Module 1
Pharmaceutical Chemistry
Inorganic and Organic Pharmaceutical and Medicinal Chemistry
Kathreen Mae D. Cascabel
BSPharmacy
General Chemistry
Chemistry – study of matter
Matter – anything that occupies space and has mass
UNITS OF MEASUREMENT
1.
2.
3.
4.
Composition
Structure
Changes that matter undergoes
Energy involved in such changes or interactions
Length
Mass
Time
Temperature
Meter (m)
Kilogram (kg)
Seconds (sec)
Kelvin (K)
Mass – refers to the amount of matter present in the material
Weight = Mass x Pull of gravity
Classification of Matter
 Element
- simplest form of matter, 1 kind of material or atom
 Compound
- substances composed of two or more elements united chemically in definite proportion
 Mixture
- composed of 2 or more substances that are not chemically combined
Plasma
 Colorless fluid part of blood, lymph, or milk in which corpuscles or fat globules are suspended
Serum
 Amber- colored protein-rich liquid that separates out when blood coagulates
 Used to provide immunity
 Diagnostic agent
Classification of Mixture
A. According to the Nature of Particles
a. Homogenous
b. Heterogenous
B. According to the Size of Particles
a. Solution
- uniform mixture (homogenous), composed of solute and solvent where solute is soluble
b. Suspension
- Coarse Mixture, finely divided solid materials distributed in a liquid where solid is insol.
c. Colloid
- particles of solute not broken down to the size of the molecules but are small enough to
remain suspended and evenly dispersed throughout the medium
Process of Separating Components of Mixtures
1. Decantation
- difference in specific gravity or density
2. Distillation
- evaporation and then condensation
3. Evaporation
4. Magnetic Separation
5. Filtration
6. Sorting
7. Centrifugation
- speeding up of settling process of a precipitate
8. Fractional Crystallization
- lowering of temp so that the more insoluble comp crystallizes out first
9. Chromatography
- difference in solvent affinity
Properties of Matter
1. Intrinsic/Intensive
2. Extrinsic/Extensive
- INDEPENDENT of mass or amount (density, specific gravity, melting point)
- DEPENDENT on mass (weight, volume, pressure, heat content)
Changes that matter undergoes
1. Physical Change - change in phase
2. Chemical Change
- change in both intrinsic and extrinsic properties
Evidences of Chemical Change
 Evolution of gas
 Formation of precipitate
 Emission of light
 Generation of electricity
 Production of mechanical energy
 Absorption/liberation of heat
Types of Chemical Reactions
A. Direct Union
B. Decomposition/Analysis
C. Single Replacement
D. Double Displacement
Fe + S  FeS (all sulfides are BLACK)
Na2CO3  Na2O + CO2
Na + HCl  NaCl + H2
NaCl + AgNO3  NaNO3 + AgCl
Processes Involved in Chemical Change
1. Oxidation
+𝑂
2. Reduction
−𝑂 𝑜𝑟 + 𝐻
3. Neutralization
𝑎𝑐𝑖𝑑 + 𝑏𝑎𝑠𝑒  𝑠𝑎𝑙𝑡 + 𝑤𝑎𝑡𝑒𝑟
4. Hydrolysis
𝑤𝑎𝑡𝑒𝑟 + 𝑠𝑎𝑙𝑡  𝑎𝑐𝑖𝑑 + 𝑏𝑎𝑠𝑒
5. Saponification
𝑎𝑙𝑘𝑎𝑙𝑖 + 𝑓𝑎𝑡𝑠  𝑠𝑜𝑎𝑝 + 𝑔𝑙𝑦𝑐𝑒𝑟𝑜𝑙
6. Fermentation
𝑜𝑟𝑔𝑎𝑛𝑖𝑐 𝑠𝑢𝑏𝑠𝑡𝑎𝑛𝑐𝑒𝑠 + 𝑚𝑖𝑐𝑟𝑜𝑏𝑒𝑠  𝑎𝑙𝑐𝑜𝑕𝑜𝑙
3. Nuclear Change – ∆ in structure, properties, composition of the nucleus  in the transmutation of the element
 Nuclear Fission
- splitting of a heavy atom
 Nuclear Fusion
- union of 2 light atoms to form a bigger molecule
Oxidation state computations:
1. KMnO4
K = +1 (1) = +1
Mn = x
O4 = -2 (4) = -8
1+x–8=0
X = +7
2. Na2Cr2O7
Na2 = +1 (2) = +2
Cr2 = x (2) = 2x
O7 = -2 (7) = -14
+2 + 2x – 14 = 0
2x = 14 – 2
2x = 12
X = +6
3. AsO3-3
As = x
O4 = -2 (4)
X – 8 = -3
X=8–3
X = +5
+1
H
Li
Na
K
Rb
Cs
Fr
+2
Be
Mg
Ca
Sr
Ba
Ra
+3
Al
-2
O
S
-1
F
Cl
Br
I
At
ATOMIC STRUCTURE
Protons
Neutrons
Mass no.
Electrons
Isotopes
Isotones
Isobars
Isomers
Similarities
Element
Neutrons
Mass number
Molecule
= Electrons = Atomic number
= Mass number – Atomic number
= Protons + Neutrons
= Protons - Charge
Difference
Mass number
Protons
Element
Structure
P =6
ION
Cation =
12
+
N = Mass no. – P
= 12-6
=6
Anion =
E = P – charge
=6–0
=6
Democritus
John Dalton
J.J Thompson
Rutherford
Niel Bohr Model
Erwin Schrodinger
James Chadwick
+1
6
C
12
-
-1
C
6
E = P - Charge
= 6 – (+1)
=5
E = P -Charge
= 6 – (-1)
=7
Matter is made up of small indivisible particles | Coined “atomos”
“Billiard Ball Model” – atom is a hard indestructible sphere
Dalton’s Atomic Theory
 Matter is made up of atoms
 All atoms of a given element are alike
 Atoms enter into a combination with other atoms to form compounds but
remain unchanged during ordinary chemical rxn
Atom can combine into simple numerical ratios
Disproved: subatomic particles
“Raisin Bread” model
Proton; Gold Film Experiment: Atom is mostly an empty space (99% passed)
Planetary model
Quantum Mechanic Model; “Electron Cloud” – electrons move in 3D structure (Orbitals)
Neutron
ION – charged atom
 Atomic Number - number of protons
 Mass number - protons + neutrons
ALLOTROPISM
 Allotrope – atoms of different elements can link together in different ways to form substances with diff properties
 Allotropes of Carbon : Diamond and Graphite
 Allotropes of Oxygen
o *O+
nascent
o O2
molecular
o O3
ozone
Orbitals – region in space where the probability of finding an electron is greatest
QUANTUM NUMBERS
Symbol
Values
Function
Principal Quantum Number
 Main energy level
n
1, 2, 3
(+ integer)
Determine the size of the
particle
Azimuthal or Angular
Momentum
l
0 to (n-1)
Subshell or sublevel,
determines the shape (s, p, d,
f)
Magnetic Quantum Number
m or ml
-l to +l
Orbitals, determine the
orientation
Spin Quantum Number
s or ms
- ½ or + ½
Direction of the spin or
rotation
Law of Conservation of Mass
- The total mass of all products of a chemical reaction is equal to the total mass of all reactants of
that reaction
Law of Definite Proportions/Proust’s Law
- Inorganic compounds
- A chemical compound always contains exactly the same proportion of elements by mass
Law of Multiple Proportion
- Organic compounds
- When chemical elements combine, they do so in a ratio of small whole numbers
GENERAL PRINCIPLES IN ELECTRON CONFIGURATION
Pauli’s Exclusion Principle
– No two electrons can have the same set of 4 quantum numbers
Each atomic orbital can only accommodate 2 electrons (Ex: 1s2)
Heisenberg’s Uncertainty Principle
– Impossible to determine simultaneously the e- momentum & position
Aufbau Building Up Principle
– Lower energy levels are filled up first
Hund’s Rule of Maximun Multiplicity
– Orbitals are filled up singly before pairing up
PERIODIC TABLE OF ELEMENTS
Antoine-Laurent Lavoisier
Johann Dobereiner
Newlands
Meyer and Mendeleev
Henry Mosley
- Hydrogen, First true periodic table
- Triads (Li, Na, K | Ba, Ca, Sr | S, Se, Te | Cl, Br, I)
- Octaves
- Physical and chemical properties are periodic functions of their atomic weights
- Elements are arranged based on atomic numbers (present)
Family A
 Representative Elements
 Occupy:
o S block
 Group IA – Alkali Metals
 Group IIA – Alkaline Earth
o P Block
 Group IIIA to VIIIA
Family B
 Transition elements
 Occupy:
o D block: Transition Metals
o F block: Lanthanide or Lanthanoid series – Rare
Earth Metals
PERIODIC TRENDS (noble gases not included)
Atomic Radius (½ the distance bet 2 nuclei)
Metallic Property
Ionization potential (energy to remove an e-)
Electron affinity (energy when e- is added)
Electronegativity (ability to attract e-)
*Arrows indicate increasing values
Kinematic Molecular Theory – explains phases of matter based on movement (exclu. direction) of molecules/ions/atoms
 SOLID - definite shape and size, definite volume
 LIQUID - follows the shape of container, definite volume
 GAS
- indefinite shape and volume
SOLUTIONS – homogenous mixture single phase system of two of more substances
 Saturated Solution
- maximum amount of solute
 Unsaturated Solution
- less solute
 Supersaturated Solution
- more solute than the solvent can dissolve
Factors Affecting Solubility
1. Nature of Solute and Solvent
 “Like dissolves like”
Solubility
– maximum amount of solute expressed in grams that can be dissolved in 100 g of water
Miscibility
– ability of one substance to mix with another substance
2. Temperature
 ↑ temperature = ↓ solubility of a gas
Exothermic
– solubility decreases with increase in temp (Mg citrate)
Endothermic
– solubility increases with increase in temp
3. Pressure ( for gases only)
Henry’s Law
– the solubility of a gas increases as pressure increases
4. Particle Size/Surface Area
 Decreased particle size = Increased surface area = Increased solubility
5. Presence of Salts
 Salting Out
 Salting In
– presence of salt decreases solubility
– presence of salt increases solubility
Methods of Expressing Concentration of Solutions
Percent Solution
 % by mass
 % by volume
 % mass/volume
 ppm (parts per million)
 proof
Mole fraction (x) = moles of the substance
total moles of solution
Molarity (M) – moles of solute per L of solution
Molality (m) – moles of solute per kg of solvent
Normality (N) – no. of equivalents of solute per L of
solution
Mole (n) = grams/MW
FORCES OF ATTRACTION
INTRAMOLECULAR FORCES – within molecules
1. Ionic Bond
- transfer
2. Covalent Bond
- sharing
a. Polar (unequal)
b. Nonpolar (equal)
INTERMOLECULAR FORCES – between molecules; physical attraction
1. Van der Waals
a. Keesom (Dipole-dipole)
o Orientation/Alignment effect
o 1-7 kcal/mole
b. Debye (Dipole-Induced Dipole)
o Induction
o 1-3 kcal/mole
c. London Dispersion (Induced dipole-Induced dipole)
o Very close proximity  internal vibration will cause dispersion of charges
o 0.5-1 kcal/mole
2. Ion-Dipole
- charged ion + polar molecule (salt & water)
3. Ion-Induced Dipole - charged ion + nonpolar molecule (I2 + KI)
4. Hydrogen Bond
- between H and electronegative atom (F, O, N, Cl, S) ; can be intramolecular (A=T)
Physical Properties of Systems
1. Additive Property
2. Constitutive Property
3. Colligative Property
- depends on sum
- type and arrangement
- number of solute
| molecular weight
| optical rotation, refractive index
| VPL, BPE, FPD, OP
Density = mass per unit volume (M/V)
Specific gravity = density of sample/density of standard
Specific volume = reciprocal of specific gravity, opposite of density
COLLIGATIVE PROPERTIES – property of solution depend on the number of solute particles dissolved in a solvent
Colligative Property
Vapor Pressure Lowering
Notes



Boiling Point Elevation
The addition of a non-volatile solute lowers
the VP of a liquid
A liquid in a closed container will establish
an equilibrium with its vapor
When equilibrium is reached, vapor exerts a
pressure (vapor pressure)
VOLATILE – exhibits VP
NONVOLATILE – no measurable VP
BP – temp at which liquid pressure is equal to
atmospheric pressure (1 atm = 760 mmHg)
The boiling point of a solution containing a nonvolatile solute would be higher than the pure
solvent because the solute would lower the
vapour pressure of the solvent
Freezing Point Depression
FP – temp at which the solid and liquid phases
are in equilibrium under an external pressure
In general, solutions have a lower freezing point
than the pure solvent
Applications:
 Salt is spread on roads to melt ice
 Ethylene glycol as “anti-freeze”
Osmotic Pressure
Osmosis – movement of water across a
semipermeable membrane from low to high
concentration
This is the pressure required to offset the
movement of solvent thru a s. membrane
Also defined as the pressure required to prevent
osmosis in solutions.
Hypertonic – causes crenation
Hypotonic – causes swelling/lysis
Isotonic – 0.9% (w/v) NaCl
Formula
Raoult’s Law – lowering of a vapor
pressure of a solvent is equal to the
product of the mole fraction of the
solute and vapor pressure of the solvent
– 𝜟𝑷 = 𝑷° 𝒙 𝒎𝒐𝒍𝒆 𝒇𝒓𝒂𝒄𝒕𝒊𝒐𝒏
∆𝑇𝑏 = 𝐾𝑏 𝑚
∆𝑻𝒃 = 𝑲𝒃
𝟏𝟎𝟎𝟎 𝒘𝟐
𝒘𝟏 𝑴𝑾𝟐
Kb = ebullioscopic/molal BPE constant
(0.52 °C/m)
m = molality
w1 = weight of solvent
w2 = weight of solute
MW2 = molecular wt of solute
∆𝑇𝑓 = 𝐾𝑓 𝑚
∆𝑻𝒇 = 𝑲𝒇
𝟏𝟎𝟎𝟎 𝒘𝟐
𝒘𝟏 𝑴𝑾𝟐
Kf = cryoscopic/FPD constant
(Kf = 1.86°C/m)
𝝅𝑽 = 𝒏𝑹𝑻 𝑜𝑟
𝝅 = 𝑴𝑹𝑻
π = osmotic pressure in atm
V = volume in L
n = no of moles of solute
𝐿.𝑎𝑡𝑚
R = gas constant (0.08205 𝑚𝑜𝑙.𝐾)
T = absolute temperature
GAS LAW
Boyle's/Mariotte
Charles'
Gay-Lussac's
FORMULA
𝑷₁𝑽₁ = 𝑷₂𝑽₂
𝑽₁
𝑻₁
=
𝑽₂
𝑻₂
𝑷₁
𝑷₂
=
𝑻₁
𝑻₂
CONSTANT
𝟏
𝑜𝑟
𝑷 ∝𝑽
Temperature
𝑜𝑟
𝑽∝𝑻
Pressure
𝑜𝑟
𝑷∝𝑻
Volume
𝑷₁𝑽₁
𝑷₂𝑽₂
=
𝑻₁
𝑻₂
Combined
R = 0.08206
𝑷𝑽 = 𝒏𝑹𝑻
Ideal
(𝑷 +
𝒂𝒏𝟐
) (𝑽 − 𝒏𝒃) = 𝒏𝑹𝑻
𝒗𝟐
𝐿.𝑎𝑡𝑚
𝑚𝑜𝑙.𝐾
At STP:
T = 273.15 K
P = 1 atm
V = 22.4 L
Real/Van der Waals
an2 = internal pressure per mole
nb = incompressibility
Rauolt’s
Henry’s Law of Gas
Solubility
Dalton’s Law of Partial
Pressures
Avogadro’s
𝑷𝒔𝒐𝒍𝒖𝒕𝒊𝒐𝒏 = 𝑿𝒔𝒐𝒍𝒗𝒆𝒏𝒕 𝑷𝒔𝒐𝒍𝒗𝒆𝒏𝒕
X = mole fraction
𝑷𝒓𝒆𝒔𝒔𝒖𝒓𝒆 ∝ 𝑺𝒐𝒍𝒖𝒃𝒊𝒍𝒊𝒕𝒚
Total pressure in a mixture is equal to the sum of
the partial pressures of each gas
𝑃𝑡 = 𝑃1 + 𝑃2 + 𝑃3 … ….
Volume of gas at STP is directly proportional to the
number of moles
𝑽₁
𝑽₂
=
𝒏₁
𝒏₂
𝑜𝑟 𝑽 ∝ 𝒏 𝑜𝑟
𝑽
=𝒌
𝒏
Temperature
Temperature
k = 6.022 X 1023
Rate of diffusion and speed gas are inversely
proportional to the square root of their density
Graham’s
𝑅𝑎𝑡𝑒𝑑𝑖𝑓𝑓𝑢𝑠𝑖𝑜𝑛 ∝
1
√𝑑𝑒𝑛𝑠𝑖𝑡𝑦
Diffusion – gradual mixing of molecules of one gas with molecules of another gas by virtue of kinetic properties
Effusion – passage of a gas under pressure through a small opening
ACIDS AND BASES
Electrolytes – conductors
 Weak Electrolytes: incomplete dissolution
 Strong Electrolytes: strong acids and bases, complete dissolution
Non-Electrolytes – will not dissociate, will not conduct electricity
Acid-Base Theories
Theory
Arrhenius
Bronsted-Lowry Theory
Lewis Theory
Pearson’s HSAB
ACIDS







Acid
Base
+
Yields H or H3O
OH
Proton donor
Proton acceptor
E acceptor
E- donor
Hard acids are e- acceptor with high positive
charges and relatively small sizes while soft
acids have positive charges and relatively small
+
BASES






Sour taste
Litmus: blue to red
+ metals  H gas
+ carbonate and bicarbonate  CO2
Phenolphthalein: colorless
Methyl orange: pink/red
HCl, HClO3, HClO4, HBr, HI, HNO3, H2SO4, H3PO4
Bitter taste
Litmus: red to blue
Feel slippery
Phenolphthalein: Pink to violet
Methyl orange: Yellow
NaOH, KOH, Ca(OH)2
NEUTRALIZATION – Acid + Base  Salt and Water
Titration
– progressive addition of a sol’n of known concentration to a substance of unknown conc
Indicator
– Substance that changes color at the end point
Neutralization point (Stoichiometric point/Equivalence Point/Theoretical Point)
– point when equal amounts of acid and base have reacted; non-observable
Endpoint
– Experimental approximate of neutralization point; observable
pH – the negative logarithm of the H+ concentration
𝒑𝑯 = −𝒍𝒐𝒈 [𝑯+]
Sorensen’s pH scale
Neutral = 7
Acidic < 7
Basic > 7
𝐻𝐴 + 𝐻2 𝑂 ↔ 𝐻3 𝑂+ + 𝐴−
𝐵 + 𝐻2 𝑂 ↔ 𝑂𝐻 − + 𝐵𝐻 +
𝐻2 𝑂 + 𝐻2 𝑂 ↔ 𝐻3 𝑂+ + 𝑂𝐻 −
pH Calculations
Strong Acids
Strong Bases
For weak acids
For weak bases
Water Ionization
𝒑𝑯 = −𝒍𝒐𝒈 [𝑯+]
𝑝𝐻 = −𝑙𝑜𝑔 [𝑂𝐻 −]
or
𝒑𝑯 = 𝟏𝟒 − (−𝒍𝒐𝒈 [𝑶𝑯− ])
1
Weak Acids
𝑝𝐻 = 2 𝑝𝐾𝑎 − 𝑙𝑜𝑔𝐶𝑎
Weak Bases
𝑝𝐻 = 𝑝𝐾𝑤 − 𝑝𝐾𝑏 + 𝑙𝑜𝑔
𝑏𝑎𝑠𝑒
𝑠𝑎𝑙𝑡
or
1
𝑝𝐻 = 𝑝𝐾𝑤 − 2 (𝑝𝐾𝑏 − 𝑙𝑜𝑔𝐶𝑏)
BUFFERS
 Solutions that have the property of resisting changes in pH when acids or bases are added to them
 This property results from the presence of a buffer pair which consists of either:
- Weak acid and some salt of a weak acid or its conjugate base
- Weak base and some salt of a weak base or its conjugate acid
Henderson-Hasselbach Equation
𝑠𝑎𝑙𝑡
Weak acids
𝑝𝐻 = 𝑝𝐾𝑎 + 𝑙𝑜𝑔 𝑎𝑐𝑖𝑑
Weak bases
𝑝𝐻 = 𝑝𝐾𝑏 + 𝑙𝑜𝑔 𝑠𝑎𝑙𝑡
𝑏𝑎𝑠𝑒
Buffer Capacity (Buffer action/Buffer efficiency/Buffer index/Buffer value)
 Ability of a buffer solution to resist changes in pH
Approximate formula
[𝒔𝒂𝒍𝒕]+[𝒃𝒂𝒔𝒆]
𝒑𝑯 = 𝒑𝑲𝒂 + 𝒍𝒐𝒈 [𝒂𝒄𝒊𝒅]−[𝒃𝒂𝒔𝒆]
Exact formula/Koppel-Spiro Van Slyke’s Equation
𝑲𝒂 [𝑯𝟑 𝑶+]
+ 𝟐
𝒂 +[𝑯𝟑 𝑶 ])
𝜷 = 𝟐. 𝟑𝑪 (𝑲
Where C = total buffer concentration, that is, the sum of the molar concentrations of the acid and the salt.
Maximum Buffer Capacity
- occurs when pH = pKa
- 𝜷𝒎𝒂𝒙 = 𝟎. 𝟓𝟕𝟔 𝑪
THERMOCHEMISTRY
Heat (q)
- an energy transfer due to temperature difference
Work (w)
- form of energy transfer between a system and its surroundings in the form of
compression or expansion of gas
Internal Energy (U)
- total energy attributed to the particles of matter and their interactions within a system,
composed of thermal energy and chemical energy
Enthalpy (H)
- energy of a reaction
Entropy (S)
- degree of disorderliness
Heat Capacity (c)
- amount of heat required to raise the temperature of an object or substance by 1 degree
Specific Heat
- amount of heat required to raise the temperature of an object per gram
Chemical Reactions
1. Endothermic Process
2. Exothermic Process
Hesse’s Law – the total energy is the sum of all
energies in all steps of a reaction
- reaction wherein heat is absorbed by the system, indicated by a (+) change in enthalpy
- reaction wherein heat is released by the system, indicated by a (-) change in enthalpy
Spontaneous
Non-Spontaneous
Enthalpy
-H
+H
Entropy
+S
-S
Reaction
Exothermic
Endothermic
Le Chatelier’s Principle
 When a stress is applied to a system
in equilibrium, the equilibrium shifts
to relieve the stress
Laws of Thermodynamics
1. Law of Conservation of Energy, states that energy cannot be created or
destroyed; it can only be redistributed or changed from one form to another.
2. The second law of thermodynamics says that the entropy of any isolated
system not in thermal equilibrium almost always increases.
3. The third law of thermodynamics states that the entropy of a system
approaches a constant value as the temperature approaches zero.
GROUP IA: ALKALI METALS


Most reactive metals
Valence = 1
A. HYDROGEN (inflammable air)
o Lightest and most reactive element
o Isotopes:
a. Protium
- most abundant
b. Deuterium
- heavy hydrogen (D2O)
c. Tritium
- radioactive
Hardness of water
Temporary – Ca or Mg bicarbonates (removed by boiling/ addition of OH source)
Permanent – sulfates, chlorides, or hydroxides of Ca or Mg
Water
Purified Water
Water for Injection
SWFI
BWFI
- official solutions, tinctures and extracts
- extemporaneous compounding test reagents
- solvent for parenterals; must pass pyrogen test
- extemporaneous compounding of parenterals
- has one or more antimicrobial agents (e.g. Benzyl alcohol)
small volumes of IM injection, not for IV administration
B. LITHIUM (earth)
o Lightest metal
o Depressant and Diuretic (SE: hyponatremia)
1. Lithium Bromide
2. Lithium Carbonate (Lithase®, Eskalith®)
- Depressant
- DOC for mania
Lithium Toxicity (LMNOP)
 Lithium Side effects
 Movement (tremor)
 Nephrogenic diabetes insipidus (ADH antagonist  polyuria)
 Hypothyroidism
 Pregnancy problems (teratogenic)
IP3 – Inositol triphosphate (affected by Lithium)
Mania
1.
2.
3.
4.
5.
6.
7.
Distractability
Irresponsibility
Grandiosity
Flight of ideas
Increase in goal directed activity/ Psychomotor agitation
Decrease need for sleep
Talkativeness or pressured speech
C. SODIUM (natrium)
o Primary extracellular fluid cation
o Action: fluid retention
Acetate
Acetate of Soda
Diuretic, Urinary and systemic acidifier, Antacid
Bicarbonate
Soda Saleratus
Sal de Vichy
Soda acid Carbonate
Systemic antacid, Carbonating agent
SE: Alkalosis, Rebound hyperacidity, Edema
Fleet Enema
Cathartic, Source of P or phosphate,
Urinary acidifier(+ methenamine)  HCHO
(formaldehyde), NH3  urinary antiseptic
Dihydrogen Phosphate/
Biphosphate
NaH2PO4
Leucogen
Sodium Hydrogen Sulfite
Sodium Acid Sulfate
Washing Soda, Sal soda
Soda Ash
Monohydrate Na carbonate
Bisulfite
Carbonate
Chloride
Citrate
Rock/Table/Solar salt
Na3C6H5O7
Fluoride
Caustic soda, sosa, lye
Phosphite
Electrolyte replenisher, Tonicity adjuster,
Condiments, Preservative
Alkalizer, Buffer, Diuretic, Expectorant
Shorten the coagulation time (parenterally)
Saponifying agent (hard soap)
Reducing agent
Dakin’s solution
Chlorox
Hypochlorite
Iodide
All iodides are for cough
Lactate
Na3C3H5O3
Nitrite
NaNO2
Natrium, Nitrosum
Chile salt peter
Sulfate
Glauber’s salt
C4H4O6
Expectorant, Antifungal, Iodine solubilizer
Cyanide poisoning, Meat preservative
Cathartic
Primary standard for KFR (Karl Fischer Reagent)
Thiocyanate
Thiosulfate
Na2S2O3 • 5H2O
Oxidizing agent, bleaching agent
Disinfectant (Labarraque’s solution)
Antacid, Diuretic
Nitrate
Tartrate
Antacid, Carbonating agent
Anticariogenic (2% solution)
Hydroxide
nitrites,
nitrates,
thiosulfates,
thiocyanates
are
vasodilators
Anti-oxidant
Hypotensive agent (vasodilator)
Antichlor
Hypochlor
Cyanide poisoning with Na nitrite
VS in iodometry and permanganometry
D. POTASSIUM (kalium)
o Most abundant and predominant intracellular cation
o Deficiency: hypokalemia
Manifestation: muscle paralysis (Barker’s syndrome)
o Diuretic, Important in muscle contraction
Acetate
Bicarbonate
Bitartrate
Diuretic salts
Antacid, Diuretic, Urinary and systemic alkalizer
Potassium Acid Carbonate
Salaeratus
Cream of tartar
Creamor, Argol
Systemic antacid, carbonating agent,
bicarbonate source
Bromide
Carbonate
Depressant
Potash
Salt of peter
Perlash, Salt of Wormwood
Kalium Chloratum
Kali Chloridum
Citrate
Electrolyte replenisher (Note: SLOW push)
Diuretic, Expectorant, Diaphoretic
Caustic potash
Lye potash
Potassa
Saponifying agent (soft soap)
Kalium Jodatum
Expectorant, antifungal, iodine solubilizer
Nitrate
Saltpeter
Salitre, Niter
Salt prunelle
Diuretic, meat preservative
Permanganate
Mineral chameleon
Oxidizing agent, Antiseptic,
VS in permanganometry
Hydroxide
Iodide
Oxalic acid
removes
stains of
Antacid, carbonating agent, carbonate source
Oxidizing agent
Component in toothpaste, gargle & mouthwash
Chlorate
Chloride
Laxative
Dihydrogen
Phosphate
Na K Tartrate
Cathartic
Rochelle salt
Sal signette
Thiocyanate
Cathartic, sequestering agent
Hypotensive
K2Sx • K2S2O3
Sulfurated potash
Liver of sulfur
K arsenite
Fowler’s Solution
Antileukemic
Sb K Tartrate
Tartar emetic
Schistosomiasis
E. Ammonium (NH4)
o Hypothetical alkali metal
o Pcol action:
a. Diuretic
b. Buffer
c. Expectorant (like Iodide)
d. Anti-cariogenic (like Fluoride)
Ammonium Bromide
Household ammonia –
contains 10% NH4; is
known as 16° ammonia
Depressant/Sedative
(NH4)2CO3
Ammonium carbonate
Sal volatile
Hartshorn
Preston Salt
Baker's Ammonia
Ammonium Sesquicarbonate
Expectorant (ammonium)
Antacid (carbonate)
Basis of smelling salts (aromatic spirit of ammonia)
Aromatic NH4 Spirit
Spirit of Hartshorn
Spirit sal volatile
Respiratory stimulant
NH4Cl
Muriate of hartshorn
Ammonium Muriate
Sal Ammoniac
Salmiac
Expectorant, Diuretic, Urinary acidifier
CI: Impaired hepatic function
Treatment for Brominism
HgNH2Cl
Mercuric Ammonium Cl
Ammoniated mercury
White precipitate
NH4I
Ammonium Iodide
Source of iodide, expectorant, antifungal
NH4CH3COO
Ammonium acetate
Spirit of minderesus
Styptic
Strong Ammonia
Solution
Ammonia Hydroxide
Stronger Ammonia Water
Diluted Ammonia Solution
circulatory stimulant by inhalation
Ammoniacal AgNO3
Howe’s solution
F. CESIUM
o Catalyst in polymerization of resin forming material
Topical anti-infective
GROUP IB: COINAGE METAL – can occur in free metal state, Complexes/chelates
A. COPPER (Cuprum)
o Only reddish metal, 3rd most malleable, 3rd best conductor
o Protein precipitant, Enhances physiological utilization of iron
o Component of hemocyanin and cytochrome oxidase (Deficiency: Hypochromic anemia)
o Alloys: Brass (+ Zn), Bronze (+ Sn)
o Wilson’s disease | D-Penicillamine
CuSO4 • 5 H2O
*Cu3(AsO3)2 •
Cu(C2H3O2)2+
(Cu)3(C6H5O7)8
Blue vitriol
Blue stone
Caparrosa Azul
Piedra Lipiz
Paris green
Copper acetoarsenate
Component of Benedict’s, Barfoed’s, and Fehling’s
Antidote for P poisoning
Increase hematinic activity of Fe
Ingredient of Bordeux mixture  algaecide in pool
Insecticide (suicidal drug in the past)
Astringent in 8% concentration
B. SILVER (argentum, shining, bright)
o Oligodynamic property (germicidal action)
o Argyria | NSS or PNSS
Soluble
AgNO3
Ag(NH3)2NO3
Insoluble AgI
Ag proteinate
Lapiz infernulariz
Lunar caustic
Indelible ink
Caustic pencil, Azotas
Warts and Opthalmia neonatorum (1% drops) –
Crede’s prophylaxis
Howe’s solution
Dental protective, Desensitizing agent
Poisonous, Disinfectant
Antiseptic for eye (nlt 19 nmt 23%)
Ear and throat (nlt 7.5 nmt 8.5%)
General germicide
Mild (Argyrol)
Strong (Protargol)
Colloidal (Collargol)
Present: Erythromycin (for N. gonorrhea and Chlamydia
trachomatis – no. 1 cause of blindness)
C. GOLD (Aurum”, Shining dawn, King of all metals, Purple of Cassibis)
o Most malleable and ductile, Best conductor of electricity
o Dimercaprol
o Dissolved by:
Aqua regia (3 part HCl + 1 part HNO3)
Selenic acid
1. Aurothioglucose (IM)
2. Gold Na Thiomalate (IM)
3. Auranofin (PO)
- treatment of gout and R.A
- treatment of gout and R.A
- AE: glossitis
Gold preparations are used
as Disease Modifying AntiRheumatic Drugs
(DMARDs) for Rheumatoid
arthritis.
GROUP IIA: ALKALINE EARTH METALS
A. BERYLLIUM
o Never employed in medicine because it is the most toxic metal
B. MAGNESIUM
o Lightest of all structurally important metal
o 2nd most abundant intracellular cation
o Chlorophyll component
o Compound of Grignard’s reagent
o Natural Sources:
1. As silicates (talc, asbestos)
2. As CO3 (magnesite, dolomite)
3. As SO4 (kieserite)
o Pcol action:
1. Laxative (PO)
2. Depressant
3. Natural Ca-channel blocker (anticonvulsant – IM)
o Antidote: Ca gluconate
MgCO3
Magnesium carbonate
Magnesia
Antacid, Laxative
Mg(OH)2
Milk of magnesia
Magnesia magma
Antacid, Laxative
MgO
Calcined magnesia
Antacid, Laxative
Component of universal antidote
2MgO • 3SiO2
Mg trisilicate
Antacid (Adv: prolonged action)
MgSO4
Epsom salt
Bitter salt (Ref or
dissolve in cold water)
Cathartic (PO)
Anticonvulsant (IM)
Antidote for Ba and barbiturate toxicity
Mg3(C6H5O7)2
Lemonade purganti
Purgative lemon
Hydrated Mg Silicate
Talc
Soapstone
French chalk
Mg3(Si2O5)(OH)4
Asbestos
Filtering agent
Clarifying agent
Dusting powder
C. CALCIUM
o 2nd most abundant cation in extracellular fluid
o Vit. D is needed for its maximum absorption
Hyperpara  HyperCa Hypophos
o PTH controls Ca levels in the blood
o Pcol action:
1. Coagulation
2. Contraction
3. Release of neurotransmitter
4. Bones and teeth (98-99%)
o Deficiency states:
Osteoporosis (density) Osteomalacia (resorption) Rickets (mineralization) Hypocalcemia
CaBr2
CaCO3
CaCl2
Sedative/depressant
Precipitated Chalk
Carbonic Acid
Calcium Salt
Creta Praecipitata
Muriate of lime
Fosforo de Homberg
Ca gluconate
Antacid, Ingredient of toothpaste, dentrifices
Ca replenisher
Ca supplement and replenisher, Heart failure
Ca(OH)2
Slaked lime
Milk of lime
Calcium hydrate
Antacid, Saponifying agent
Ca(C3H5O3)2
Ca lactate
Ca supplement
CaHPO4 • 2H2O
Source of Ca and PO4
CaO
lime, quicklime, calx
Component of Bordeux mixture, Insecticide
Ca3(PO4)2
Bone ash
Antacid
CaClO
CaSO4 • ½ H2O
or 2 H2O
D. STRONTIUM
1. SrCl2
Chlorinated lime
Chloride of lime
Gypsum
Terra alba
Satin Spar
Alabaster Light
Disinfectant, Bleaching agent
Rodenticide, Prep of surgical casts and dental
impressions
Plaster of Paris – calcium sulfate hemihydrate
- Temperature desensitizing agent (Sensodyne®)
E. BARIUM (Heavy)
o Baritosis | Epsom salt
1. BaSO4
Ba meal, Esophotrast
2. Ba(OH)2
Baryte
- radiopaque for GIT imaging (non-toxic since not soluble)
- CO2 absorbent
F. RADIUM
o Radioactive element used for cancer radiotherapy & diagnostic purpose
GROUP IIB: VOLATILE METAL
A. ZINC
o
o
o
o
Present in inZulin and carbonic anhydraZe
Astringent, Antiseptic, Antiperspirant, Protectant
Parakeratosis
Metal Fume Fever | NaHCO3
Butter of Zinc
Burnette’s disinfectant
liquid
Zinc white
Lassar’s paste
Flores de Zinc
Lana o Algodon Flioficos
ZnCl2
ZnO
ZnO2
Disinfectant/antiseptic, Dentin desensitizer,
Corrosive
Escharotic, more caustic than astringent
Antiseptic, astringent, topical protectant
Antiseptic
ZnS
White lotion
White sulfide
Parasiticide, topical protectant, antiseptic
ZnSO4 • 7 H2O
White Vitriol
Emetic, ophthalmic astringent in 0.25% sol’n
Pharmaceutical necessity in white lotion
Hydrated Zn Silicate
Natural Calamine
Topical protectant
Zinc-Eugenol cement
Dental protective
B. CADMIUM
o Astringent, manufacture of stink bomb
o Itai-Itai | BAL
1. CdCl2
- emetic, treatment of Tinea infection
2. CdS (yellow sulfide) - anti-seborrheic
3. CdSO4
- ophthalmic antiseptic
C. MERCURY (Quicksilver, Messenger of the Gods)
o Diuretic, Antiseptic, Treatment of syphilis, Cathartic, Parasiticidal/fungicidal
o Thermometer, amalgams (dental cement)
o Minamata | EDTA
1.
2.
3.
4.
5.
6.
7.
Hg2Cl2
HgCl2
HgI
HgI2
K2HgI4
HgNH2Cl
HgO
Mercurous chloride (Calomel)
- cathartic, local antiseptic
Mercuric chloride (Corrosive sublimate) - disinfectant
- treatment of syphilis
- stimulant of indolent ulcers
Potassium Mercuric Iodide
- antiseptic, component of Mayer’s reagent
White precipitate
- topical antiseptic
Yellow Precipitate
- ophthalmic and anti-infective
GROUP IIIA
A. BORON
o Industrial use: In vulcanizing rubber
1. H3BO3 (Sal sativum, Boracic acid, Hydrogen borate, orthoboric acid)
 Lobster appearance
 1. Buffer (ophthalmic solution 2%)
2. Antiseptic
3. Tonicity adjusting agent (isotonic can still cause hemolysis)
2. Na2B4O7 • 10H2O (Borax, Na tetraborate, Dobell solution, Na pyroborate, Tinkal)
 Antiseptic, Eye wash, Wet dressing for wounds
B. ALUMINUM
o Most abundant metal
o 3rd most abundant element
o Astringent, Aluminum foils used for burn patients
AlCl3 • 6 H2O
Astringent, Antiseptic, Antiperspirant
AlNH4(SO4)2 •12H2O
AlK(SO4)2 •12H2O
Alum
Al(OH)3
Amphogel, Cremalin gel
AlPO4
Phosphagel
Al2(CO3)3
Alumina
Al2(SO4)3
Cake/Pickle/Pearl/Papermaker's Alum
Al Acetate
Burrow's Solution
Bentonite
Pumice
Antacid, Protectant
(D/A: Constipation and PO4 deficiency)
Antacid, astringent, demulcent
(A: doesn’t inferfere PO4 abs.)
Treatment of phosphatic calculi
Al2O3
Kaolin
Astringent, Antiperspirant
China clay
Native hydrated aluminum silicate
Soap clay, Mineral Soap
Native colloidal hydrated aluminum silicate
Pumice stone, Piedra Pomez
Treatment of silicosis
Adsorbent in diarrhea
Suspending agent
Dental abrasive
C. GALLIUM
o Pcol use: treatment of cancer-related hypercalcemia by binding with transferring
o Nonpharma: substitute for mercury in manufacture of arc lamps; Galvanized iron
GROUP IVA
A. CARBON
o Crystalline: Diamond (purest native form) and Graphite (lead pencil)
o Amorphous: Coal and Anthracite
1. CO2
- acne, warts, corns, calluses, eczema, persistent hiccups (most potent resp. stimulant)
2. CO3
- Antacid, pharmaceutical for effervescent tablet
3. CO
- 210x greater affinity to hemoglobin than oxygen leading to asphyxia then death
- Targets cytochrome oxidase
- Pathogonomic of CO poisoning: Cherry red color of blood and mucous membranes
Treatment:
1. 100% O2
2. Artificial air (He 80%, O2 20%)
3. Hyperbaric O2
B. SILICON
o 2nd most abundant element, Component of glass
1. SiO2
2. Glass
Sodium silicate, Na4SiO4
3. Purified Siliceous Earth
Silicates of:
4. Kaolin
Native hydrated aluminum silicate
5. Bentonite
Native colloidal hydrated aluminum silicate
Mg (talc, asb)
Al (k, b, p)
6. Talc
French Chalk, Piedra Grasa, Soapstone, Creta Gallica
Zn (calamine)
7. Attapulgite
Polymagma, Diatabs, Quintess
8. Simethicone
Polymeric dimethyl siloxane
9. Asbestos
C. TIN (Stannum)
1. SnF2
2. SnO2
- anticariogenic 8% solution
- germicide for Staph infection
- Toxicity: silicosis
- Na2CO3 + pure silica
- Adsorbent
- Adsorbent
- Suspending agent
- Clarifying, dusting
- Adsorbent
- Antiflatulent
I
II
III
NP
– borosilicate
– treated SL
– soda lime
– gen. SL
B
– coeff of expansion
– brown
– ↑refractive index
K
D. LEAD (Plumbum)
Pb
o Astringent, Protein Precipitant
o Plumbism | EDTA , Ca Versenate (adults) , Succimer (kids)
1. Pb(CH3COO)2
Sugar of Lead, Burrow’s sol’n
- astringent
2. Pb2(CH3COO)
Goulard’s extract
- astringent, antiseptic
3. PbO
Litharge®
- cans (toxic)
GROUP IVB
A. TITANIUM (Titan, Sons of the Earth)
o Powerful reducing agent
1. TiO2
- Opacifying agent (Ocusert®) and UV ray protectant
B. ZIRCONIUM
o antiperspirant but banned due to granuloma formation
Cyanide (CN) - MOA: inhibits cytochrome oxidase (ETC)
Source: cassava, Na nitroprusside
Treatment:
1. NaNO2/Amylnitrite MOA: methemoglobinemia
2. Sodium thiosulfate MOA: CN to thiocyanate
3. Methylene blue
MOA: methemoglobinemia
GROUP VA
A. NITROGEN (Mephitic air, azote, without life)
o Most abundant gas in air: 71% N2, 29% O2
N2
Azote
Cont: BLACK
N2O
Laughing Gas, Nitrogen monoxide,
Cont: BLUE
Dinitrogen monoxide
NO2
Nitrite
NO3
Nitrate
HNO3
Spirit of Nitre, Aqua Fortis/Fuerte/Eau Forte
B. PHOSPHORUS (light carrier, St. Elmo’s Fire)
o White/yellow (poisonous), Red (non-poisonous)
o CuSO4
1. PO4
- antacid, cathartic
2. H3PO4
(Orthophosphoric Acid)
3. HPH2O2
- antioxidant
INERT ATMOSPHERE
Liquid nitrogen – refrigerant
Inhalational anesthetic (general)
SE: diffusion hypoxia
Vasodilator, For CN poisoning
Preservative
Allotropes of P:
 Scarlet
 Violet
 Metallic/Black
 Red
- tribromide ∆240°C with Hg
- white ∆200°C with Na
- 530° with Pb
- white + chromic acid
C. ARSENIC (Lewisite Metal)
o Protoplasmic poison
o Insecticide: Copper Aceto Arsenate (Paris green)
o Mee’s Line | BAL (British Anti Lewisite)
o First anti-syphilis (Paul Ehrlich) – Arsphenamine/Salvarsan/Magic bullet/Compound 606
1. As2O3
2. AsI3
3. K arsenite
D. ANTIMONY
1. Na stibogluconate
2. SbKOC4H4O6
Fowler’s solution
- Insecticide, Anti-leukemic
- Primary standard in the preparation of cerric sulfate
- antileukemic
Tartar emetic, Brown mixture
- Leishmaniasis
- Schistosomiasis; emetic
E. BISMUTH (Beautiful Meadow)
o Astringent, Antiseptic, Internal protective for ulcer, Used in silvering of mirror
o Dark stool, Blue-black gums | Dimercaprol
1. Bi Subcarbonate, Subgallate, Subnitrate
2. Milk of Bi (Bismuth Cream) Bi subnitrate + Bi OH
- Antacid, Astringent, Antiseptic
- Antacid, Internal protective, Inhibits H. pylori
GROUP VB
A. TANTALUM
o Not affected by any body fluid, Sheet form used in repair of bones, nerve and tissue
GROUP VIA: CHALCOGENS
A. OXYGEN (Empyreal air, Dephlogisticated air, Yne, Aire Vital, Fire Air, Aire Puro)
o Most abundant element, discovered by Scheele
o Uses:
Oxygen Requirement:
1. Treatment of hypoxia/asphyxia
1. Anoxic
- inadequate O2 tension in air
2. Oxidative metabolism for the production of energy
2. Anemic
- lack of O2 carrier in heme
3. Final e- acceptor in ETC
3. Stagnant
- blood circulation is retarded
o Container: GREEN
4. Histotoxic - cell defect interference of
cell metabolism
Carbon Dioxide (Carbonic Acid Gas, Carbonic Anhydride)
 Container: GRAY
 Solid Carbon Dioxide or “Dry Ice” - refrigerant
B. SULFUR (Brimstone, Shubari, Enemy of Copper)
o Antifungal, Parasiticide, Scabicide, Depilatory agent
H2SO4
Oil of Vitriol
Vitrilic Acid
Aceitede de Vitriolo
Dehydrating agent in Pyroxylin
Nordhausen acid – Fuming
H2SO4
Sulfur Dioxide
Sulfurous Anhydride
Antioxidant
Sublimed Sulfur (condensed sulfur vapors)
Flower of Sulfur
Asufre, Rhombic S
Cathartic
+ Lime  Vleminckx’s solution
Precipitated Sulfur (sulfur + metal hydroxides)
Milk of Sulfur
Prepared by mixing
Sulfurated Potash (K polysulfides + K thiosulfate)
Liver of Sulfur
Psoriasis, Parasiticide
White lotion (ZnS)
C. SELENIUM (Selena, Moon)
- Promotes Vit. E absorption, Antioxidant (SeS2 /Selsun blue – anti-dandruff)
GROUP VIB
A. CHROMIUM (Glucose tolerance factor)
B. MOLYBDENUM
C. URANIUM
- hyperglycemia
(K2Cr2O7- powerful oxidizing agent)
- Co-factor enzyme
(Molybdenum Oxide + FeSO4 – hematinic)
- Becquerel, Atomic bombs
GROUP VIIA: HALOGENS (Salt-forming group)
A. FLUORINE
o Strongest oxidizing agent
o Fluorosis (Mottled enamel, Abnormal bone growth)
1.
2.
3.
4.
NaF
SnF2
Na2FPO3
CCl2F2
- anticariogenic at 2% solution
- anticariogenic at 8% solution
- anticariogenic
- refrigerant, aerosol propellant (Freon®)
B. CHLORINE (Dephlogisticated muriatic acid)
o Most abundant extracellular anion, green gas
o Used as water disinfectant
1. Hypochlorite (Na, K) - bleaching agent
2. HCl (Muriatic acid, Spirit of Sea Salt, Marine Acid, Espiritu de Sal Marine) - treatment of achlorhydria
C. BROMINE
o Dark reddish brown fuming liquid with suffocating odor
o Sedative/depressant
o Brominism (Skin eruption, Psychosis, Weakness, Headache) | NaCl and NH4Cl
D. IODINE
o
o
o
o
o
Oldest known germicide
Expectorant, Antifungal
Preparation of T3 and T4
Deficiency: Goiter
Elemental Iodine preparation:
1. Strong Iodine Solution (Lugol’s Solution)
2. Iodine Solution
3. Iodine Tincture
4. Povidone-Iodine (Betadine®)
E. ASTATINE
o Only metallic
o Only synthetic halogen
o Only radioactive halogen
- 5%
- 2%
- 2% with 50% alcohol
- PVP (nonionic surfactant)
GROUP VIIB
A. MANGANESE
o Co-factor in:
1. Protein synthesis
2. Phosphorylation
3. Fatty acid and cholesterol synthesis
o Poisoning: Parkinson-like symptoms (resting tremors)
1. KMnO4 (Mineral Chameleon)
- oxidizing agent, antiseptic
B. TECHNETIUM (Technetos)
o 1st element produced artificially
o Used in preparation of radiopharmaceuticals
RADIOPHARMACEUTICALS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Tc99m-Phytate
Tc99m-heptagluconate
Tc99m-IDA
Tc99m-Etidronate
I-131-Human Serum Albumin
NaI-125
Sodium Phosphate Serum
Sodium Chromate Cr 51
Gold Au 198
Chlormerodin Hg 197/203
Liver imaging & potency studies
Kidney imaging, determine renal function
Hepatobiliary studies
Bone imaging
Blood plasma volume/cardiac output determination
Thyroid function
Localization of ocular tumors, polycythemia vera
RBC mass, volume, survival time, scanning of spleen
Scintillation scanning of the liver
Scintillation scanning of the kidneys or the brain
1
Alpha particles (a 42He )
 heaviest and slowest of all radioactive emissions (0.1 the speed of light)
 penetrating power is very low and can be stopped by a sheet of paper or a very thin sheet of Al
 usually emitted only from elements having atomic numbers greater than 82
2
Beta particles (B or B )
 negatively charged species having a mass of an electron
 move at a faster velocity (0.9 the speed of light)
 their emissions from elements do not alter the mass number but do alter the atomic number
 more penetrating power and able to travel 10 to 15 cm in water or penetrate almost 1 inch thickness of Al
 sometimes called negatrons
 emitted by unstable nuclei having neutrons in excess of protons
3
Gamma Radiation (t)
 photon of electromagnetic radiation
 demonstrates both wave and particle properties as do electrons and beta particles
 short wavelength similar to x-rays and travel at the speed of light
 no mass and no charge
 excellent penetrating power (very thick lead is required to protect against it)
2+
+
GROUP VIIIA: NOBLE GASES
A. HELIUM
o 2nd lightest gas
o Donald-duck-like sound
o Use:
1. Carrier/diluents of medically important gases
2. Component of artificial gas
o Container: BROWN
B. NEON
o For advertising
C. ARGON
o Most Abundant noble gas
o Substitute for N2 in providing inert atmosphere; Container: RED (Argon methane)
o By-product of fractionalization of liquid air
D. KRYPTON
o Least abundant of all noble gases
o Have inhalational anesthetic activity
E. XENON
o Investigational with inhalatory anesthetic activity
F. RADON (Niton)
o Synthetic noble gas
o Used for treatment of CA (cervical CA)
GROUP VIIIB
A. IRON
o
o
o
o
o
o
Present in proteins:
1. Hemoglobin
2. Transferrin
3. Ferritin – storage form of iron
4. Cytochrome oxidase
Enhance absorption of
1. Vit C
2. Copper
Most important element in engineering
Use: hematinic
Toxicity:
1. GIT distress
2. Cardiac collapse
Antidote: Dexferroxamine
1.
2.
3.
4.
5.
6.
7.
8.
Metals present in
cytochrome oxidase:
1. Fe
2. Cu
Iron toxicity: Hemochromatosis/Hemosiderosis
(Prussian blue stain of the heart)
FeSO4 (Iron Sulfate, Copperas, Green Vitriol, Iron Vitriol)
Ferrous gluconate
Ferrous fumarate
FeCO3 (Chalybeate pills, Ferruginous pills)
FeCl3
Basham’s Mixture (Iron + NH4 acetate)
Fe4*Fe(CN)6+3 (Ferriferrocyanide or Prussian blue)
Fe3*Fe(CN)6+2 (Ferroferricyanide or Turnbull’s blue)
B. COBALT
o Essential in development of erythrocyte and hemoglobin
o Component of Vit. B12 (cyanocobalamin)
o Deficiency: Megaloblastic anemia and Pernicious anemia
1. CoCl2
2. Cobalt zincate
3. Cobalt meta-aluminate
Lover’s ink, sympathetic ink
Rinmann’s Green
Thenard’s blue
- Hematinic, SE: constipation, tarry stool
- Fergon®, Advantage: less irritating
- Toleron®
- Hematinic
- Astringent, Styptic, tannin detection
- Astringent, Styptic
Schilling’s test
- dessicator indicator
- test for Zn ion
- test for Al ion
C. NICKEL (Old nick’s copper)
o Fossil fuel, fancy jewelries
D. OSMIUM
o Heaviest/densest metal
1. Osmic acid and Osmium tetroxide
Both used in staining microorganism for microscopic study especially electron microscopy.
E. PLATINUM
F. PALLADIUM
- Catalyst in finely divided steel
- Catalyst in finely divided steel
BUFFERS
o
o
pair or related chemical compounds capable of resisting large change in the pH of a solution
composed of a weak acid & its salt (conjugate base) or a weak base & its salt (conjugate acid)
Phosphate Buffer System
 𝐷𝑖𝑕𝑦𝑑𝑟𝑜𝑔𝑒𝑛 + 𝑚𝑜𝑛𝑜𝑕𝑦𝑑𝑟𝑜𝑔𝑒𝑛 𝑝𝑕𝑜𝑠𝑝𝑕𝑎𝑡𝑒
 D/A; insolubility of the phosphate salts of metals such as Ag, Zn, and Al and phosphate salt of growth
 Sorensen Phosphate buffer system – for ophthalmic (isotonic with body fluids)
Borate Buffer System
 used in preparations containing metals that would otherwise precipitate in the presence of phosphate
 CI in parenterals bec of toxicity of borates
3 Primary Borate Buffer System presently recognized:
1 Feldman’s Buffer System (pH 7-8.2)
- boric acid + NaCl, sodium borate
2 Gifford Buffer System (6-7.8)
- boric acid + KCl, sodium borate
3 Atkins and Pantin Buffer System (7.6-11)
- boric acid + NaCl, sodium carbonate
__________________________________________________________________________________________________
(a) Intracellular fluid (K, Mg, PO4)
(b) Extracellular fluid: (Na, Cl)
 interstitial fluid
 plasma and vascular fluid
__________________________________________________________________________________________________
Buffer systems that the body utilize:
1. Bicarbonate/Carbonic Acid (HCO3-/H2Co3)
- plasma and kidneys
22. Monohydrogen phosphate (HPO4 /H2PO4 ) - cells and kidneys
3. Hemoglobin and proteins
- red blood cells
Acidosis – below 7.38
Alkalosis – above 7.42
COMPENSATORY MECHANISM OF THE BODY
Conditions
Causes
Buffer System
Metabolic Acidosis
HCO3 deficit (diabetic acidosis, diarrhea, renal failure)
HCO3-/H2Co3
Metabolic Alkalosis
HCO3 excess (administration of excess alkali, vomiting)
HCO3-/H2Co3
Respiratory Acidosis
H2Co3 excess (cardiac disease, lung damage, drowing)
Hemoglobin and protein
Respiratory Alkalosis
H2CO3 deficit (fever, anoxia, hysteria, salicylate poisoning)
HCO3-/H2Co3
Metabolic acidosis – treated with the sodium salts of bicarbonate, lactate, acetate, and citrate
Metabolic alkalosis – treated with ammonium salts (action is in the kidneys where it retards the Na-hydrogen exchange)
Electrolyte Combination Therapy
1. Fluid Maintenance
 to supply normal regrement for water and electrolytes to those who cannot take them orally
 should contain at least 5% dextrose to minimize the build-up of metabolites associated with starvation
(urea, phosphate and ketone bodies)
 general electrolyte composition: Na, Cl, HCO3, Mg & P ions
2. Electrolyte Replacement
 needed when there is a heavy loss of water and electrolyte
Official Combination Electrolyte Infusions
Ringer’s Injection
Lactated Ringer’s Injection
Oral electrolyte solutions
– 8.6 g NaCl, 0.3 g KCl and 0.33 g Ca Chloride per liter
– 600 mg NaCl, 30 mg KCl & 20 mg Ca and 310 mg Na lactate per 100 ml
– to supply water and electrolyte in amount needed for maintenance
– given to replace mild to moderate fluid loss
__________________________________________________________________________________________________
ESSENTIAL AND TRACE IONS
Essential – not synthesized by the body and must be included in the diet
Trace – required for normal functioning but does not need to be included in the diet
Ions
Iron (Fe or Fe3+)
Principal Metabolic Functions
Constituent of hemoglobin
Iodine (I-)
Constituent of thyroxin and triiodothyronine
Cobalt (Co2+)
Constituent of Vit. B12 (cyanocobalamin)
Zinc (Zn2+)
Constituent of insulin and carbonic anhydrase
2+
Copper (Cu2+)
Sulfur (S2-)
Formation of hemoglobin (increases iron utilization)
Constituent of oxidase enzymes
Constituent of proteins mucopolsaccharides,
heparin, biotin, detoxication
Clinical Manifestations of Deficiency
Anemia
Endemic (simple) goiter
Cretinism
Deficiency of Vit. B12
Pernicious anemia
Polycythemia
Anemia
Stunted growth
Hypogonadism
Hypochromic anemia
Wilson’s disease
Cystinuria
Cystine renal calculi
Iron – electron carrier in respiration chain; responsible for transport of molecular oxygen
Body Components Containing Iron
Occurrence
Iron bound as
Blood System
1 hemoglobin
2 plasma
Tissues
1 Functional Iron (myoglobin, cell hemes
2 Storage Iron
Mode of Linkage
Heme
Transferrin
Heme
a. ferritin
b. hemosiderin
Functions
Oxygen Transport
Iron Transport
Cell respiration
Iron pool detoxication
GASTROINTESTINAL AGENTS
Inorganic agents used to treat gastrointestinal disorders include:
1 antacids - products for altering gastric pH
2 protectives for intestinal inflammation
3 adsorbents for intestinal toxins
4 cathartics or laxatives for constipation
Stomach pH: 1 when empty to 7 when food is present
Gastritis – specified circumscribed erosion
Peptic ulcer or Esophageal ulcer (heartburn) occurs when the esophageal sphincter is defective due to gastric food entering the
esophagus during a belch or upon lying in bed; emotional makeup is also a factor. Malignancy and hemorrhage are common with
gastric ulcers. Perforation is more common with duodenal ulcers.
Antacids - alkaline bases used to neutralize the excess gastric HCl associated with gastritis and peptic ulcers
a.
b.
c.
d.
e.
f.
should not be absorbable or cause systemic alkalosis
should not be a laxative or cause constipation
should exert the effect rapidly and over a long period of time
reaction with gastric HCl should not cause a large evolution of gas
should buffer in the pH 4-6 range
should probably inhibit pepsin
COMBINATION ANTACID PREPARATIONS
a. Aluminum Hydroxide Gel-Magnesium Hydroxide (Aludrox, Wingel, Maalox, Creamalin)
b. Aluminum Hydroxide Gel-Magnesium Trisilicate (Gelusil, Tricreamalate, Triosgel)
c. Magaldrate – Aluminum Hydroxide & Magnesium Hydroxide (Riopan)
d. Simethicone-Containing Antacids (Di-gel, Mylanta, Kremil-S) – simethicone - defoaming agent
e. Aliginic Acid-Sodium Bicarbonate-Containing Antacids (Gaviscon, Fomtab)
PROTECTIVES AND ADSORBENTS – mild diarrhea
Diarrhea - when some factor impairs digestion and/or adsoprtion, thereby increasing bulk of intestinal tract
Acute Diarrhea - caused by bacterial toxins, chemical poisons, drugs, allergy and disease
Chronic Diarrhea - from GI surgery, carcinomas, chronic inflammatory conditions & various adsorptive defects).
BISMUTH-CONTAINING PRODUCTS
 intestinal hydrogen sulfate acts upon bismuth salts to form bismuth sulfate (result: black stools)
SALINE CATHARTICS (purgatives)
o Laxatives – mild cathartics, prolonged use causes “Laxative habit”
1. Stimulant Laxatives
– act by local irritation
2. Bulk-forming Laxatives – from cellulose and other non-digestible polysaccharides which swell when wet
3. Emollient Laxatives
– lubricants or stool softeners (e.g. Mineral Oil)
4. Saline Cathartics
– increase osmotic load of GI tract
NON-OFFICIAL SALINE CATHARTICS
Sodium Sulfate (Glauber's Salt)
Potassium Phosphate (Dibasic Potassium Phosphate, Dipotassium Hydrogen Phosphate, DKP)
Potassium Bitartrate (Cream of Tartar, Potassium Acid Tartrate, Potassium Hydrogen Tartrate)
Calomel (Mercurous Chloride, Mild Mercury Chloride)
FLAME TEST
METALS
Non-luminous flame
Under cobalt glass
Sodium
persistent golden yellow
nil
Potassium
violet
crimson
Lithium
carmine red
purple
Calcium
brick red
light green
Strontium
crimson
purple
Barium
yellowish green
bluish-green
Borate, Cu, Tl, P
green
Pb, As, Sb, Bi, Cu
blue
Ammonium
colorless
yellow
GROUPS OF ANION
Group No. - Member
Precipitate Formed and Visual Result
with 1 M AgNO3 + 6 M HNO3
with 1 M BaCl2 + HNO3
I – Cl, Br I
AgCl *white+
AgBr *cream+
AgI *yellow+
insoluble in HNO3
No ppt
II – NO2-, S-2, C2H3O4- (acetate)
AgS *black+
soluble in HNO3, NO2 and C2H3O2 *no ppt+
No ppt
III – SO3, CO3-2, C2O4-2
White ppt soluble in HNO3
White ppt of BaSO4, CaSO4, BaC2O4
soluble in HNO3
IV – PO3-3, AsO4-3, CrO4-2
Ag3PO4 *yellow+
Ag3AsO4 *brown+
Ag2CrO4 *red+
all ppt soluble in HNO3
BaCrO4
*yellow+
Ba3(AsO4)2 *white+
all ppt soluble in HNO3
V – NO3-, ClO-
No ppt
No ppt
VI – SO4 -2
No ppt
White ppt soluble in HNO3
GROUPS OF CATION
GROUP OF CATION
I (Insoluble chloride)
CATION
Pb+2
Hg+2
COLOR OF
PPT
White
White
Ag+2
White
Hg+
Bi+3
Cu+2
Black
Brown
Black
Cd+2
As+3
As+5
Sb+
Yellow
Yellow
Yellow
Orange
Sn
Yellow
Fe
Al
Cr
Ni
Co
Mn
Zn
Brown
White
Gray green
Black
Black
Pink
white
IV (Sulfate insoluble groups)
Ba
Ca
Sr
White
White
White
V (Soluble group/Alkali
metals)
Mg
Na
K
NH4
II (Acid insoluble sulfide)
A. Insoluble in acid and
base
B. Insoluble in acid
III (Base insoluble sulfides)
ADD’TL
Yellow ppt with K2Cr2O7
Black ppt with NH3
Mercuric ion:
Yellow ppt with NaOH
Scarlet ppt with excess KI
White ppt with HNO3, soluble in
NH4OH
Reddish brown ppt with K ferroCN
Blue in solution
In the presence of HCl, gives a violet
ppt with rhodamine B (a pink dye)
(+) Thenard’s blue
Green in solution
(+) Vogel test
(+) Rinmann’s Green
Yellow ppt with cobalt uranyl acetate
White ppt with Na bitartrate
Alkalinized vapour turns red litmus paper to blue
Brown ppt with Nessler’s reagent
METAL OR ANION
Acetate (CH3COO- or
C2H3O2-)
Aluminum (Al)
Ammonium
thiocyanate (NH4SCN)
Arsenate (AsO43-)
Arsenites (AsO33-)
Borates (BO33-)
Bromine (Br)
Carbonate (CO32-)
Chloride (Cl)
Citrate (C6H5O73-)
Chromium
Cobalt
Copper
Iodide
Nickel
Phosphate (PO43-)
Potassium (K)
Saccharin
Salicylate
Silver (Ag)
Tartrate
Thiosulfate (S2O32-)
Zinc
H2SO4 + Ethanol (CH3C2OH)
COLOR REACTIONS
 fruity odor (ethyl acetate)
+ Ammonium TS
 gelatinous ppt that dissolves in excess Ammonium TS
+ Aluminon reagent
red lake
+ cobalt solution (acidic)
intense blue colored complex at interface
+ Ferric salts
blood red Fe(SCN)3 (ferric thiocyanate)
+ Silver nitrate TS
chocolate brown soluble in HNO3
+ Ammonium molybdate test
yellow ppt
+ Silver nitrate TS
yellow ppt soluble in HNO3
+ Magnesia mixture
differentiating test for arsenates & arsenites
+ H2SO4 + methanol (CH3OH)
green bordered flame
+ Turmeric paper
orange +NaOH  olive green
+ CCl4 (carbon tetrachloride)
Orange color
+ acidic aqueous solution
effervescence
+ Phenolphthalein
red
+ AgNO3
white curdy ppt, soluble in NH3, insol in HNO3
+pyridine + acetic anhydride
carmine red
(3:1)/Denige’s reagent
*Denige’s test is the differentiating test between citrates and tartrates
+ NaOH
grayish green slug, which dissolves with excess reagent
+ NaOH
blue ppt of Co(OH)2 (boiling) olive green rose green
+ potassium nitrate (KNO2) + acetic acid yellow ppt
+ α-nitro-β-naphthol
brown ppt soluble in HCl
+ Fe + HCl
deposit of red film on iron
+ potassium ferrocyanide
green ppt forming a blue solution with ammonia
+ Chlorine water or KMnO4 solution
violet color
+ H2SO4 + sodium bisulfite(cold)
decolorized
+ H2SO4 + oxalic acid (hot)
decolorized
+ dimethylglyoxime
bright red crystalline ppt insoluble in NH3
+ α-nitro-β-naphthol
reddish brown ppt soluble in HCl
+ Silver nitrate
yellow ppt
+ Ammonium molybdate
yellow ppt in HNO3 and NH3
+ Tartaric acid
white crystals of potassium bitartrate insoluble in
ethanol and glacial acetic acid but soluble in NaOH
*Potassium bitartrate is the only insoluble compound of potassium
Fluorescin test: Resorcinol + H2SO4 +
fluorescent green liquid
excess NaOH
+ Ferric chloride (FeCl3)
violet color
+ Acids
white ppt of salicylic acid
+ HCl
white curdy ppt insoluble in HNO3 but soluble in NH3
+ Pyridine + acetic anhydride (3:1)
emerald green
+ HCl
white ppt turning yellow
+ FeCl3
dark violet which quickly disappears
H2S
white ppt of ZnS (only white sulfide)
COMMON NAMES
CHEMICAL NAME
FORMULA
Alcohol, grain
ethyl alcohol or ethanol
C2H5OH
Alcohol, wood
methyl alcohol or methanol
CH3OH
Alum
potassium aluminum sulfate
K2SO4 · Al(SO4)3 · 24H2O
Ammonia water
ammonium hydroxide solution
NH4OH
Agua Fortis
concentrated nitric acid
HNO3
Agua Regia
conc. nitric acid and conc. hydrochloric acid
HNO3 / 3HCl
Baking soda
sodium bicarbonate
NaHCO3
Baryte
barium hydroxide
Ba(OH)2
Bauxite
impure aluminum oxide
Al2O3
Benzol
benzene
C6H6
Bleaching powder
calcium oxychloride or chloride of lime
CaOCl2
Blue vitriol
copper sulfate
CuSO4 · 5 H2O
Borax
sodium tetraborate
Na2B4O7 · 10 H2O
Brimstone
sulfur
S
Brine
sodium chloride solution
NaCl
Calomel
mercurous chloride
Hg2Cl2
Cane sugar
sucrose
C12H22O11
Carbolic acid
phenol
C6H5OH
Carbona
carbon tetrachloride
CCl4
Carborundum
silicon carbide
SiC
Caustic potash
potassium hydroxide
KOH
Chalk
calcium carbonate
CaCO3
Chile saltpeter
sodium nitrate
NaNO3
Chloroform
trichloromethane
CHCl3
Cinnabar
impure merciruc sulfide
HgS
Corrosive sublimate
mercuric chloride
HgCl2
Cream of tartar
potassium bitartrate
KHC4H4O6
Cryolite
sodium aluminum fluoride
Na3AlF6
Deuterium oxide
heavy water
D2O
Dry ice
solid carbon dioxide
CO2
Epsom salts
magnesium sulfate
MgSO4 · 7 H2O
Flourspar
calcium fluoride
CaF2
COMMON NAMES
CHEMICAL NAME
FORMULA
Galena
lead sulfide
PbS
Glauber's salt
sodium sulfate decahydrate
Na2SO4 · 10 H2O
Gypsum
dihydrated calcium sulfate
CaSO4 · 2 H2O
Hematite
ferric oxide
Fe2O3
Iodoform
triiodomethane
CHI3
Laughing gas
nitrous oxide
N2O
Limestone
calcium carbonate
CaCO3
Limewater
calcium hydroxide solution
Ca(OH)2
Litharge
lead oxide
PbO
Lunar caustic
silver nitrate
AgNO3
Lye
sodium hydroxide
NaOH
Marsh gas
methane
CH4
Milk of Magnesia
magnesium hydroxide
Mg(OH)2
Muriatic acid
hydrochloric acid
HCl
Nitroglycerine
glyceryl nitrate or glyceryl trinitrate
C3H5(NO3)3
Oil of vitriol
conc. sulfuric acid
H2SO4
Phosgene
carbonyl chloride
COCl2
Plaster of Paris
hydrated calcium sulfate
(CaSO4)2 · H2O
Prussian blue
ferric ferrocyanide
Fe4*Fe(CN)6+3
Prussic acid
hydrocyanic acid
HCN
Pyrite
iron sulfide
FeS2
Quicklime
calcium oxide
CaO
Quicksilver
mercury
Hg
Rochelle salt
sodium potassium tartrate
NaKC4H4O6
Sal ammoniac
ammonium chloride
NH4Cl
Salt (table)
sodium chloride
NaCl
Saltpeter
potassium nitrate
KNO3
Sand
silicon dioxide
SiO2
Slaked lime
calcium hydroxide
Ca(OH)2
Turnbull's blue
ferrous ferricyanide
Fe3*Fe(CN)6+2
Vinegar
dilute acetic acid
CH3COOH
Washing soda (sal soda)
sodium carbonate
Na2CO3 · 10 H2O
Water glass
sodium silicate
Na2SiO3
Zinc blende
impure zinc sulfide
ZnS
o
ORGANIC CHEMISTRY
branch of chemistry that deals with carbon-containing compounds with: H, O, P, N, S, X
Organic Compounds
Simple Hydrocarbons
Aliphatic
Alkanes
Alkenes
Aromatic
Hydrocarbon Derivatives
Alicyclic/
Carbocyclic
X
N
RX
ArX
Amines
O
S
ROH
1° RNH2
1° RCH2OH
2° R2NH
2° R2CHOH
3° R3N
3° R3COH
RSH
RSR
4° R4N+
ArOH
Alkynes
ROCNH2
ROR
RCHO
RCOR
RCOOH
RCOOR
RCONH2
RCOOOCR
Acid/Acyl
Chloride
ArSH
Carbon
 Contains 4 binding sites for other atoms to attach to it
 These four binding sites, when bonded with other atoms/molecules form a tetrahedron
 Group 4, Period 2
 Atomic No. 6
o 1s2 2s2 2p2
o Needs 4 more electrons to complete its octet
o Valence: 4
o Can only share: covalence
SYSTEMS OF NOMENCLATURE
1. Common
 Uses the name given when it was discovered
 Formic acid – ants
 Butyric acid – butter
 Prefixes: n-, iso-, neo2.
Derived
 Derived from parent compound
3.
IUPAC

Most systematic
No. of C atoms
1
2
3
4
5
Prefix
Meth
Eth
Prop
But
Pent
No. of C atoms
6
7
8
9
10
Prefix
Hex
Hept
Oct
Non
Undec
ORGANIC MEDICINAL CHEMISTRY
•
•
deals with the physicochemical properties of drugs that affect its biological action
the practice of medicinal chemistry is devoted to the discovery and development of new drugs
ANTI-INFECTIVE AGENTS
•
•
•
•
Joseph Lister
– introduced phenol (carbolic acid)
Paul Ehrlich
– Salvarsan (compound 606), Selective toxicity
Atoxyl (sodium arsanilate and arsphenamine) – for sleeping sickness
Germicides
– anti-infective agents that are used locally
Antisepsis
Decontamination
Disinfection
Sanitation
Sterilization
Pasteurization
• Apply to living tissue
• Destruction or marked reduction in the number or activity of microorganisms
• On inanimate objects
• Reduction to a level acceptable for public health
• Kills all types including spores
• Nonsporulating microorganisms (65:-100:C)
LOCAL ANTI-INFECTIVES OR GERMICIDES
ALCOHOLS AND RELATED COMPOUNDS
o
o
o
activity ↑ with MW until C8 (octanol), Branching ↓ antibacterial potency
As primary alcohol chain ↑, Van der Waals interactions ↑, ability to penetrate microbial membranes ↑
As water solubility ↓, potency ↓ with MW
1. Alcohol, USP (Spiritus vini rectificatus, wine spirit, Grain alcohol)
 Fermentation product from grain and many other carbs, or sulfuric-acid-catalyzed hydration of ethylene
 Most widely abused of all recreational drugs
 Commercial: 95% ethanol (forms an azeotrope in water that distills at 78.2:C)
 Antidote: disulfiram blocks aldehyde dehydrogenase  acetaldehyde (nausea, vomiting, flushing)
Denatured
Rubbing (70%)
Dehydrated/Absolute
Isopropyl
- Completely denatured alcohol contains added methanol (wood alcohol) and benzene
- Astringent, rubefacient, refrigerant, mild local anesthetic
- nlt 99% ethanol; obtained by azeotropic distillation
- Rapidly bactericidal (50% to 95%), 40% equal antiseptic power to a 60% ethanol
2. Ethylene Oxide
 Used to sterilize temp-sensitive medical equipment and those that could not be autoclaved
 Carboxide – 10% ethylene oxide + 90% CO2 (to prevent explosion)
 MOA : alkylation of functional groups in nucleic acids and proteins
3. Formaldehyde Solution (Formalin)
 nlt 37% of formaldehyde + methanol (retard polymerization to formic acid and paraformaldehyde)
 MOA : direct, nonspecific alkylation of nucleophilic functional groups
4. Glutarol/Glutaraldehyde (Cidex)
 components: glutaraldehyde and buffer
PHENOLS AND THEIR DERIVATIVES (standard for germicides)
o
o
o
phenol coefficient – ratio of a dilution of a given test disinfectant to the solution of phenol that is required to kill a
strain of S.typhi under carefully controlled time and temperature
straight-chain and substitution with alkyl, aryl, and halogen ↑ bactericidal activity
low concentrations : denature bacterial proteins, high concentrations : lysis of cell membranes
1. Phenol (carbolic acid)
 Introduced as surgical antiseptic by Joseph Lister; its use is now obsolete
 Exhibits germicidal activity (general protoplasmic poison), caustic, local anesthetic
Liquefied Phenol
Phenol with 10% water
p-Chlorophenol
used in combination with camphor in liquid petrolatum
p-Chloro-m-xylenol
2% (shampoo), for athlete’s foot and jock itch
Hexachlorophene
easily adsorbed onto skin and enters sebaceous glands (neurotoxicity)
2. Cresol
Chlorocresol
3. Thymol
4. Eugenol
5. Resorcinol
Hexylresorcinol
- mixture of three isomeric methylphenols; obtained from coal tar or petroleum
- preservative
- m-cresol; from Thymus vulgaris; mild fungicidal (tinea)
- from clove oil; applied on cotton to relieve toothaches, ingredient in mouthwashes
- weak antiseptic, keratolytic
- produces nubness when applied to tongue; ingred in lozenges
OXIDIZING AGENTS
o
o
MOA: Oxidation (peroxides) and protein denaturation (permanganates)
poor penetrability to infected tissues and organic matter
1. Hydrogen Peroxide
2. Carbamide Peroxide (urea + H2O2)
3. Hydrous Benzoyl Peroxide (2.5%, 5%, 10%)
- active against anaerobic bacteria, wound cleansing
- releases hydrogen peroxide when mixed with water
- most effective topical OTC agent for the control of acne
HALOGEN-CONTAINING COMPOUNDS
1. Iodine (oldest known germicide)
Iodine tincture
Lugol’s sol’n/Strong Iodine Sol’n
Iodine Solution
(2% solution of iodine in 50% alcohol with NaI)
(5% iodine in water with KI)
(2% iodine in water with KI)
2. Iodophors (Iodine + nonionic surfactants)
Povidone-Iodine (Betadine)— complex with the nonionic surfactant polymer, polyvinylpyrrolidone
CHLORINE-CONTAINING COMPOUNDS
o
o
disinfection of water supplies
forms Hypochlorous acid (HClO) when dissolved in water
1. Halazone
2. Chloroazodin
3. Oxychlorosene Sodium
- disinfects drinking water
- a glyceryltriacetate solution is used as wound dressing
- complex of sodium salt of dodecylbenzesulfonic acid and hypochlorous acid
CATIONIC SURFACTANTS
o
o
o
o
o
o
o
Quaternary ammonium compounds that ionize with water and exhibit surface-active properties
MOA: adsorb onto the surface of bacterial cell, causing lysis
Compounds with polar head group and nonpolar hydrocarbon chain form micelles
critical micelle concentration – right concentration
Gerhard Domagk – pioneer
inactivated by soaps and other detergents, also adsorbed on glass, talc, and kaolin to reduce action
tissue constituents, blood, serum, and pus tend to reduce effectiveness of these substances
solutions are intended for disinfecting surgical instruments, gloves, etc. (NEVER REUSE – can harbor pathogens)
1.
2.
3.
4.
5.
Benzalkonium Chloride
Methylbenzethonium Chloride
Benzethonium Chloride
Cetylpyridinum Chloride
Chlorhexidine (Bactidol)
- Detergent, emulsifier, wetting agt, antiseptic, preservative (+Na nitrate)
- for diaper rash (Bacterium ammoniagenes which produces NH4 in urine)
- Antisepsis, irrigation of mucous membranes
- General antiseptic, tx of gingivitis (Forms: lozenges, mouthwash)
- Best antiseptic based on antibacterial effect, no systemic toxicity
DYES
o
o
o
Used before discovery of sulfonamides and antibiotics
Forms colorless leucobase forms in alkaline conditions
Active against G+ bacteria and many fungi; Gram negative bacteria are generally resistant
1. Gentian Voilet (Crystal v)
2. Basic Fuchsin
3. Methylene Blue
- vaginal suppositories (yeast infections), topical (cutaneous candidiasis)
- carbol-fuchsin solution (Castellani’s paint) – used topically for fungal infections
- Antidote for cyanide poisoning
High conc: promotes the conversion of hemoglobin to methemoglobin
Low conc: treat drug-induced methemoglobinemia
MERCURY COMPOUNDS (MERCURIALS)
o
o
o
2 classes:
a. compounds with at least one carbon-mercury bond (does not ionize readily)
b. mercury bonded to heteroatoms (ionize partially or completely)
MOA : reaction with sulfhydryl (-SH) groups in enzymes and other proteins (reversible by treatment with thiolcontaining compds such as cysteine and dimercaprol *BAL+)
antibacterial activity greatly reduced in the serum because of presence of proteins that inactivate Hg compds
1.
2.
3.
4.
5.
Nitromersol
Thimerosal
Mercuric Chloride (corrosive sublimate)
Mercurous Chloride (calomel)
Ammoniated Mercury (white precipitate)
— was a very popular antiseptic for skin & ocular infections
— topical bacteriostatic antiseptic
— were used as antiseptic
—used for skin infections
PRESERVATIVES
o
o
prevent microbial contamination, maintain sterility in the event of accidental contamination
Effective at low concentrations against all possible microbes, nontoxic, compatible, stable for the shelf life
PARABENS (p-hydroxybenzoic acid)
o
Useful for liquid dosage forms, Antifungal, Preservative effect tends to increase with molecular weight
1. Methylparaben
- more effective against molds
2. Propylparaben
- more effective against yeast, more oil soluble so it is preffered for oils and fats
3. Butylparaben
4. Ethylparaben
OTHER PRESERVATIVES
1.
2.
3.
4.
5.
6.
7.
8.
9.
Chlorobutanol
- bacteriostatic in pharmaceuticals for injection, opthalmic, and intranasal
Benzyl Alcohol
- common in vials of injectables with 1%to 4% concentrations in water or saline
Phenylethyl Alcohol
- occurs primarily in rose oil ans pine-needle oil; used in perfumery
Benzoic Acid
- preservatives in foods and pharmaceuticals at low pH
Sodium Benzoate
- preservative in acidic liquid preparations in which benzoic acid is released
Sodium Propionate
- antifungal preservative
Sorbic Acid
- antifungal preservative; preserve preparations containing sugars
Potassium Sorbate
Phenylmercuric Nitrate and Acetate
ANTIFUNGAL AGENTS
FATTY ACIDS (All fatty acids and their salts have fungicidal properties)
1. Propionic Acid
– present in perspiration (0.01%)
2. Undecylenic Acid
– from destructive distillation of castor oil
3. Sodium Caprylate
– from caprylic acid (in coconut and palm oil)
Ketoconazole, Itraconazole, Fluconazole
-
For SC and systemic mycoses
Clotrimazole, Miconazole, Econazole
-
For superficial mycoses
AZOLES (MOA: interacts with C-14 α-demethylase to block demethylation of lanosterol to ergosterol in membranes)
1. Ketoconazole
- Only topically, Inhibits androgen and adrenal steroid synthesis (AE: gynecomastia)
2. Itraconazole
- Lacks the endocrinologic effects of ketoconazole
3. Fluconazole (PO, IV)
- Excellent penetrability into the CSF DOC for cryptococcal meningitis
POLYENES (MOA: Pore formation; binds to ergosterol  disrupts membrane function  cell death)
1. Amphotericin B
(Streptomyces nodosus)
- DOC for systemic mycoses
2. Nystatin
(Streptomyces noursei)
- Candida infections
3. Natamycin
(Streptomyces natalensis)
NUCLEOSIDES (MOA: Inhibits DNA and RNA synthesis)
1. Flucytosine
- pyrimidine, + Amphotericin B (systemic mycoses & meningitis - Cryptococcus & Candida)
ALLYLAMINE
1. Terbinafine
- inhibits squalene epoxidase
GRISEOFULVIN (Penicillum griseofulvum)
o MOA: Interacts with the microtubule within the fungus and inhibit mitosis (metaphase)
o Absorption is increased with fatty acids
ANTITUBERCULAR AGENTS
MOA
Isoniazid
(Isonicotinic acid
hydrazide)
Pyrazinamide
(Pyrazinecarboxamide)
Pyrazinoic acid (active)
Notes
(-) cell wall synthesis
Adverse Effects
First line
Hepatotoxicity
Peripheral neuritis (TX: pyridoxine)
Combined with other agents
(resistance develops rapidly)
First line drug for short term tx
Hepatotoxicity
Optic neuritis (red- green color
blindness)
Ethambutol
Ethionamide
Para-Aminosalicylic
Acid
Structural analogue of
isoniazid
Competitive inhibitor
for PABA
Clofazimine
Rifampin
(S. mediterranei)
(-) RNA polymerase
For isoniazid-resistant TB
Severe GI irritation
Basic red dye for leprosy,
including dapsone-resistant
forms
Hyperpigmentation
Most active agent
Enzyme inducer
Reddish secretions
+ INH or ethambutol  higher
hepatotoxicity
Cycloserine
Streptomyces: S. orchidaceus, S.
garyphalus, S. Lavendulus
Capreomycin
Streptomyces capreolus
Streptomycin
(-) CHON synthesis
Hepatotoxicity, Peripheral neuritis
First antibiotic for TB
Ototoxicity, nephrotoxicity
ANTISCABIES AND ANTIPEDICULAR AGENTS
SCABICIDES (to control the mite Sarcoptes scabei)
1. Benzyl Benzoate
2. Crotaminon
- DOC for scabies; from Peru balsam and other resins
PEDICULOSIDES (head, body, and crab lice)
1.
2.
3.
4.
Pyrethrin
Piperonyl Butoxide
Permethrin
Lindane
- from chrysanthemum plants (MOA: nerve poisoning)
- enhances the pediculicide effects of pyrethrins
- for head lice only
- Gamma-benzene hexachloride, AE: neurotoxicity (Kwell, Scabene, Kwindane)
ANTIBACTERIAL ANTIBIOTICS
CELL WALL
BETA-LACTAM ANTIBIOTICS
1. Penicillins (Penicillum notatum)- Interfere with last step of cell wall synthesis (transpeptidation or crosslinking)
o Beta lactam attached to thiazolidine ring, Nucleus: 6-aminopenicillanic acid
I.
Natural Penicillins
Penicillin G (Benzylpenicillin) – PO, IV, IM(Procaine and Benzathine) Use: RHD and Syphilis
Penicillin V (Phenoxymethylpenicillin) – PO
II.
Penicillinase-Resistant/Antistaphylococcal Penicillins/Narrow Spectrum
Methicillin (2,6-dimethoxyphenylpenicillin) - Prototype; off the market (interstitial nephritis)
Nafcillin (2-ethocy-1-phenylpenicillin)
Isoxazolyl Penicillins (Oxacillin, Cloxacillin,Dicloxacillin – best absorbed orally)
III.
Aminopenicillins/Broad Spectrum
Ampicillin (Parenteral, poor GI absorption) - Prodrugs: Hetacillin, Bacampicillin, Cyclacillin
Amoxicillin (PO)
IV.
Extended Spectrum/Anti-Pseudomonal Penicillins
Carboxypenicillins (Carbenicillin, Ticarcillin)
Ureidopenicillins (Piperacillin – most potent, Azlocillin, Mezlocillin)
2. Beta-lactamase Inhibitors (Clavulanic acid, sulbactam, tazobactam)
o No antibacterial activity. They inactivate beta-lactamases
3. Cephalosporins
o Beta-lactam ring attached to dihydrothiazine ring; Nucleus: 7-aminocephalosporanic acid
Generation
Gram +
Gram First
fa, pha, Cephradine
+++
+
Second
fo, fu, fp, Cefaclor, Cefamandole, Loracarbef
+++
++
Third
t/d, pera, tax, Moxolactam
+
+++
Fourth
Cefepime, Cefpirome
++
++++
Fifth
Ceftaroline, Ceftobipole
++++
++++
4. Carbapenems
Thienamycin, Meropenem, Imipenem (cleaved by dihydropeptidase; cilastatin)
5. Monobactam (Aztreonam – magic bullet for Pseudomonas)
o The beta-lactam ring is not fused to another ring, no cross sensitivity with penicillin
POLYPEPTIDES
Vancomycin (S. Orientalis)
 DOC for Pseudomembranous colitis and MPSA
 Only IV (not orally absorbed); AE: Flushing (Red Man Syndrome)
Bacitracin (B. Subtilis) – nephrotoxic (not for IV)
Polymyxin (B. Polymyxa) – only for G+ ; MOA: Alter cell membrane permeability; Polymixin B and Colostin (Polymixin E)
Gramicidin (S. Brevis) – only for G-
PROTEIN SYNTHESIS
Binds to 30s (AT)
AMINOGLYCOSIDES (Streptomycin, Gentamicin, Netilmicin, Neomycin, Tobramycin, Amikacin – from Kanamycin A)
o Streptomyces (mycin) | Micromonospora (micin)
o Allergic reactions, Muscle relaxation, Incompatile with B-lactams, Nephrotoxic (neomycin)
Ototoxic (streptomycin), G- cocci only
o IV (not absorbed orally) except neomycin (topical and oral only)
TETRACYCLINES (Doxycycline, Minocycline, Tetracycline, Demeclocycline)
o Broadest spectrum antibiotic
o AE: Gastric discomfort, deposition in the bones and primary dentition causing discoloration and
hypoplasia of the teeth and a temporary stunting of growth, hepatotoxicity, phototoxicity
(demeclocycline), vestibular problems (minocycline)
o Fanconi-like syndrome – ingestion of expired tertacycline
Binds to 50s
MACROLIDES
o Common chemical characteristics
1. A large lactone ring
2. A ketone group
3. A glycosidically linked amino sugar
Erythromycin (Ilotycin) - S. erythreus
 Alternative/DOC for Pen G allergy and Legionnaire’s disease
 Esters (eg. stearate, estolate, and ethylsuccinate) have improved acid stability
 AE: epigastric distress, cholestatic jaundice (estolate form of erythromycin)
Clarithromycin
 Used with Omeprazole or Lansoprazole (H.pylori eradication), more potent for strep and staph
Azithromycin, OD
 For nongonococcal urethritis (Chlamydia, LRTI, PID, pharyngitis, Legionnaire’s)
 40 to 68 hours half life is prolonged because of extensive tissue sequestration and binding (↑Vd)
LINCOSAMIDES (Clindamycin) - Streptomyces lincolnensis
o Sulfur-containing; Resemble sulfonamides in antibacterial spectrum and biochemical MOA
o For abdominal and female genitourinary tract infections caused by B. fragilis
o AE: Pseudomembranous colitis, rash, (DOC: Vancomycin)
CHLORAMPHENICOL (S. venezuelae)
o For typhoid fever (Ceftriaxone-new DOC), meningococcal infections and H.influenza infections in
cephalosporin-allergic patients, anaerobic infections
o Precautions and monitoring:
 Bone marrow suppression (dose-related)
 Aplastic anemia (non-dose related)
 Gray Baby Syndrome (neonates)
INHIBITION OF NUCLEIC ACID SYNTHESIS
MUPIROCIN (Pseudomonas fluorescens)
o Used topically for impetigo, eczema, staphylococcal and beta-hemolytic streptococcal infections
o MOA: Inhibition of RNA and DNA synthesis
QUINOLONES
o Patterned after nalidixic acid (introduced for the treatment of UTI and URTI)
o 1,4-dihydro-4-oxo-3-pyridinecarboxylic acid moiety (essential for antibacterial activity)
o Fluoroquinolones have enhanced antibacterial activity
 Ciprofloxacin – most potent
 Norfloxacin – anti-pseudomonal
o Chelates with metals
o MOA: Inhibits DNA gyrase (topoisomerase II)
o AE: Diarrhea, nausea, headache, dizziness, nephrotoxicity, phototoxicity
NITROFURAN AND NITROHETEROCYCLIC COMPOUNDS
1.
2.
3.
4.
Nitrofurazone
Furazolidone (PO)
Nitrofurantoin
Nifurtimox
5. Metronidazole
- topical treatment of burns
- diarrhea (SPEcKs;) CI: Alcohol
- Urinary antiseptic
- Treatment of Chagas’ disease/American Sleeping sickness (Trypanosoma cruzi)
Vector: reduviid bug/kissing bug
- DOC for E. Histolytica, G. Lambia, Trichomonas vaginalis
Metallic taste, Disulfiram-like effect
SULFONAMIDES
o
o
o
o
Gerard Domagk studied a bright dye, Prontosil (metabolized in vivo to sulfanilamide – active)
MOA: Compete with PABA for dihydropteroate synthetase  prevents synthesis of folic acid
AE: Crystalluria, Steven-Johnson Syndrome, Kernicterus, Anemia
Sulfonamides are usually used with dihydrofolate reductase inhibitors (e.g Trimethoprim)
1. DOC for UTI
- Sulfamethoxazole and trimethoprim/Cotrimoxazole (Bactrim®)
2. DOC for Pneumocystis carinii
- Bactrim; alternative drug: Pentamidine (aromatic diamide)
3. Burn therapy
- Silver sulfadiazine and Mafenide (Flammazine®)
4. Conjunctivitis
- Sodium sulfacetamide
5. Chloroquine-resistant malaria - Quinine + pyrimethamine + sulfadoxime (Fansidar®)
SULFONES
1. Dapsone
- DOC for leprosy (Test: G6PD)
ANTIMALARIALS
o
o
Common structural feature: quinoline ring, or a “quinoline with an additional benzene added” (an acridine ring)
None except the cinchona alkaloids has a quinuclidine ring
CINCHONA ALKALOIDS
Reserved for malarial strains resistant to other agents
AE: Cinchonism, Abortifacient
DOC for erythrocytic falciparum
Acute P. vivax attack
Anti-inflammatory (RA and discoid lupus)
Highly supressive (P. vivax and P. falciparum)
Curative (P. falciparum)
Only for exoerythrocytic stages of malaria
Radical cure of the P. vivax & ovale, Gametocidal for all species
Giardiasis, tapeworm and malaria, leishmaniasis
CI: primaquine (inc. Toxicity)
Quinine
Chloroquine
7-CHLORO-4AMINOQUINOLINES
Amiodaquine
8-AMINOQUINOLINES
Primaquine
Quinacrine
9-AMINOACRIDINES
Mefloquine
For multi-drug resistant forms of Plasmodium falciparum
CYCLOGUANIL
Both erythrocytic and exoerythrocytic
ANTIVIRAL AGENTS
Herpes
HIV (Antiretroviral)
DNA Polymerase Inhibitors
NRTI
NNRTI
Protease Inhibitors
Influenza
Vidrabine
Acyclovir, Valacyclovir, Ganciclovir
Zidovudine, Abacavir, Dideoxynosine, Lamivudine, Stavudine,
Tenofovir, Disoproxil, Fumarase, Zalcitabine
Delavirdine, Efavirenz, Nevaripine
Amprenavir, Indinavir, Lopinavir, Nalfinavir, Ritonavir,
Saquinavir
Amantadine, Rimantadine, Olsetamivir, Sanamivir
ANTHELMINTHICS
CHEMOTHERAPY FOR NEMATODES
Albendazole
Mebendazole (Antiox ®)
Pyrantel Pamoate
Piperazine
Ivermectin
Thiabendazole
Diethylcarbamazine
Inhibits microtubule synthesis
Inhibits microtubule synthesis, Depletes glucose
Depolarizing neuromuscular agent (nicotinic receptors)
Flaccid paralysis of helminth (Blocks Ach response)
Targets GABA receptors  paralysis
Also affects microtubular aggregation
AE: Erythema multiforme and SJS (fatal)
Unknown
Roundworm (intestinal and muscle)
Hookworms (old and new)
Whipworm
Pinworm
Onchocerca volvulus (river blindness)
Strongyloidiasis (threadworm)
Filariasis
CHEMOTHERAPY FOR TREMATODES
Praziquantel
Increases membrane permeability to calcium 
contraction  vacuolization  parasite death
CHEMOTHERAPY FOR CESTODES
Niclosamide
(-) oxidative phosphorylation
For intestinal cestodes only: T.
saginata, D latum, H. nana
CANCER CHEMOTHERAPY
Cancer (Latin “crab”)
Solid Tumors
Carcinomas - epithelial cells
Sarcoma
- connective tissues
o Bone (Osteosarcoma)
o Muscles (Leiomyosarcoma)
Hematologic malignancies
Lymphoma - lymphatic system
Leukemia
- blood-forming elements

Each cycle of cancer chemotherapy kills a
certain percentage of tumor cells
CHEMOTHERAPEUTIC AGENTS
1. Phase-Specific/Narrow Spectrum Antineoplastic
2. Phase-Nonspecific/Broad Spectrum
3. Cell Cycle Nonspecific/Extended Spectrum
Etiology
 Viruses – EBV, HBV, HPV
 Environmental and occupational exposure
o Ionizing and UV radiation
o Vinyl chloride, asbestos, benzene
 Lifestyle factors
 Medications
 Genetic factors
Warning Signs of Cancer (American Cancer Society)
Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding/discharge
Thickening or lump in the breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness
Screening
 Mammography
 FOBT
 Papanicolau smear
 DRE
Tumor markers
1. Carcinoembryonic antigen (CEA)
2. Alpha-fetoprotein (AFP)
3. Prostate specific antigen (PSA)
Tumor Biopsy
 Definitive test (read by a pathologist)
 Types: FNAB, Incision, Excision
Staging: TNM, AJC
Tumor cell burden
 Number of tumor cells in the body (109)
Chemotherapy Objectives
 Cure – eg. Leukemia
o Remission induction (maximal cell kill)
o Consolidation therapy (10°)
 Palliation
 Adjuvant chemotherapy
 Neoadjuvant chemotherapy
Basis for Dosing: Body weight, BSA, AUC
Reasons for Combination Therapy
 Overcoming or preventing resistance
 Cytotoxicity to resting or dividing cells
 Biochemical enhancement of effect
 Rescue of normal cells
 CMF (breast CA) – Cyclophosphamide,
Methotrexate, 5-FU
ALKYLATING AGENTS (MOA: Alkylation – Inh DNA replication)
Nitrogen Mustards
Examples
Mechlorethamine
- WWII (vesicant)
- Nitrogen Mustard
Chlorambucil (DOC for CLL)
Cyclophosphamide
Ifosfamide
Mephalan
Ethylenimenes/
Methylmelamines
Alkyl sulfonates
Nitrosureas
For brain tumors
Triazines
Platinum Coordination
Complex
Thiotepa, Altretamine
(hexamethylmelamine)
Busulfan
Carmustine, Lomustine
Streptozotocin
Dacarbazine
Cisplatin
Carboplatin
Substituted Urea
Others
Hydroxyurea
Procarbazine, Temozolamide
Adverse Effects





Bone Marrow depression
Hemorrhagic cystitis (fibrosis of the bladder)
o Acrolein (cyclophosphamide)
MESNA (sodium 2-mercaptoethane sulfonate)
Germ cells – amenorrhea, testicular atrophy, sterility
Neurotoxicity (ifosfamide) – chloroacetaldehyde
Secondary malignancies
Pulmonary Toxicity
Pulmonary Toxicity
Toxic to beta cells of islets of Langerhans (Insulinomas)
Cisplatin
 Severe persistent vomiting
 Nephrotoxicity (dose-limiting)
Carboplatin
 Mild nausea and vomiting
 Not nephro-, neuro-, or ototoxic
 Myelosuppression (dose-limiting)
ANTITUMOR ANTIBIOTICS (MOA: Intercalation)
A. Anthracyclines
 Daunorubicin/Daunomycin
S. peucetius
 Doxorubicin/Adriamycin/Hydroxydaunorubicin
 Epirubicin
 Idarubicin
B. Anthracenediones
 Mitoxantrone
C. Other Agents
 Bleomycin (Pulmonary toxicity)
 Dactinomycin/Actinomycin D
 Plicamycin/Mithramycin
 Mitomycin C
S. verticillus
Streptomyces spp.
S. plicatus
S. caespritosus
CARDIOTOXIC
Dexrazoxane
ANTIMETABOLITES (MOA: Inhibit DNA synthesis)
 Structural analogs of naturally occurring substrates for biochemical reactions (False substitutes)
Adenosine Analogs
Purine Analogs
Folic Acid Analog
Pyrimidine Analogs
Cladribine, Fludarabine
Mercaptopurine (6MP or thiouric acid)
Thioguanine
Fludarabine (5’phosphate of 2-Fluoro-adenine arabinoside)
Thioguanine
Methotrexate
o Inhibits dihydrofolate reductase (converts folic
acid to tetrahydrofolic acid)
Capecitabine, 5-Fluorouracil, Gencitabine
Cytarabine (AR-A, cytosine arabinoside)
Stomatitis, myelosuppression, erythema,
rash, urticaria, alopecia, vomiting
Renal damage, Abortifacient
Folinic acid/Leucovorin
Ulceration of the GI mucosa, dermopathy
(hand foot syndrome)
Indications: Colorectal, breast, ovarian, pancreatic,
and gastric CA
Topically: Basal cell CA
PLANT ALKALOIDS
Vinca
Alkaloids
Vinca rosea
Camptothecins
Podophyllotoxins
Taxanes
Prevent formation of mitotic spindle
Inhibit topoisomerase 1
Inhibit topoisomerase II
Promote microtubule assembly and
stabilization  inhibiting cell division
Vinblastine, Vincristine, Vindesine, Vinorelbine
Irinotecan, Topotecan
Etoposide, Teniposide (Myelosuppression)
Docetaxel (Taxotere), Paclitaxel (Taxol)
HORMONES
 Hormone-responsive
 Hormone-dependent








Androgens
Antiandrogens
Antiestrogens
Aromatase inh
Corticosteroids
Estrogen/N mustard
GnRH or LHRH
Progestins
- Palliative, Regresses after treatment with the hormone
- Removal of a hormone causes tumor regression
 Ex. Surgery (orchiectomy for advanced prostate CA); breast CA – Tamoxifen
- Fluoxymesterone, testosterone
- Flutamide, nilutamide (for prostate CA with Goserelin/Leuprolide)
- Toremifene, Tamoxifen (ER + Breast CA | Endometrial CA)
- Aminoglutethamide (2nd line for metastatic breast CA)
- Dexamethasone, Prednisone (for lymphoma, ALL | Cushing’s: lymphocytopenia)
- Diethylestradiol, Ethinyl estradiol (for prostate CA | Gynecomastia, Thromboemboli)
- Goserelin, Leuprolide (for prostate CA)
- Medroxyprogesterone, megestrol
ENZYMES
 L-asparaginase
o Source: E. coli
o MOA: degrades asparagines
o Indication: (+vincristine and prednisone): Childhood ALL