Basic Principles of Pharmacology Flashcards

Exam 1

1
Q

Differentiate the following: Pharmacodynamics, Pharmacokinetics, Pharmacogenomics, & Toxicology

A

-Pharmacodynamics: Describes what the drug does to the body.
-Pharmacokinetics: Describes what the body does to the drug; absorption, distribution, metabolism, excretion
-Pharmacogenomics: Looking at a genetic profile to determine how effective a drug will be
-Toxicology: Specifically relates to poison, toxins, and how they relate to the body

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2
Q

Agonistic vs Antagonist

A

Agonistic: Elicits a response from a receptor when it binds to the receptor
-Effect may be lesser or greater than the native ligand (endogenous hormone or catecholymine)

Antagonistic: Blocks the endogenous/native ligand from binding to the receptor
-Does not activate a response

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3
Q

Allosteric vs Orthosteric
Specific Binding vs Non Specific Binding

A

Allosteric: Binds anywhere but the active site on the receptor
-Is a non competitive inhibitor because it does compete for the active site

Orthosteric: Binds directly to active site on the receptor

Specific Binding: Binds specifically to the receptor. There is a max dose because receptors are not infinite

Non-specific Binding: The more drug that is given, the more non-specific the binding becomes. The drug saturates the receptors and must bind somewhere else.
Ex: Albumin

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4
Q

Describe the difference between toxins and poisons

A

Poison: A nonbiological substance such as arsenic, cadmium, lead
Toxins: A biological substance such as toxic mushrooms, a puffer fish

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5
Q

Describe the Relative Bond Strengths

A

Covalent Bond: Share electrons. Strongest bond, but least specificity. Irreversible

Electrostatic: Ionic Bonds;
-Charged molecules
- Hydrogen bonds
- Van der waals forces

Hydrophobic, lipid soluble drugs: Weakest bond, highest specificity

Bond strength and specificity are inversely related

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6
Q

Racemic Mixtures, Stereoisomerism, Isomers

A

-Isomers of a drug have the same chemical equation, but different shape.
-Stereoisomerism (Optical Isomers) is when isomers are mirror images of each other, but do not behave the same way. This applies to more than half of all drugs
-Racemic Mixtures are optical isomers

Ex: (R) Ketamine- More toxic than (S) Ketamine, increased unwanted side effects
(S) Ketamine: 4x more potent, less unwanted side effects

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7
Q

Competitive & Allosteric Inhibitors

A

Competitive Inhibitor: Binds to the active site in place of agonist. If a high enough dose of the agonist is given, it can “out-compete” the competitive inhibitor

Allosteric Inhibitors: Bind somewhere other than the active site on the receptor, so they are not competitive. Agonist response is always muted when given with an Allosteric inhibitor

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8
Q

Active Receptors vs Inactive Receptors

A

Receptors live in equilibrium between the active and inactive state. These configurations can switch back and forth between active and inactive without a drug/endogenous ligand present. When a drug favors the active form of a receptor, a downstream response will be elicited

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9
Q

Other Mechanisms of Antagonism: Physiologic Antagonism

A

Two or more physiologic processes that have an opposite effect

Ex: SNS vs PNS; epinephrine secreted acts on the B1 receptors, increases heart rate. Acetylcholine acting on the muscarinic receptors decreases heart rate

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10
Q

Pharmacodynamics: What happens when an Agonist is given with a single dose of 1) Allosteric Agonist, 2) Competitive Inhibitor, or 3) Allosteric Inhibitor?

A

-Agonist + Allosteric Agonist/Activator: We will see an increased/maximal drug response here compared to giving an agonist alone

-Agonist + Competitive Inhibitor: We can initially have a muted response; however, giving more of the agonist will allow it to out-compete the competitive inhibitor and we will have an increased response

-Agonist + Allosteric Inhibitor: We will have a muted response here. There is no way to out-compete the Allosteric inhibitor because they do not bind to the same area on the receptor

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11
Q

Agonist Mimic, Indirect Agonist

A

Agonist mimics or Indirect Agonists are downstream inhibitors. You have a receptor activated that causes a cascade of effects: A—> B—>C. Let’s say there is an enzyme that is supposed to break down “C”. You give the agonist mimic and it breaks down that enzyme, increasing your amounts of “C”

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12
Q

Receptor- Antagonist Interactions; Competitive Inhibitors & Non-Competitive Inhibitors, insurmountable vs surmountable

A

Competitive inhibitors/antagonists: They are SURMOUNTABLE because you can continue to give increasing doses of the antagonist to overcome the competitive inhibitor as long as they do not form covalent bonds

Competitive Orthosteric inhibitors/antagonists: Compete for the active site, but if they form covalent, irreversible bonds, it makes make them INSURMOUNTABLE

Non-competitive Allosteric inhibitors/antagonists: They are INSURMOUNTABLE because they are not directly competing for the same site. These are irreversible

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13
Q

Partial Agonist, Inverse Agonist vs. Full Agonist

A
  • A partial agonist, when given alone, will always have a muted/lessened response
    -When given with full agonist; acts as antagonist

-Inverse Agonist: Favors the receptor in its inactive form. It lowers the receptors’ activity below its constituitive activity, causing it to be less active with the drug present than without. Clinically, these act as antagonists but stronger

-A full agonist elicits a full downstream response once given

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14
Q

Other Mechanisms of Antagonism: Administration of opposite charge

A

Ex: Protamine (+) binds to and inhibits the effect of Heparin (-)

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15
Q

Potency; Dose-Response Curve

A

-Potency directly correlates to affinity; as drug potency increases, drug affinity for that receptor increases
-EC50 represents when a drug is 50% effective. The EC50 and potency are inversely related.
-As potency decreases, the EC50 increases and shifts to the RIGHT
-As potency increases, the EC50 decreases and shifts to the LEFT
-If graph is shifting horizontally, we are seeing a change in POTENCY

-Drugs can have different potency, but efficacy can be the same

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16
Q

Efficacy: Dose-Response Curve

A

-Based upon drug-receptor interaction
-Efficacy correlates to the EC50
-Increased receptor occupation of drug means increased effectiveness
-Also depends on intrinsic activity, are these drugs agonists, antagonists, partial agonists, etc..

-If curve is shifting vertically, there is a change in efficacy

-Drugs can have different potency, but efficacy can be the same

Efficacy is more important than potency

17
Q

Drug Response Curve Vocab

A

-EC50: Point at which the drug is 50% effective
-Inversely related to affinity & potency
-ED50: Dose at which drug is 50% effective
-Emax: Drug is at 100% efficacy

-Kd: Point at which 50% of the receptors are bound
-Bmax: All receptors are bound

18
Q

Role of Drug Carriers; Most Common in the blood

A

-The role of drug carriers is to bind to the drug and carry it through the cardiovascular system. Plasma proteins have inert binding sites that the drug will bind to, causes no change
-Albumin is the most important/prevalent carrier
-Drugs cannot cross any carriers when bound to plasma proteins because of size
-Drugs can diffuse into tissues in their free form
-Conditions that decrease your levels of albumin affect drug distribution
-Dose is dependent on how much drug is bound and how much is free floating
-Multiple drugs can also compete for the inert binding site

Types of carriers:
1) Albumin; mostly acidic drugs
2) A1-Acid Glycoprotein; mostly basic drugs
3) Lipoproteins; mostly neutral drugs

19
Q

Therapeutic Index

A

The larger the therapeutic index, the safe the drug is.

TD50= Median toxic dose

ED50= Median effective dose

Calculate therapeutic index: TD50/ED50
(LD50 for animals, not used in humans)

20
Q

Drug pH & pKa

A

-Most drugs are weak acids or weak bases. pKa is the pH at which ionized & unionized concentrations are equal.
-Drugs need to be uncharged in order to cross the cell membrane; pKa affects the charge

-pH < pKa; favors protonated form
-pH > pKa; favors unprotonated form

Weak acids: protonated form is uncharged, unprotonated is charged

Weak bases: protonated form is charged, unprotonated form is uncharged

21
Q

Drug Variations in response (tolerance, physiologic antagonism etc)

A
  1. Tolerance; more drug given over time, the more drug it takes to reach efficacy
  2. Tachyphylaxis; a quick tolerance
  3. Chemical antagonist
  4. Physiologic Antagonism
22
Q

Causes of Drug Variations

A
  1. Different concentration of the drug reaches the receptor site due to variations in rate of absorption, distribution, or clearance. Age, weight, sex, disease state are all factors
  2. Variation in concentration of the endogenous ligand; not everyone has the same amount of receptor sites
  3. Functionality of receptors
  4. Changes in the downstream cascade (most likely) due to proteins altering the response
    -Body has a natural ability to compensate for this
23
Q

Define monoclonal antibodies and how they are produced

A

-Biologics, drugs created from living organisms
-Extracted from living organisms such as abx, blood, transplants, microbiota and produced by recombinant DNA technology

-Mice are immunized with an antigen, and antibodies are made. Once the mice’s serum titer level is sufficient, they are euthanized and their spleen is removed as a source of cells for cell fusion

24
Q

Naming for monoclonal antibodies, pathologic conditions

A

Ends in -mab
Rheumatoid Arthritis, Eczema (Dupixent), Psoriasis, Hidradinitis suppurativa

25
Q

Role of the FDA

A

-Oversee the development process of drugs in the US
-Grants approval for marketing
-Reviews claims and makes recommendations

26
Q

Difference in regulation between prescription and OTC drugs

A

-Prescription drugs have a higher potential for harm w/ misuse
-Only available under the care of an authorized health professional
-Must be safe AND effective

-OTC drugs are freely available to the public
-Lower risk for harm, but does not mean they’re safe. OTC herbal supplements do not have to be effective, only safe

27
Q

The steps to bring a prescription drug to market

A
  1. In vitro studies, ~ 2years
  2. Apply for patent at year 2
  3. Animal testing begins, 2-4 years, apply for IND
  4. Phase I begins- small group of healthy adults test the drug
  5. Phase II- Small group (100’s) of adults with said disease condition. Usually double blind studies
  6. Phase III- Clinical testing on 1000’s of sick adults, market formulation, submit NDA (Year 9-10)
  7. Phase 4- Marketing. Patent will expire sometime shortly after this phase and generic will become available