1: Pharmacodynamics 1 Flashcards

1
Q

pharmacodynamics vs. pharmacokinetics

A

dynamics: drug effects on the body - dose-response relationships and drug-receptor interactions
kinetics: the body’s effects on the drug - ADME (absorption, distribution, metabolism, elimination) - [plasma] over time

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2
Q

what is biopharmaceutics?

A

science of how you package a drug to get it where it needs to go (we won’t talk about this much)

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3
Q

what is the cornerstone of pharmacology?

A

the receptor = drug target

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4
Q

definition of drug side effect

A

an unwanted or bothersome effect of a drug usually related to the main effect

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5
Q

definition of drug toxic effect

A

a harmful or adverse effect of a drug

  • generally not related to the main effect
  • often related to excessively high drug concentration
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6
Q

factors that affect the magnitude of response to drug therapy

A
  • dose administered
  • concentration at site of action
  • duration in which the drug remains at the site of action
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7
Q

time-action curve: two important questions for every drug

A
  1. How quickly will the drug act?
  2. How long will the drug effect last?
    • time to onset of therapeutic effect
    • minimum effective concentration
    • peak concentration
    • duration of action
    • residual effect
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8
Q

what type of function do drugs modify?

A

cellular function only

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9
Q

3 potential types of sites of drug action

A
  1. extracellular
  2. intracellular
  3. on the cell surface
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10
Q

examples of extracellular sites

A
  • neutralization of excessive gastric acid by antacids

- heparin in preventing blood coagulation

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11
Q

examples of intracellular sites

A
  • drugs used to treat infections
  • drugs used for cancer chemotherapy
  • hormones such as estrogen
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12
Q

examples of cell surface sites

A

many drugs act by combining with receptors on the cell surface

  • ACh and muscarinic receptors
  • catecholamines and alpha- and beta-receptors
  • histamine and H2 receptors
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13
Q

what determines the quantitative relationship b/w dose/concentration of drug and pharmacologic effects?

A

receptors

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14
Q

what determines the selectivity of drug action?

A

receptors - size, shape, and electrical charge of a drug molecule + changes in the chemical structure of a drug

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15
Q

definition of agonists

A

drugs that bind to a receptor and stimulate a biological response

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16
Q

definition of antagonists

A

drugs that bind to a receptor without altering receptor function, but prevent other drugs/substances from binding (such as agonists)

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17
Q

definition of inverse agonists

A
  • look like antagonist, but changes receptor to inhibit basal activity of that receptor
  • not many drugs use this action
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18
Q

macromolecular nature of most drug receptors

A

proteins

  • regulatory proteins (GPCRs, ion channels, transporters)
  • enzymes
  • transport proteins
  • structural proteins
19
Q

concentration-effect curves of agonists

A
  • responses to [low] increase proportionally (graded response - but there are some exceptions (bimodals))
  • as doses increase, the incremental response decreases
  • may become saturated = hallmark of a receptor-mediated response
20
Q

definition of effective concentration

A

EC50

-concentration at which you get 50% of the maximal response

21
Q

law of mass action for drugs

A

[D] + [R] [DR] –> effect
k1 = association rate constant
k-1 = dissociation rate constant

the effect of a drug is directly proportional to the amount of drug-receptor complex formed

22
Q

rate of association? rate of dissociation?

A

association: k1 [D][R]
dissociation: k-1 [DR]

23
Q

definition of dissociation constant

A

KD
-measure of how tightly the drug binds to the receptor
= [D][R]/[DR] = k-1/k1 (in moles)
-at KD, half the receptors are bound by drug
-allows you to compare affinities of different drugs

24
Q

the lower the KD, the ______ the affinity

25
relationship between occupied receptor B and drug concentration C
occupied receptor B = (C x Bmax)/(C + KD)
26
law of mass action: assumptions (3)
- the binding is totally reversible - D and R only exist as free and bound - all receptor sites are considered to have equivalent affinity for D and to be independent
27
definition of potency
- the dose of a drug required to produce a particular effect of given intensity - comparison based on doses that produce the SAME effect (usually ED50)
28
definition of affinity
- the ability of the drug to interact with the receptor - measured by KD - one of the determinants of potency
29
definition of efficacy
- the biological response resulting from the drug-receptor interaction/ magnitude of response from drug-receptor interaction - maximal efficacy is often limited by toxicity - includes how well the enzyme can convert the DR combo into the final product
30
which is more important as a drug property: potency or efficacy?
efficacy however, you also hope for good efficacy b/c less chance for adverse effects [D] + [R] [DR] ---------------> effect (potency) (efficacy)
31
definition of a partial agonist
- elicits a biological response, but it is not a full response, even at full receptor occupancy - cannot produce same maximal effect as a full agonist, regardless of concentration used - may competitively inhibit the response of a full agonist - mechanisms complex, but probably related to drug binding in inactive form of receptor
32
definition of receptor antagonism and three types
a drug-receptor interaction that interferes with or prevents the development of a drug response by an agonist - competitive - mixed - irreversible
33
definition of competitive antagonism
- antagonist combines with the same site on the receptor as the agonist - antagonism can be reversed by increasing dose of the agonist (outcompetes the antagonist) - has affinity but lacks significant intrinsic activity (efficacy)
34
how does a competitive antagonist shift the dose-response curve?
shifts the curve to the right in a parallel fashion (shape does not change) - indicates a reduction in the effective potency of the agonist magnitude of shift to the right is proportional to the [antagonist]
35
concept of spare receptors
- when the maximal response can be elicited by an agonist at a concentration that does not result in 100% occupancy of available receptors - important in the action of irreversible antagonists
36
how does an irreversible antagonist shift the dose-response curve in the presence of spare receptors?
- at lower [antagonist], you get a parallel, right shift and still get maximal response b/c there are more receptors present than are needed for full response - but reach a critical level of receptors required for maximal response: then as [antagonist] increases, the slope of the line decreases and you get a down shift (in a sense) of the line - with lessened maximal effect
37
definition of noncompetitive antagonists
- antagonist produces its effect at a site of the receptor other than the site used by the agonist - agonist and noncompetitive antagonist do NOT compete with one another for a single binding site - antagonism cannot be completely reversed by increasing the [agonist] - increasing [antagonist] increases KD and decreases Emax of the agonist - reduces both the efficacy and the affinity (increased KD) - right shift of the EC50
38
describe the log dose-response curve in the presence of a noncompetitive antagonist
- shifted to the right - as the dose of noncompetitive antagonist increases, the slope of the agonist curve and maximal response obtained are progressively decreased - at very high [antagonist], no amount of agonist can produce a response
39
comparison of reversible vs. irreversible antagonists
- an irreversible antagonist will usually bind to the same site as the agonist, but will not be readily displaced - irreversible inhibition is generally caused by covalent reaction b/w antagonist and receptor - inhibition persists even after an irreversible antagonist is removed
40
definition of positive allosteric activators
=positive allosteric modulator (PAM) - can increase potency and/or efficacy - synergistic with agonists
41
definition of negative allosteric activators
= negative allosteric activator/modulator - can decrease potency and/or efficacy - ex: noncompetitive antagonists
42
definition of functional/physiological antagonism + example
- two drugs influence a physiological system but in opposite directions - each drug is unhindered in the ability to elicit its own characteristic response ex: ACh on BP (lowers it) vs. epinephrine on BP (raises it)
43
definition of chemical antagonism
- a chemical reaction occurs b/w an agonist and an antagonist to form an inactive product - agonist is inactivated in direct proportion to the extent of the chemical reaction with the antagonist ex: Ca-antacids chelate tetracycline antibiotics; sodium nitrite inactivates cyanide