *p.v. - vaginally
 q - every, per
 q1-2 - every 1 to 2 hours
 *q.a.d/q.o.d - every other day
 q.a.m - every morning
 q.d. - every day
 *q.h.s. - every day at bedtime
 *q.i.d. - 4 times a day
Common Pharmaceutical
abbreviations cont…
 *qty. - quantity
 q.w. - every week
 *rx - prescription
 *SC; SQ; SubQ - subcutaneous
 sig. - write, label
 *s.l./SL - sublingually, under the tongue
 *stat. - immediately
 *supp. - suppository
 *susp. - suspension
 *syr. - syrup
 *tab. - tablet
 tbsp. - tablespoon
Common Pharmaceutical
abbreviations cont…
 *t.i.d/tds - 3 times a day
 top. - topical
 *troch. - lozenge
 tsp. - teaspoon
 *mdu - as directed
 *N/nocte - at night
 *M/mane - in the morning
Storage conditions of medicine
 Storage conditions can affect the stability
and shelf life of a medicinal product or
device
 the medicine room or dispensary must be
kept at 25 °C
 Thermolabile drugs – subject to
destruction, decomposition, or change in
response to heat
◼ medicines must be stored in a storage area,
refrigerator or cold room
◼ thermolabile medicines must be kept in a
refrigerator
Storage conditions of medicine
cont…
 the refrigerator must be used only for storing
pharmaceuticals
 the refrigerator must me connected to a stand-by
genarator or other emergency power system to
ensure unenterupted power supply
 the temperature of the refrigerator must be
maintained between 2 °C and 8 °C
 the temperature of the fridge must be monitored and
charted twice a day
 A WHO approved dial/alcohol/mercury thermometer
must be used (NB. a minimum/maximum
thermometer must not be used) The thermometer
must be hung from the middle of the refrigerator
Storage conditions of medicine
cont…
 if the power is off for any length of time,
the refrigerator should not be opened until
the power supply is restored
 cooler boxes must be used to maintain the
cold chain during transport, distribution or
cleaning of the refrigerator
 Other formulations (powders for
reconstitution) can be stored at 25 °C but
once they are reconstituted (mixed with
distilled water or diluent) they will have to
be stored between 2 °C and 8 °C e.g.
Amoxycyllin suspension
Storage of vaccines
 All vaccines and diluents must be stored in
the refrigerator between 2 and 8 degrees
Celsius
 During distribution all vaccines must be
transported in insulated containers at a
temperature between 2 °C and 8 °C
 Cold Chain Monitor Cards (CCMs) and
Vaccine Vial Monitors (VVMs) can be used
to monitor the temperature of vials
 Correct packing of vaccines and diluents in
the refrigerator is vital if they are to be
kept at safe temperatures
Correct packing of the refrigerator
(vaccines)
Storage of vaccines cont…
 Vaccines must not be kept:
◼ in the door compartments of domestic
refrigerators
◼ close to the evaporator plate (close to the back
or top of the refrigerator)
 NB. all vaccines must be protected by
insulated packaging during distribution. the
containers must be filled with sufficient ice
packs to give the container twice the length
of cold life anticipated for a particular
journey.
Calculations
Dosage calculations
 Example 1: Drug made up from stock solution
A patient is prescribed 70mg of pethidine. Calculate
the volume required if the stock solution contains 10g
of pethidine per 200ml.
NB. Before calculating ensure that the units are the same
10g = 10 x 1000mg = 10 000mg

Volume required = strength required/stock strength x volume of stock/1

Volume required = 70/10000 x 200/1 ml

= 14/10ml
= 1.4 ml
Tablets taken orally
 750mg of ciprofloxacin is presccribed.
On hand are 500mg breakable
tablets. How many tablets should be
given?
Volume required = strength required/stock strength x volume of
stock/1

Volume required = 750/500 x 1/1

= 3/2
= 1.5 tablets
Exercise
 How much is drawn from a patient ordered an injection of
80mg Pethidine? Each stock ampoule contains 100mg per
1ml
 A child requires 50mg of phenobarbitone. If stock ampoule
contain 200mg in 2ml, how much will you draw up?
 What volume is required for the injection if a patient is
ordered 500mg of capreomycin sulphate if each stock
ampoule contains 300mg/ml?
 A patient needs 500mg of medication. Stock solution
contains 1g per 1ml. What volume is required?
 If 1000mg of chloramphenicol is required and stock on hand
contains 250mg/10ml in suspension, calculate the volume
required.
 A patient is prescribed 3g of sulphasalizine, the stock on
hand contains 600mg/5ml. How much should be given to
the patient?
Exercise
Strength Stock on hand Volume
required required
1000U 1000U/2ml

1.25microgram 2.5micrograms/
s 1ml
20mg 100mg/50ml

1megaunit 1megaunit/10m
l
4g 1g/5ml
Exercise
 You receive the following prescription

Rx Prednisone40mg D po pc 7/7 then

30mg D po pc 7/7 then
20mg D po pc 7/7 then
10mg D po pc 7/7 then
5mg D po pc 1/52
Interpret the rx and calculate how many
tablets must be issued to the patient if
you only have prednisone 5mg.
Rx ciprofloxacin 500mg D po pc 3/5
Calculate the number of tablets to be given, if the stock in
hand is ciprofloxacin 500mg tablets.

Rx Salbutamol 2mg QID prn 1/52

rep x 3
Interpret and calculate the number of
tablets to be given if you only have salbutamol
4mg tablets in stock
Rx Prednisolone 30mg D po pc 1/52
Interpret and calculate the dose (ml) for the
patient and the total amount of Prednisone (ml) to be
given for the duration of treatment if stock is
5mg/5ml.
Pharmaceutical Management of
selected medical conditions
 Respiratory system
◼ Rhinitis 1
◼ Sinusitis 2
◼ Laryngitis 3
◼ cancer of the larynx 3
◼ Pharyngitis 4
◼ Tracheostomy 5
◼ Tonsilitis and adenoiditis 5
◼ Pnuemonia 6
◼ Asthma 7
◼ COPD (Emphysema) 8
◼ Acute bronchitis 9
◼ Haemothorax 10
◼ Pnuemothorax 10
Medicine Box
 Indications
 Mechanism of Action (MOA)
 Contraindications
 Pharmacokinetics
 Cautions
 Drug interactions
 Adverse effects
 Prescriber’s points/nursing
considerations
 Dosage
Rhinosinusitis
 Inflammation of the mucous membranes of the nose and
paranasal sinuses. In primary care it is defined as nasal
blockage/obstruction/congestion or nasal discharge
(anterior/posterior nasal drip) together with one of:
◼ Facial pain/pressure
◼ Reduction or loss of smell (in adults)
◼ Cough (in children)

 RX – anti-infectives
Decongestants an other preparations for
topical use
topical anti-allergy agents (excluding
corticosteroids)
Decongestants for systemic use
Rx – decongestants for topical use
 Oxymetazoline

◼ Indications
short term symptomatic relief of nasal congestion
◼ MOA
a sympathomimetc that selectively agonizes alpha (1 and 2) adrenergic receptors
in the nasal blood vessels resulting in vasoconstriction. The vasoconstriction
results in increased diameter of the airway lumen and reduces fluid release in the
post capillary venules.
◼ Pharmacokinetics
maximal effects last for about 6 hours and decline over the following 6 hours
◼ Cautions
if used topically in recommended doses n at-risk patients, e.g. patients with
hyperthyroidism, ischaemic heart disease, hypertension or diabetes mellitus,
careful observation is recommended
◼ Drug interactions
Monoamine oxidase inhibitors: possible hypertensive crisis
tri-cyclic anti-depressants: blood pressure should be closely monitored as
hypertension and cardiac arrythmias may occur
◼ Adverse effects
Burnng or dryness of of the mucousa
◼ Special prescriber’s points
use should be restricted to a few days only
◼ Adult dose
Instill 1-2 drops into each nostril 1-3 times daily (8-12 hourly)
Sinusitis
 Acute inflammation of the paranasal
sinuses due to viral, bacterial, or
fungal infections or allergic reactions.
Symptoms include nasal obstruction
and congestion, purulent rhinorrhea,
cough facial pain, malaise, and
sometimes fever
Class test 1
Interpret and calculate the number of
tablets to be given

1. Rx: Theophylline 250mg tabs po qid prn 1/12

Stock 500mg tabs

2. Rx: prednisone 20mg d po pc 1/5

then 15mg d pc 1/5
then 10mg d pc 1/5
Stock 5mg tablets`