By Bronwen Bryant, Kathleen Knights
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This book uses these approaches where appropriate; examples include the titles of Chapter 24, ‘Lipid-lowering drugs’, and Chapter 45, ‘Antifungal and antiviral drugs’. An example of drugs classified by body system can be found in Unit IV, ‘Drugs affecting the central nervous system’, whereas in Chapter 18, ‘Psychotropic agents’, antidepressants are grouped together by mechanism of action as ‘Tricyclic antidepressants’ (a chemical class), ‘Monoamine oxidase inhibitors’ or ‘Selective serotonin reuptake inhibitors’.
E. they contain carbon in their structures. All the major classes of organic compounds, including hydrocarbons, proteins, lipids, carbohydrates, nucleic acids and steroids, are represented in pharmacopoeias (see Figure 1-3 later). Many drug molecules are acids or bases, which is important not only for their taste and irritant effects but also for how the drugs move across membranes (see Figure 6-3) and are affected by the normal body processes of metabolism and excretion (pharmacokinetics). MOLECULAR SIZE The sizes of drug molecules can also vary enormously, ranging from tiny lithium, the third-lightest element with an atomic weight of about 7, used as a specific antimanic agent (DM 18-5), through to proteins such as insulin (DM 36-2), erythropoietin (DM 49-1) and influenza vaccine (DM 28-6).
Structure– activity studies identified series of molecules with agonist or antagonist actions on many types of receptors. The importance of using a control group when testing drugs or other treatments was recognised and the randomised controlled clinical trial became the expected standard (see CIB 4-3). This was the era of the ‘magic bullet’3 with major developments being the production of safe, orally active antimicrobials, both synthetic (sulfonamides) and natural (penicillins). g. streptomycin for tuberculosis.