midterm #1 Flashcards
median effective dose ED50
dose that’s effective in 50% of individuals tested
median lethal dose LD50
dose that’s lethal in 50% of individuals tested
ionized molecules (3 + what percentage depends on (3))
- when drug dissolved in a liquid, some of its molecules become ionized
- ions not lipid-soluble, cannot cross membranes
- percentage of ionized molecules depends on: drug acid/base, liquid acid/base, drug pKa (pH at which half its molecules are ionized)
- faster absorption with lower percentage of ionized molecules!
first-pass metabolism
metabolism of drugs in the liver before the drug is distributed throughout the body
- ingested drugs reach liver before arriving at the heart
- only applies to drugs absorbed by the intestines
rates of elimination
first-order elimination:
- half-life, asymptotic elimination rate
- low toxicity
zero-order elimination:
- constant elimination rate
- as soon as toxicity is hit (e.g. alcohol, overdose response)
kidneys
- maintain balance of water and salt
- excrete unwanted molecules (e.g. liver metabolites)
- filter out everything, then allow re-absorption of all that’s required
oral administration
stomach: impermeable, no distribution
intestines: permeable, distribution
- much easier absorption for lipid-soluble drugs
combination of absorption and elimination
rate of elimination (half-life) for any drug stayconstant, but absorption differs depending on administration route
-> resultant curve depends on administration
upregulation vs downregulation
upregulation:
- increase in receptors/sensitivity/transmitter production
- response to drugs blocking receptors
downregulation:
- decrease in receptors/sensitivity/transmitter production
- response to drugs activating receptors
blood-brain barrier: active vs passive diffusion
active:
- transport, also against concentration gradients
- requires energy
passive:
- diffusion through channel protein
- attaching to carrier protein
urinalysis and blood sampling
+ problems (3)
urinalysis: looks for metabolites
blood sampling: looks for drug itself
problems:
- elimination time > detection time (cannot say when drug’s been taken)
- length of drug use (metabolic deposits)
- individual differences
tempering with drug tests
substitution: put in someone else’s urine
adulteration: change molecules, e.g. attach to fat
dilution: decrease concentration
potency
efficacy
effectiveness
potency: amount required to produce a given effect
efficacy: maximum response achievable for a given dose
effectiveness: ability to produce the therapeutic effect, taking into account secondary and side effects
therapeutic index
LD50/ED50 -> safety ratio, how safe a drug is
protective index
TD50/ED50 -> safety ratio
TD50: dose at which 50% of people have complaints
- reserved for humans
certain safety factor
LD1/ED99 -> where 99% have effect and 1% dies
- pertains to instant and not long-term use
pharmacological antagonism (2)
reduced effect due to presence of another drug
(1) competitive:
- at site of action
- need more drug to achieve max result (curve shifted to right)
(2) non-competitive:
- drug B binds to receptor or allosteric site, reduces receptor activity
- reduces max achievable result (decreased efficacy)
physiological antagonism
when substances produce different effects counteracting each other, via different binding sites and mechanisms
additive effects (2)
combined drug effects
(1) synergistic: combined effects are greater than their sum
(2) potentiation: ineffective drug becomes (more) effective in presence of another drug
pharmacodynamic tolerance (2)
tolerance in CNS (number of receptors/neurotransmitters)
(1) protracted:
- after several exposures
- need more drug for same psychological effect (graded)
(2) acute / tachyphylaxis:
- after only one exposure
- psychological effects during intake, not elimination
- reduced subjective effect (threshold)
pharmacokinetic tolerance
changes in metabolism resulting from constant concentrations in body
increases in rates of:
- enzymes (enzyme induction)
- elimination from body
cross-tolerance + factors (2)
tolerance that extends to another drug
factors:
- enzymes
- CNS: site of action (downregulation), similar reward-feedback mechanism (upper limit for DA release)
behavioural tolerance + factors (2)
adjustment and compensation as a result of experience
factors:
- self-awareness
- determination
homeostasis
allostasis
homeostasis: internal equilibrium condition
allostasis: physiological changes to obtain homeostasis to adapt to severe environmental demands
- more permanent state with chronic illness or stress