module 8: basic anatomy & physiology
Basic Anatomy and Physiology!
Levels of Organization
Cells
Tissues
Organs
Organ Systems
Cell Anatomy:
nucleus
→ houses genetic material (DNA) & direct cellular activities
ribosomes
→ sites of protein synthesis—converts generic instructions into proteins
lysosomes
→ contains enzymes for digestion or recycling of cellular components
golgi apparatus
→ packages and distributes proteins throughout the cell
endoplasmic reticulum (ER)
→ smooth: synthesizes lipids
→ rough: synthesizes proteins
cell membrane
→ encloses cell contents and controls what enters/leaves
mitochondria
→ generates ATP (cell energy)
Tissues:
epithelial:
→ forms lining of organs and covers external surfaces
acts as a protective barrier and assists in absorption and secretion
EX: lining of digestive tract
connective:
→ supports and connects other tissues (e.g., bone, cartilage, and fat)
EX: tendons, ligaments (gives bones the structure and stability)
muscle:
→ generates movement by contracting and relaxing
3 Types!
skeletal: movement
cardiac: heart
smooth: organs
nervous:
→ transmits signals throughout the body
made up of neurons and supporting cells
EX: brain, spinal cord, peripheral nerves
Integumentary System!
skin, hair, and nails
Function:
protective barrier
temperature regulation
sensory perception
Pharmacy Relevance:
topical medications
transdermal medications
has common side effects
Musculoskeletal System!
bones and muscles
Function:
structural support
movement
joint functions
Pharmacy Relevance:
medications used to treat bone disorders or muscle-related symptoms and/or disease
adverse effects
Nervous System!
Two Types!
Central Nervous System (CNS)
brain and spinal cord
Peripheral Nervous System (PNS)
nerves
Function:
senses environment
processes information
initiates responses
controls and coordinates bodily functions
transmits signals between brain to body
responsible for involuntary and voluntary actions
EX:
voluntary = moving a limb
involuntary = breathing
Pharmacy Relevance:
medications affecting NS include: antidepressants, pain relievers, anesthetics, and antiepileptics
EX’s of Commonly Prescribed Medications:
Seizure Disorders
Phenytoin
Lamotrigine
Carbamazepine
CNS Side Effects: sedation, dizziness, ataxia
These medications reduce neuronal excitability in the brain and leads to affecting balance and alertness
Anxiety and Insomnia
Benzodiazepines (Alprazolam)
Z Drugs (Zolpidem)
CNS Side Effects: sedation, dizziness, possible confusion
These medications enhance GABA which slows CNS activities and leads to grogginess
Depression
Selective Serotonin Reuptake Inhibitors (SSRIs)
CNS Side Effects: headache, dizziness, agitation
These medications alters levels of serotonin in the brain & can also affect/disrupt normal transmitter balance which leads to mild NS effects
Migraines
Triptans
CNS Side Effects: drowsiness, dizziness, “heavy head” sensation
These medications constrict blood vessels and modulate pain pathways in the brain. Also changes normal cerebral blood flow sometimes leading to dizziness or sedation
Endocrine System!
pituitary gland, thyroid gland, adrenal gland, and pancreas
→ reproductive organs also considered due to their hormones
Function:
regulates metabolism, growth & development, tissue function, and mood
maintains homeostasis by balancing hormone levels in the blood
key role in reproduction and stress response
Pharmacy Relevance:
medications affecting include: insulin, thyroid hormones, corticosteroids, and contraceptives
Endocrine System Components
pituitary gland
→ releases hormones that regulate growth, blood pressure, and other glands (e.g., thyroid, adrenals)
Diseases:
acromegaly: excess growth hormone
- Medication to treat: somatostatin analogs
→ e.g., octreotide
hypopituitarism: insufficient hormone production
- Medication to treat: growth hormone analog
→ e.g., somatropin
thyroid gland
→ regulates metabolism, energy levels, and body temperature through the T3 (triiodothyronine) and T4 (thyroxine) hormones
Diseases:
hypothyroidism: underactive thyroid
- Medication to treat: levothyroxine
→ replaces low thyroid hormone
hyperthyroidism: overactive thyroid
- Medication to treat: methimazole or propylthiouracil (PTU)
→ reduces hormone production
parathyroid glands
→ four small glands located on back of thyroid, essential for calcium and phosphate balance
Diseases:
hyperparathyroidism: too much PTH (parathyroid hormone), leading to high calcium levels
- Medication to treat: cinacalcet
→ lower PTH levels
hypoparathyroidism: too little PTH, causing low calcium levels
- Medication to treat: calcium supplements and vitamin D
adrenal glands
→ produces cortisol (stress response), aldosterone (salt/water balance), and adrenal androgens
Diseases:
cushing’s syndrome: excess cortisol
- Medication to treat: ketoconazole or metyrapone
→ blocks cortisol production
addison’s disease: adrenal insufficiency
- Medication to treat: glucocorticoids
→ e.g., prednisone, hydrocortisone as replacement therapy or to reduce inflammation
pancreas
→ produces insulin and glucagon for blood glucose regulation
→ also has digestive enzyme functions (exocrine)
Diseases:
diabetes mellitus (Type 1 and Type 2)
- Medication to treat: insulin for Type 1 or advanced Type 2, or oral antidiabetics to manage Type 2
→ insulin: various formulations like rapid-acting lispro or long-acting glargine
→ oral antidiabetics: metformin and sulfonylureas
ovaries and testes (gonads)
→ ovaries produce estrogen and progesterone; testes produce testosterone. these hormones regulate reproductive functions and secondary sex characteristics
Diseases:
polycystic ovary syndrome (PCOS)
hypogonadism (reduced hormone production)
- Medication to treat: hormone replacements (e.g., estrogen/progestin therapies, testosterone injections) & oral contraceptives (females)
Cardiovascular System!
heart and blood vessels
Function:
delivers oxygen and nutrients to tissues
removes carbon dioxide and other waste products from the body
plays crucial role in maintaining homeostasis, regulating temperature, and transporting hormones
Pharmacy Relevance:
many medications can directly impact cardiovascular system
Diseases:
hypertension
medication indication: elevated blood pressure
EX medications:
ACE inhibitors (e.g., Lisinopril)
Beta-Blockers (e.g., Metoprolol)
→ common side effects:
hypotension/orthostatic hypotension: feeling lightheaded upon standing
bradycardia (with beta-blockers and some calcium channel blockers)
Why these side effects occur:
lowering BP can reduce blood flow to the brain briefly upon standing, causing dizziness
beta-blockers slow heart conduction at the AV node by blocking the activation of beta-receptors by catecholamines
hyperlipidemia
medication indication: elevated cholesterol or triglycerides
EX medications:
HMG-CoA Reductase Inhibitors (statins)
Fibrates
Niacin (vitamin B3 in high doses)
→ CV side effects:
flushing and vasodilation: skin reddening, possible drop in BP
Why these side effects occur:
vasodilation: Niacin causes blood vessels to widen, improving cholesterol profiles but sometimes leading to flushing and decrease in BP
heart failure
medication indication: improve symptoms of heart failure, reduce risk of heart muscle changes, etc.
EX medications:
Diuretics (e.g., Furosemide)
Beta-Blockers (e.g., Carvedilol)
ACE Inhibitors/ARBs (e.g., Lisinopril, Losartan)
→ CV side effects:
hypotension
potential reflex tachycardia
Why these side effects occur:
hypotension: diuretics reduce fluid volume; ACE inhibitors or beta-blockers reduce cardiac workload. combined effects can make BP below normal
reflex tachycardia: compensatory mechanism when the body senses a significant drop in BP, prompting heart to beat faster
arrythmias
medication indication: to control heart rate or heart rhythm
EX medications:
Antiarrhythmics (e.g., Amiodarone)
Beta-Blockers (e.g., Sotalol)
Calcium Channel Blockers (e.g., Diltiazem)
→ CV side effects:
new or worsened arrhythmias
brachy or tachycardia
Why these side effects occur:
proarrhythmic effects: some drugs that stabilize heartbeat can also disturb normal conduction if doses aren’t managed carefully
heart rate changes: by modifying conduction or contractility, they can slow or (rare) paradoxically speed up heart rate
clotting disorders
medication indication: prevention or treatment of blood clots or cardiovascular events
EX medications:
Vitamin K Antagonists (e.g., Warfarin)
Direct Oral Anticoagulants (DOACs) (e.g., Rivaroxaban, Apixaban)
→ CV side effects:
bleeding and hemorrhage (impact on blood vessels and clotting ability)
potential bruising or prolong bleeding times
Why these side effects occur:
reduced clotting factors: they can reduce or inhibit clotting factors which help prevent clots but increases risk of bleeding in tissues and blood vessels
Respiratory System!
lungs, airway, and diaphragm
works alongside cardiovascular and endocrine system
Function:
oxygenates blood which is then circulated throughout body
remove s CO2
regulates blood pH and maintaining acid-base balance
Pharmacy Relevance:
medications include: bronchodilators, corticosteroids, and mucolytics
Gastrointestinal System!
mouth, esophagus, stomach, intestines, liver, pancreas, and gallbladder
Function:
converts food into energy and nutrients that the body can use
absorbs nutrients into bloodstream to be transported to cells throughout body
eliminates undigested food and waste products from the body
Pharmacy Relevance:
directly impacts the absorption and circulation of medications administers via GI tract
some most common effects for most medications occur in gastrointestinal system (nausea, diarrhea, constipation)
Renal/Urinary System!
kidneys, ureters, bladder
Function:
filters and removes waste products from the blood
works to maintain electrolyte, fluid, and acid-base homeostasis
anemia: decreased rbc’s and hemoglobin
risk for cardiovascular diseases
certain meds may need medication dosage adjustments if kidneys are compromised
Pharmacy Relevance:
many medications are filtered and removed from body via renal system
Measuring Kidney Function:
Glomerular Filtration Rate (GFR) estimates how well kidneys filter waste from blood (derived from serum creatinine levels, age, sex, and race)
Creatinine Clearance:
measure based on urine and blood creatinine levels over time
Why it matters:
→ many drugs are excreted or metabolized through the kidneys; if kidney function is reduced, drug clearance and toxicity risks can increase
Kidney Disease Stages
Stage 1
GFR is normal, but signs of kidney damage (protein in urine, structural abnormalities)
Stage 2
GFR 60-89 mL/min/1.73² (mild loss of kidney function)
Medication therapy impact: monitoring may begin for BP, blood glucose (if diabetic), etc. but most patients tolerate standard dosing
Reproductive System!
Males: Testes, prostate
Females: Ovaries, uterus
Function:
regulates female and male hormones
Pharmacy Relevance:
medications are contraceptives, hormone replacement therapies, and fertility treatments
Lymphatic System!
works close with immune system
thymus, bone marrow, spleen, lymph nodes, lymphatic vessels
white blood cells, antibodies, cytokines, and other organ systems
Function:
provide host defense mechanisms to protect from infectious diseases
plays role in fluid regulation
Pharmacy Relevance:
vaccines and immunosuppressants, which modify immune responses
Invention of penicillin 100 years ago increased human life expectancy by over 20 years
Cellular and Chemical Physiology
Atom = most basic structure of matter
→ composed of a nucleus and electrons that revolve around the nucleus (positively charged protons and uncharged neutrons)
Atoms defined by number of protons in their nuclei
EX: carbon has 6 protons, but if it had 7 it would no longer be carbon but nitrogen
Number of protons in nucleus = atomic number
96% of body is composed of 4 elements—oxygen, carbon, hydrogen, and nitrogen
In addition to atomic number, each element has an atomic mass number (sum of protons and neutrons)
EX: Carbon (C): mass number of 12 = each atom in the element has 12 neutrons and protons
Molecule is produced when 2 or more atoms share electrons or combine w/ each other through a type of magnetic attraction
EX: molecule of water is H20, 2 atoms of Hydrogen share electrons with 1 atom of Oxygen
Biological systems made up of molecules classified as: sugars (carbohydrates), fats (lipids), and proteins (enzymes)
Amino acids—20 of them—are building blocks of proteins.
EX of protein: insulin
Cell is a living structural and functional unit surrounded by a membrane that has several substructures.
center of each cell is a nucleus
→ as cells divide, each cell contains the same genetic material
Chromosomes are long strands of DNA (deoxyribonucleic acid)
each person has 46 chromosomes. sections of the 46 chromosomes that code for proteins are called genes
→ genes code for production of proteins within the cell, but can also turn on and off activity of other genes
11 organ systems total!
Integumentary System
outermost area of skin is = epidermis
under epidermis is dermis
then subcutaneous tissue which contain fat cells, blood vessels, and nerves
sweat (sebaceous) glands produce 600 mL sweat per day
Skeletal System!
206 bones, 106 just in hands and feet
supplied by blood vessels and nerves
bone marrow produces blood cells
bone stores calcium, phosphorus, and triglycerides
Joints—where two bones meet—allow movement
cartilage consists of collagen fibers
Muscular
skeletal muscle connects and moves bones; impulses from nerves allow voluntary movement
cardiac muscle is autoregulated
smooth muscle is not voluntarily controlled
Nervous
SNS (somatic): gather info from 5 senses, voluntary control
ANS (autonomic): gather info from organs such as stomach and lungs, involuntary control
efferent nerves classified as parasympathetic and sympathetic have opposing actions
→ EX: increasing vs decreasing heart rate
Endocrine
hormones are chemicals that act as messengers and excreted in response to signals originating in hypothalamus and pituitary glands
pineal gland in brain secretes melatonin
thyroid gland produces thyroid hormone: controls cellular metabolism and regulates body temp
parathyroid regulates body levels of calcium, phosphate, and magnesium
thymus produces hormone that promote immunity
adrenal produces glucocorticoids, mineralocorticoids, small amount of androgen, and epinephrine and norepinephrine
→ glucocorticoids: regulate metabolism and resistance to stress and anti-inflammatory effects
→ mineralocorticoids: regulate blood pressure by affecting amount of fluid retained in circulation
→ epinephrine & norepinephrine: known as adrenaline and nonadrenaline, are neurotransmitters excreted during exercise or stressful situations to increase heart rate and blood flow to organs and dilute airways
pancreas secretes insulin: lowers blood glucose levels, glucagon raises blood glucose levels
ovaries produce estrogen and progesterone
testes produce testosterone
Cardiovascular
heart: 4 chambers, 4 valves
right atrium receives deoxygenated blood from body through superior and inferior vena cava → pumped through tricuspid valve into right ventricle → pumps blood into lungs through pulmonary valve into right and left pulmonary arteries (picks up oxygen) → oxygenated blood (from lungs) received back into heart through pulmonary veins, into left atrium → blood passes through biscuspid valve into left ventricle → left ventricle pumps blood through aortic valve into aorta → blood throughout body
blood vessels that carry blood from heart are called arteries (contains oxygen)
capillaries are small blood vessels that connect arteries and veins: where nutrients and gases (oxygen) are exchanged within tissues
lymphatic
fights infection and maintains immune response to foreign substances, also drains excess fluid and transports fat
respiratory
if co2 builds up, blood = too acidic (pH too low) → toxic to cells
→ pH represents hydrogen ion content of the blood
if pH too high = blood is basic
pathphysiology!
hypertension: more common in blacks than whites, occurs in families (genetic predisposition)
depression: more common in women than men
diabetes: common among blacks, hispanic, american indian, asian american
sedentary lifestyle increase type 2
type 2 and alzheimer, older patients greater risk than younger
signs of symptom and disease:
subjective clues: signs of the disease
→ how patient describes disease
objective clues: symptoms of the disease
→ what health professionals find during physical examination or other tests
epidemiology: studying large numbers of people
analyzing populations of people rather than individuals
EX: when food poisoning occurs at a school or other large gathering of people
pharmacotherapy: treating disease with drugs
lifestyle modifications: changing patient’s diet, exercise, physical surroundings (e.g., removing a pet)
decreasing risk factors: eliminating tobacco, alcohol, illicit drugs, etc.
surgery:
pharmacotherapy: treating w/ prescription or nonprescription medications or dietary supplements
pharmacokinetics:
study of movement of drugs through the body
→ therapeutic doses: doses that produce the desired effects in people
some can be toxic to patients
4 Processes!
absorption
drug enters the blood
EX: through transdermal patch, inhaled into nose or lungs, taken by mouth, injected, etc
bioavailability: describe ratio between amount of drug that reaches the blood & amount of drug placed into body
→ high bioavailability means most of the drug taken ends up getting into systemic circulation via blood
→ low bioavailability means a small amount of drug reach systemic circulation via blood
distribution
movement of the drug through the blood and into various cells or tissues where it exerts its effect
metabolism
chemical changes made to the drug by the body
→ often made by the liver but can sometimes be made by gastrointestinal wall, kidneys, lungs, or blood
liver is main metabolizing organ of the body!
→ has enzymes that metabolize drugs into inactive compounds, or metabolites.
→ they are contained in special structures of the liver, CYP 450 system
CYP 1A2 and CYP3A4 are enzymes that cause drugs to interact w/ each other because they both have effects on or are metabolized by specific enzymes in the system
inactive chemical = prodrug
excretion
the drug or its metabolites leave the body, usually in urine or feces, sometimes through the lungs
→ can either be excreted as active drugs or inactive metabolites
the amount of drug excreted or metabolized to inactive compounds in a given organ or tissue over a certain amount of time is expressed mathematically
→ the time it takes for the serum drug concentration to decline by one-half is called = drugs half-life
Example of 4 Steps:
Alcohol!
alcohol is absorbed in stomach & first part of small intestine
→ moves through blood and into the brain, where it acts as a CNS depressant (slows down transmission of impulses among nerves in the brain)
metabolized in the liver, lungs, urine, and sweat to inactive compounds, including acetaldehyde. amount of acetaldehyde & other metabolites produced is predictably proportional to amount of alcohol in blood & also excreted through lungs and into the breath
pharmacodynamics: relationship between serum or tissue drug levels and drug effects
EX: higher concentration of BP drugs have more antihypertensive effects than do lower concentration
alcohol
→ low 50 mg/dL = euphoria
→ 100 mg/dL = impairment motor functions
→ 150-250 mg/dL = nausea and dysphoria
→ 300 mg/dL = loss of consciousness
→ 400 mg/dL = coma, sometimes death
strength of a drug is amount contained in a unit of the product, whether a tablet or tsp of liquid
EX: diazepam 5-mg tablets or amoxicillin suspension 150mg/5mL
some drugs have doses that can be therapeutic to one, but toxic to another
Dosage Forms Commonly Used
→ Solid Dosage Forms
pills
tablets
capsules
→ Liquid Dosage Forms
solutions
suspensions
syrups and elixirs
→ Topical and Other Dosage Forms
creams and ointments
lotions (emulsions)
transdermal patches and subdermal inserts
Vaginal, Urethral, and Rectal Dosage Forms
suppositories
Injectable Dosage Forms
injectable solutions
injectable suspensions
injectable emulsions
generic name
brand name (trade or proprietary) name
dosage forms