Mechanisms of Drug Action (Cecilia A. Jimeno, MD) Flashcards
Drugs are usually grouped according to what properties?
Pharmacodynamic properties
Define: Pharmacodynamics
What the drug does to the body
It includes receptor interactions, dose-response phenomena and mechanisms of therapeutic and toxic action.
Define: Pharmacokinetics
What the body does to the drug
Study of absorption, distribution, metabolism and excretion of the drug
“Toxic effects are usually an (1) of the therapeutic effect.”
(1) extension
What type of receptor does insulin interact with?
Tyrosine kinase receptor
What receptive substance did John Newport Langley investigate?
Atropine in pilocarpine induced salivation.
What does pilocarpine do?
It induces salivation in people with dry mouths.
What term did Paul Ehrlich coin?
Receptor
“A drug will not work unless it is bound!”
Describe drugs, effectors and receptors in terms of composition
Drug - heterogenous
Receptor - homogenous
Effectors - heterogenous (i.e. ion channels or kinases)
“Receptors determine (1) relations between dose or concentrations of drug and pharmacologic effects.”
(1) quantitative
Describe the relation between potency and quantity of a drug.
The more potent the drug, the less of it is needed to effect a change.
Describe: Sigmoid Dose-response Curve
Saturation - total number of receptors may limit the maximal effect of a drug
What properties of the ligand must be considered in receptor binding?
- Size
- Shape
- Electrical charge
Describe the mechanism of action of paracetamol
Only works in brain COX
Good anti-pyretic but poor anti-inflammatory
Describe the action of glucocorticoid
It is anti-inflammatory.
It can bind to mineralocorticoid receptors.
T/F: The same drug may be both an agonist and antagonist.
True
This may be the case for different receptors.
What are the two major domains of a receptor?
- Ligand binding domain
2. Effector domain
What are non-protein receptors?
DNA receptors
Anti-microbial and anti-tumor drugs bind to these.
Methods of identifying receptors
- Drug binding (radioisotope-tagged)
2. Molecular biology (gene sequencing)
Define: Orphan Receptor
Receptor with a structure similar to existing receptors but for which the endogenous ligand has not yet been determined.
Types of protein receptors
- Regulatory
- Enzymes
- Transport
- Structure
What chemical signals do regulatory receptors deal with?
Neurotransmitters, autacoids and hormones
What ligands does dihydrofolate reductase bind?
Methotrexate and alpha-glucosidase inhibitors
What is methotrexate?
Anti-neoplastic drug
What are alpha-glucosidase inhibitors?
Anti-diabetic drugs
What is the receptor for colchicines?
Tubulin
What are colchicines?
Anti-inflammatory agents used against gout
What are the common receptor superfamilies?
- Ligand-gated Ion Channels (Ionophores)
- G-Protein Coupled Receptors (Metabotropic)
- Enzyme-linked Receptors
- Nuclear Receptor (in cytoplasm!)
What entity developed the nomenclature system for receptors?
International Union of Pharmacology (IUPHAR) Committee on Receptor Nomenclature and Drug Classification
Describe the mechanism of action of ligand-gated ion channels
- Signal binds
- Channel opens
- Ions flow across the membrane
What can be said about neurotransmitters and ionophores?
Most neurotransmitters utilize ionophores.
What neurotransmitters use ionophores?
- Acetylcholine
- GABA
- Serotonin
- Glutamate
What is the result of ionophore activation?
There is increased transmembrane conductance and alteration of membrane electric potential.
Describe the subunits of ionophores
4 - 5 transmembrane helical subunits
Describe the Nicotinic Ach receptor
- It possesses 5 subunits (2 alpha, 1 beta, 1 delta, and 1 gamma).
- Each subunit is made up of four polypeptides.
- Alpha-helices form the gate.
- Curved conformation when sealed; straight conformation when open.
What is the result of Nicotinic Ach receptor activation?
Local excitatory postsynaptic potential resulting in depolarisation
What is the barbiturate receptor targeted for?
- Inducing sleep
2. Used as anaesthesia for convulsions and seizures
What is the mechanism of action of the barbiturate receptor?
It causes hyperpolarization by allowing entry of Cl- ions. There is failure of action potential.
What is the mechanism of action of benzodiazepine?
Allosteric activator of GABA receptor
What substances bind to the barbiturate receptor?
Barbiturates and benzodiazepine
Enumerate four anti-seizure medications that close Na+ channels.
- Carbamazepine
- Phenytoin
- Lamotrigine
- Valproate
Describe the time course of action of ionophores
Rapid (milliseconds)
How are ionophores regulated?
- Phosphorylation
2. Endocytosis
T/F: CNS acting drugs are examples of ionophores.
True
What cardiac effects does verapamil have?
- Anti-arrythmia
2. Reduce BP
Describe the mechanism of action of verapamil
Inhibits voltage-gated Ca2+ channels in the heart and vascular smooth muscles
What is the largest superfamily of receptors?
G Protein Coupled Receptors (GPCRs)