D1-D5 Flashcards
define the lethal dose (LD50)
the dose of a drug that causes death in 50% of laboratory animals
define the toxic dose (TD50)
the dose of a drug that causes toxicity (an unacceptable adverse effect) in 50% of patients
define the effective dose (ED50)
the minimum dose of a drug that produces the desired therapeutic effect in 50% of laboratory animals or human patients
define the therapeutic index in animal studies
the lethal dose of a drug for 50% of the population divided by the minimum effective dose for 50% of the population (LD50/ED50)
define the therapeutic index in humans
the toxic dose of a drug for 50% of the population divided by the minimum effective dose for 50% of the population (TD50/ED50)
the greater therapeutic index, the —– the drug
safer
define the therapeutic window
the range of dosages between the minimum amounts of the drug that produce the desired effect and a medically unacceptable adverse effect
where does the therapeutic window typically occur?
it usually opens below the ED50 (where some patients can still be provided with minimal beneficial effect) and closes below the TD50 (where only a small percentage of patients might experience significant adverse effects)
why should animal and human tests for drugs be kept to a minimum?
for ethical and economic reasons
name the 6 methods of drug administration
orally
rectally
parenterally
by inhalation
transdermally
describe when and how drugs would be taken orally
- drugs with any polar groups are generally water soluble and can be administered orally
- ingested by mouth
describe when and how drugs would be taken rectally
- some chemical compounds are unstable in the highly acidic gastric juice
- in the form of suppositories or enemas
describe when and how drugs would be taken parenterally, and state the 3 types of administration
- some chemical compounds are unstable in the highly acidic gastric juice
- injected under the skin (subcutaneous injection)
- injected into muscle tissue (intramuscular injection)
- injected into the bloodstream (intravenous injection)
describe when and how drugs would be taken by inhalation
- some volatile or highly dispersed drugs
- breathed in through the nose and mouth
describe when and how drugs would be taken transdermally
non polar compounds can be applied to the skin in the form of patches, ointments, or therapeutic baths
what are 4 considerations of drug administration?
dosage, tolerance, addiction and side effects
what is a double blind test?
neither the researchers directly observing the patients nor the patients themselves know who is given the real drug and who receives the placebo- this is to reduce the possibility of conscious or subconscious bias in the interpretation of the experimental results
what is a placebo?
a biologically inert substance
what is the placebo effect and what is its role in clinical trials?
the idea that the body can sometimes be deceived into healing itself without receiving any help in the form of medical drug
this effect must be taken into account during clinical trials, so volunteers are split into 2 groups
describe how drugs can have side effects and what these are
pharmaceutical drugs interfere with biological processes so no drug is completely safe or free from non-beneficial effects on the human body.
define drug bioavailability
the fraction of the administered dose that is absorbed into the bloodstream
what 4 things affect the bioavailability of drugs (and therefore the effective and toxic doses of a drug)?
- solubility
- polarity
- presence of certain functional groups
- method of administration
give an example of how functional groups affect drug bioavailability
polar molecules containing hydroxyl, carboxyl, and amino groups are usually soluble in water and are therefore quickly absorbed from the gastrointestinal tract into the bloodstream. However, such molecules cannot easily pass through hydrophobic cell membranes, which in many cases reduces their biological activity
why is intravenous injection the only route of administration that results in 100% bioavailability?
other routes of administration decrease bioavailability due to incomplete absorption, decomposition and other factors such as physiological differences
describe drug tolerance
- regular administration of certain drugs may reduce the body’s response to specific medications or classes of pharmaceutical drugs due to accelerated drug metabolism or changes in cellular functions
- drug users need progressively higher doses of the drug to obtain the desired therapeutic effect
what effect does drug tolerance have on the therapeutic window for some patients?
- increased doses lead to more pronounced side effects, which may eventually become unacceptable and close the therapeutic window
describe drug addiction
- the compulsive desire of a user to take a drug regardless of the health problems it might cause.
- this addiction may be purely psychological but it often involves some degree of physiological dependence that leads to withdrawal symptoms when the drug is interrupted
describe how drugs function at the molecular level
they interact with the binding sites of enzymes or cellular receptors (proteins composed of 2-amino acids)
describe a drug’s interaction with enzymes
by binding to enzymes most drugs act as inhibitors, reducing the activity of enzymes via competitive or non-competitive mechanisms.
describe a drug’s interaction with cellular receptors
if a drug binds to a cellular receptor, the cell responds to this chemical message by altering its state or allowing specific molecules to pass through the cell membrane
what does the type and efficiency of drug-receptor interactions depend on?
the chemical structures of the drug and the binding site
what type of bonds do drug-receptor interactions involve?
they can involve any types of chemical bonds
what are the two requirements for the drug and receptor to form interactions such as dipole-dipole, H, ionic bonds or London forces?
ideally, the functional groups of the drug and receptor should be complementary to one another and have correct orientations
how can efficient binding still be achieved if the structures of real drugs and their target receptors/enzymes do not match exactly?
by slight conformational changes of both the binding site and the drug molecule (induced fit theory for enzymes)
what can we do to change the nature and strength of binding of drugs?
chemical modification of certain functional groups of the drug
what is the first step of a drug development?
the identification of a lead compound (also known as a new chemical entity, NCE) that shows any kind of promising activity towards a specific biological target
describe the difference between drug discovery and drug design
drug discovery:
the lead compound can be isolated from natural products with known therapeutic effects or synthesised in the lab and screened against cell cultures, bacteria or animals.
drug design:
if the chemical composition and 3D structure of a biological target are known, a small molecule with a complementary structure. can be designed using computer modelling techniques. This is then synthesised, tested and adjusted
what is the second step to drug development?
a series of compounds similar to the lead compound are synthesised, characterised and subjected to preclinical trials
what happens during preclinical trials?
each compound is rated according to its:
- activity towards the target as well as unrelated biological targets
- chemical stability
- toxicity
- solubility in water and lipids
- preparation cost
- accessibility
- environmental impact
if all preclinical tests are successful, what happens?
information about the new drug is submitted to regulatory authorities and, with their approval, the drug is tested on humans in a series of clinical trials
describe phase I of clinical trials
SUBJECTS; small no of healthy volunteers
TEST RESULTS; toxicity and safety dosage (TD50), side effects
describe phase II of clinical trials
SUBJECTS; small no of patients
TEST RESULTS; effectiveness and effective dosage (ED50), safety and side effects
describe phase III of clinical trials
SUBJECTS; large no of patients
TEST RESULTS; comparison with other available drugs, drug compatibility, further data on effectiveness, safety and side effects
describe phase IV of clinical trials
post-clinical studies, where the study of effectiveness and safety of the drug continues during the whole period of its commercial use.
long term effects and chronic toxicity of the drug can be identified, including carcinogenic properties and effects on the immune system, fertility and reproductive functions
what is aspirin?
a mild analgesic
how do mild analgesics function?
by intercepting the pain stimulus at the source, often by interfering with the production of substances that cause pain, swelling or fever/
describe why salicylic acid (2-hydrobenzoic acid) cannot be used in its pure form
it causes severe digestive problems such as stomach irritation, bleeding and diarrhoea
how was salicylic acid first isolated?
it was taken from the bark of willow tree
how can the side effects of salicylic acid be minimised?
by using the chemically modified salicylic acid, known as acetylsalicylic acid or aspirin
how is aspirin prepared from salicylic acid?
via a condensation reaction
salicylic acid + ethanoic anhydride -> aspirin + ethanoic acid
SA is mixed with excess ethanoic anhydride and several drops of catalyst (conc phosphoric acid). the mixture is heated for a short time, diluted with water and allowed to cool down slowly, producing crystals of aspirin. The obtained product is usually impure so needs to be recrystallised from hot ethanol.
The identity of the product can be confirmed by IR spectroscopy and determining its melting point.
what are mild analgesics also known as ?
non-narcotic analgesics
non-steroidal anti-inflammatory drugs (NSAIDs)
how are mild analgesics different to strong analgesics?
mild analgesics affect the nervous system by intercepting the pain stimulus at the source.