Depressants: Benzodiazepines: Alprazolam (Xanax), Chlordiazepoxide (Librium), Clobazam (Onfi), Clonazepam (Klonopin), Clorazepate (Tranxene), Diazepam (Valium), Estazolam, Flurazepam (Dalmane), Lorazepam (Ativan), Midazolam (Versed), Oxazepam, Quazepam (Doral), Temazepam (Restoril), Triazolam (Halcion) Carisoprodol (Soma) Chloral hydrate Eszopiclone (Lunesta) Lacosamide (Vimpat) Meprobamate Methohexital (Brevital) Paraldehyde not in USA Phenobarbital Tramadol (Ultram) Zaleplon (Sonata) Zolpidem (Ambien) (As any other nonopioid prescription drug) Codeine: 200 mg/100 mL Difenoxin preparations: 0.5 mg + 25 mcg atropine Dihydrocodeine preparations: 10 mg/100 mL Diphenoxylate (not more than 2.5 mg and not less than 0.025 mg of atropine per dosage unit, as in Lomotil) Opium preparations: 100 mg/100 mL Pregabalin (Lyrica) 1See https://www.deadiversion.usdoj.gov/schedules.2Emergency prescriptions may be telephoned if followed within 7 days by a valid written prescription annotated to indicate that it was previously placed by telephone. CMEA (Combat Methamphetamine Epidemic Act of 2005) establishes regulations for ephedrine, pseudoephedrine, and phenylpropanolamine over-the-counter sales and purchases.
Introduction: The Nature of Drugs & Drug Development & Regulation
Bertram G. Katzung, MD, PhD*
A 78-year-old woman is brought to the hospital because of suspected aspirin overdose. She has taken aspirin for joint pain for many years without incident, but during the past year, she has exhibited many signs of cognitive decline. Her caregiver finds her confused, hyperventilating, and vomiting. The care-giver finds an empty bottle of aspirin tablets and calls 9-1-1. In the emergency department, samples of venous and arterial blood are obtained while the airway, breathing, and circulation are evaluated. An intravenous (IV) drip is started, and gastro-intestinal decontamination is begun. After blood gas results are reported, sodium bicarbonate is administered via the IV. What is the purpose of the sodium bicarbonate?
Pharmacology can be defined as the study of substances that interact with living systems through chemical processes. These interactions usually occur by binding of the substance to regulatory molecules and activating or inhibiting normal body processes. These substances may be chemicals administered to achieve a beneficial therapeutic effect on some process within the patient or for their toxic effects on regulatory processes in parasites infecting * The author thanks Barry Berkowitz, PhD, for contributions to thesecond part of this chapter.
the patient. Such deliberate therapeutic applications may be considered the proper role of medical pharmacology, which is often defined as the science of substances used to prevent, diagnose, and treat disease. Toxicology is the branch of pharmacology that deals with the undesirable effects of chemicals on living systems, from individual cells to humans to complex ecosystems (Figure 1–1). The nature of drugs—their physical properties and their interactions with biological systems—is discussed in part I of this chapter. The development of new drugs and their regulation by government agencies are discussed in part II.