FIRM MEDICINAL FORMS
Powders
 EXAMPLE. To write out 20,0 smallest powders of streptocide, to prescribe for drawing
to a wound.

Rp.: Streptocidi subtillissimi 20,0

D.S. For drawing on a wound
 EXAMPLE. To write out 30,0 magnesium oxide. To prescribe on m of a teaspoon 3
times a day in 2 hours after meal.

Rp.: Magnesii oxydi 30,0

D.S. By teaspoon 3 times a day in 2 hours after meal

EXAMPLE. To write out 10 powders of Codeini phosphas on 0,025 with soda.
To prescribe on 1 powder 3 times a day.

Rp.: Codeini phosphatis 0,025

Natrii bicarbonatis 0,3

M.f. pulvis

D.t.d. N. 10

S. By 1 powder 3 times a day
Cont.
 EXAMPLE. To write out 10 powders of camphor grated on 0,15 in
a waxen paper. To prescribe on 1 powder 3 times a day.

Rp.: Camphorae tritae 0,15

D.t.d. N.10 in charta cerata

S. By 1 powder 3 times a day

 EXAMPLE to Write out 100,0 complex lacritic powder and to
prescribe on 1 teaspoon 3 times a day.

Rp.: Pulveris Liquiritiae compositi 100,0

D.S. By 1 teaspoon 3 times a day
Sheaths
 EXAMPLE. To write out 10 powders of quinine of
sulphate on 0,3 capsular gelatinous. To prescribe on 1
sheath 3 times a day.

Rp.: Chinini sulfatis 0,3

D.t.d. N.10 in capsulis gelatinosis

S. By 1 sheath 3 times a day
Granules
 Rp.: Granulorum Natrii para-aminosalicylatis 100,0

D.S. By 1 teaspoon 3 times a day after meal
Tablet
 EXAMPLE. To write out 10 tablets of Dimedrol on 0,03. To
prescribe on 1 tablet 2 times a day.

Rp.: Dimedroli 0,03

D.t.d. N. 10 in tabulettis

S. By to 1 tablet 2 times a day
 EXAMPLE. To write out 10 tablets "Aeronum", to prescribe
on 1 tablet 1-2 hours prior to flight.

Rp.: Tabulettas “Aeronum” N. 10

D.S. By1 tablet 1-2 hours prior to flight
Dragee
 EXAMPLE. To write out 20 dragees containing on
0,025 aminazine. To prescribe on 1 dragee 2 times a
day.

Rp.: Dragee Aminazini 0,025

D.t.d. N. 20

S. By 1 dragees 2 times a day

Except all these firm medicinal forms exist also:
 To new medicinal forms concern - membranulae
ophthalmicae
Cont.
 EXAMPLE. To write out 30 ophthalmic Membranulas,
containing Pilocarpinum a hydrochloride. To seat on 1
Membranula for edge of a lower eyelid of 1 times a
day.

Rp.: Membranulas ophthalmicas cum
Pilocarpini hydrochlorido N. 30

D.S. To seat on 1 Membranula for lower
eyelid edge daily
 If the drug is destroyed by stomach acid or is irritating to the
mucous membrane of the stomach, it is prescribed in special
dosage forms (capsules, pills) that are soluble only in the
small intestine.
Absorption of substances regulated as a special membrane
transporter - P-glycoprotein. It promotes the excretion of
substances into the lumen of the intestine and prevents
their absorption.
P-glycoprotein pump is also blood-brain barrier, kidney,
liver, placenta and other tissues. Therefore, this
transportation system affects many processes: absorption,
distribution, elimination.
Known inhibitors of P-glycoprotein - cyclosporin A,
quinidine, verapamil, itraconazole, and many others. There
is evidence that rifampin, an inducer of this transporter.
 Due to the fact that the substance developing a systemic effect
only after getting into the bloodstream, where it enters the tissue
is provided, the term "bioavailability". It reflects the amount of
unchanged substance has reached the blood plasma, relative to
the initial dose. In this case the bioavailability of enterally value
determined lossy substance at its absorption from the digestive
tract and first-pass hepatic barrier. To assess the bioavailability
usually measure the area under the curve, which reflects the
relationship between the concentration of the substance in the
blood plasma and the time since the rate is directly proportional
to the number of substances introduced into the systemic
circulation. Also determine the maximum concentration of free
(active) of the substance in the blood plasma and the time
required to achieve it. Biodostupnost substance when
administered intravenously as 100%. On bioavailability can be
judged by the release of the drug in the urine, provided it is not
subject to biotransformation. In some cases, the criterion may be
the amount bioavailability pharmacological effect if applicable its
precise quantitative measurement.
 With the introduction of the substance under the tongue sublingual (tablets, granules, drops) - suction starts pretty quickly.
In this case, the drugs have general action, bypassing the first
hepatic passage barrier and contact with enzymes and the
environment of the gastrointestinal tract. Sublingual designate
certain substances with high activity (single hormonal agents,
nitroglycerin) where the dose is low.
Sometimes drugs are administered by gavage to the duodenum
(e.g., magnesium sulfate as a choleretic), which allows to quickly
create a high concentration of gut connection.
 When administered into the rectum (per rectum) substantial part of the
substance (about 50%) goes into the bloodstream, bypassing the liver.
Moreover, in this way the introduction substance is not exposed to
enzymes of the digestive tract. Absorption from the rectum occurs by
simple diffusion. Rectally administered drugs into suppositories or
enemas drug (volume 50 ml). If the substance is irritating effect, they are
combined with mucus.
Medicinal substances having the structure of proteins, fat and
polysaccharides in the colon are not absorbed.
Rectal use of substance and for local effects.
For parenteral routes of administration include subcutaneous,
intramuscular, intravenous, intraarterial, intrasternal, intraperitoneal,
inhalation, subarachnoid, suboccipital and others.
Parenteral routes of the most common is the introduction of substances
under the skin, into the muscle and veins. Effect occurs especially quickly
when administered intravenously, is somewhat slower - intramuscular and
subcutaneous administration. In order to prolong the effect of
pharmacotherapeutic drugs injected into a muscle in the form of poorly
soluble (suspension) in oil or other grounds, delaying absorption of
substances from the site of administration.
Intramuscular and subcutaneous should not introduce substances which
have a pronounced irritant effect, as this can cause inflammatory
reactions and even necrosis infiltrates.
 Furthermore, in some reabsorption endogenous substances (amino acids, glucose,
uric acid) participates actively transport.
A number of drugs (tetracyclines, penicillins, phenytoin, colchicine, etc.) and
especially the products of their transformation in a significant amount excreted in
the bile into the intestine, where partially excreted in the feces and can be reabsorbed and subsequently re-released into the intestines, etc. . (The so-called
enterohepatic circulation, or hepatic recirculation).
Gaseous and many volatile matter (for example, the means for inhalation anesthesia)
are displayed in the main light.
Some drugs are excreted salivary glands (iodide), sweat (protivoleproznoe means
ditofal) glands of the stomach (quinine, nicotine) and intestines (weak organic acids),
lacrimal glands (rifampicin).
It should also be borne in mind that in lactating mammary gland secretes many
substances that receives nursing mother (hypnotics, sedatives, ethyl alcohol,
nicotine, etc.). In this regard, care is required to appoint the mother of drugs, since
the milk they can get into the child's body and have an adverse effect on him.
Elimination (removal) of the substance of the body is provided by biotransformation
and excretion. To quantify elimination process uses a series of parameters:
elimination rate constant (K elim), «half life» (t1 / 2) and total clearance (CL T).
The elimination rate constant (K eljm) reflects the rate of material removal from the
body.
 To assess the clearance rate of substances from the body is used as the
parameter "half-life" (elimination half-life) - t1 / 2, which reflects the time
required for reducing the concentration of a substance in blood plasma
by 50%. This parameter is used for the selection of doses of substances
and intervals of administration to create steady-state concentration of
the drug. It is known that the removal of substances of more than 90% is
carried out for a time equal to four tl / 2, which is taken into account
when dispensing. It should be borne in mind that the t1 / 2 is determined
not only breeding material from the body, but also its biotransformation
and deposition.
Furthermore, to quantify the elimination rate substances used
parameter clearance (CL) from the English. clearance - cleaning,
reflecting the rate of plasma cleaning of the substance (expressed in
volume per unit time, if necessary with the body weight or surface: ml /
min ml / kg / min l/m2/ch etc.) . Allocate general (total), clearance (CL T),
and kidney (CL R) and hepatic (CL H) clearance. The total clearance is
associated with parameters such as volume of distribution (Vd), «half
life» (t 1/2) and the elimination rate constant (K elim).
 Resorptive effect depends on the route of administration of drugs and their
ability to cross biological barriers.
At the local and resorptive effect drugs have either a direct or reflex effect.
First implemented in place of direct contact of the substance with a cloth.
When the reflex action of matter affect exteroanterocone or interoceptors
and the effect is the change of state or the corresponding nerve centers, or
executive. Thus, the use of yellow cards in the pathology of respiratory refreflex improves their trophic (mustard essential oil stimulates exteroceptors
skin). The drug lobelia, injected intravenously, has a stimulating effect on
the carotid chemoreceptors glomerulus and stimulating the reflex center of
respiration, increases the volume and respiratory rate.
The main objective of the pharmacodynamics - find out where and how the
drugs are causing these or other effects. Thanks to the improvement of
instructional techniques, these issues are not only at the system and organ,
but also on the cellular, sub-cellular, molecular and submolecular levels.
 So, for neurotropic drugs applies the structure of the nervous
system, synaptic formation of which have the most by a high
sensitivity to these compounds. For substances that affect the
metabolism is determined by the localization of enzymes in
different tissues, cells and subcellular entities whose activity
changes is particularly important. In all cases, we are talking about
the biological substrates, "targets", which interact with the drug.
As the "target" for the drug are receptors, ion channels, enzymes,
transport systems and genes.
Receptors called active groups of the macromolecules of substrates
with which a substance. Receptors, providing the manifestation of
substances called specific.
There are the following 4 types of receptors.
 I. Receptors direct control over the function of ion channels. This type of
receptor directly associated with ion channels, include n-cholinergic
receptors, GABA receptors, glutamate receptors.
II. Receptors associated with effector through «G-proteins - the secondary
transmitter" or «G-protein-gated ion channels". These receptors are
available for many hormones and neurotransmitters (m-cholinergic
receptors, adrenergic receptors).
III. Receptors directly control the effector function of the enzyme. They are
directly related to tyrosine phosphorylation of proteins and adjusted.
According to this principle arranged insulin receptors several growth
factors.
IV. Receptors controlling transcription of DNA. In contrast to membrane
receptors type I-III is intracellular receptors (soluble cytosolic or nuclear
proteins). With these receptors interact with steroid and thyroid hormones.
Most fruitful study of receptor subtypes and associated effects. Among the
first studies of this type include work on the synthesis of many in-blockers
are widely used in various diseases of the cardiovascular system. Then came
the histamine H2-blockers receptor - effective for the treatment of gastric
ulcer and duodenal ulcer. Later it was synthesized in a variety of other drugs
that act on different subtypes of alpha-adrenergic receptors, dopamine,
opioid receptors, etc. These studies have played a major role in the creation
of new groups of selective drugs, which are widely used in medical practice.
 Pharmacological interaction due to the fact that one substance or alters
the pharmacokinetics (s) other components of the mixture
pharmacodynamics. Pharmacokinetic interaction type can be associated
with malabsorption, biotransformation, transport, deposition and
removal of the substances. Pharmacodynamic type of interaction is the
result of direct or indirect interaction of matter at the level of receptor
cells, enzymes, organ or physiological systems. In this case, the main
effect may vary quantitatively (amplified, attenuated) or qualitatively. In
addition, the possibility of chemical and physico-chemical interaction of
substances in their joint application.
Pharmacokinetic type of interaction can occur at the stage of absorption
of substances, which may vary for different reasons. Thus, in the
digestive tract may be binding substances absorbent material (activated
carbon, white clay) or anion-exchange resin (e.g. cholestyramine
hypolipidemic agent), the formation of inactive chelate or chelates (for
example, according to the principle tetracycline group of antibiotics
interact with the ions of iron, calcium, magnesium). All of these forms of
interaction prevents the absorption of drugs and thus reduce their
pharmacological effects. For some substances absorption from the
digestive tract is essential pH. So by changing the reaction of digestive
juices, can significantly affect the rate and completeness of absorption
of weakly acidic and weakly basic compounds
 General principles of treatment of acute poisoning by drugs
Acute poisoning by chemicals, including drugs, are quite common. Poisoning may be
accidental, intentional (suicide (from Lat. Suicidum - suicide (sui - myself, caedo - kill))
and associated features of the profession. Most common acute poisoning with ethyl
alcohol, hypnotics, psychotropic drugs, opioid and non-opioid analgesics,
organophosphate insecticides and other compounds.
For the treatment of poisoning by chemicals created special poison control centers
and offices. The main objective in the treatment of acute poisoning is to remove
substances from the body, causing the toxicity. In severely ill patients it must be
preceded by general therapeutic and resuscitative measures aimed at ensuring the
functioning of vital systems - respiration and blood circulation.
The principles of detoxification are as follows. First of all it is necessary to delay the
absorption of the substance on the routes of administration. If the substance is
partially or fully grown deep, should accelerate its excretion from the body, as well as
take advantage of antidotes for its neutralization and elimination of adverse effects.
a) delay absorption of the toxic substance in the blood
 If the substance to cause intoxication, is applied to the skin or mucous
membranes, wash them thoroughly (preferably flowing water).
After contact with toxic substances through the lungs should stop their
inhalation (to remove the victim from the poisonous atmosphere or wear a
gas mask on him).
When subcutaneous absorption of toxic substances from its insertion site
can slow injection of adrenaline solution around the site of administration,
as well as by cooling in the area (the skin surface placed on an ice pack). If
possible, the tourniquet is applied, obstructing blood flow and creating
venous stasis in the administration of the substance. All of these measures
reduce systemic toxic effects of the drug.
b) removing the toxic substances from the body
If a substance has grown deep and resorptive effect, major efforts should
be directed to the early elimination from the body.
 For this purpose use diuresis, peritoneal dialysis, hemodialysis,
hemosorption, blood substitution, etc. The method is forced diuresis
combined aqueous active load using diuretics (furosemide, mannitol). In
some cases the urine acidification or alkalization (depending on the
properties of the material) contributes to more rapid removal of material
(by reducing its reabsorption in the renal tubules). The method of forced
diuresis can display only free agents not associated with proteins and lipids
blood. Using this method should maintain electrolyte balance, which may be
disrupted due to excretion of large amounts of ions. In acute cardiovascular
insufficiency, severe renal dysfunction and the risk of developing cerebral
edema or pulmonary forced diuresis is contraindicated.
In addition to forced diuresis, using hemodialysis or peritoneal dialysis
(dialysis (from the Greek. Dialysis - Branch) - separation of colloidal particles
of the solute).