Phamacokinetics/dynamics Flashcards
Explain Bioavailability (F)
Proportion of administered dose that reaches systemic circulation, nothing to do with extent of drug that reaches effective therapeutic concentrations
Explain parenteral
Administered outside of alimentary tract
Explain steady state
Rate of drug administration = rate of drug elimination
Explain Tachyphylaxis
Rapidly decreasing response to drug after administration of a few doses
Explain Therapeutic Index (TI)
Ratio of drug plasma concentration producing toxic (TD50) vs therapeutic (ED50) effects in 50% of patients (high TI is beter than lower TI)
Toxic Dose
Effective Dose
Define pharmacokinetics
Pharmacokinetics- Body’s reaction to a drug. ADME
Absorption-process by which drug enters bloodstream
Liberation-drugs release from pharmaceutical form
Distribution-dispersion/dissemination of drug
throughout fluids/tissues in body
Metabolism-biotransformation/inactivation
Elimination-removal of substance from body
Explain pharmacodynamics
Pharmacodynamics- drugs reaction on body
Biochemical and physiologic effects of drug on
the body
Explain pharmacotherapeutics
Pharmacotherapeutics- Drug on disease
Biochemical and physiologic effects of the drug on
a specific disease
*Factors affecting interpretation of drug concentrations
- Tachyphylaxis-response doesn’t corrolate with drug levels
- Desensitization-decreased response over seconds/min in absence of change in agonist
- Aberrant metabolites-may produce unexpected effects
- Active metabolites- need to be measured in addition to parent compound
(Plasma drug level is assumed to reflect drug concentration at it’s target receptors)
Explain mechanism of desensitization and downregulation
- Agonist binding promotes Intracellular binding of a Gs protein
- When excessive stimulation is sensed by cell,a Beta-arrestin molecule binds to receptor to promote its internalization
- Once internalized, receptor is either:
- Recycled and it’s agonist is discarded
- The recycled receptor is placed back into the membrane as a step of resensitization
- If excess agonist stimulation continues, receptor is degraded as a means of downregulation, leaving the cell with less receptors than before
eg narcotics-later need more to get same effect
Give an example of drug synergism
Antibiotics represent synergism:
*blockage of sequential steps in a
microbe’s metabolism
*Beta-lactamase inhibitors prevent inactivation of
Beta-lactam antibiotics
*Antibiotics that can disrupt cell wall integrity
increase the likelihood of affected bacteria to
absorb a second antibiotic
(When one drug’s activity is enhanced in the presence of another drug)
Distinguish drug activity of agonist from antagonist
Agonist stimulates
Antagonist inhibits
Give exaple of drug synergism
Antibiotics
- Beta-lactam inhibitors prevent inactivation of beta-lactam antibiotics
- blockage of sequential steps in microbe’s metabolism
- antibiotics that can disrupt cell wall integrity increase the likelihood of affected bacteria to absorb a second antibiotic
Explain EC50 and Kd
EC50 is the amount of drug that causes 50% of effect
Kd measure of affinity of drug for a receptor
Agonist subtypes
Direct eg isoproterenal
Indirect eg cocaine
Mixed eg tamoxifen
Inverse eg antihistamines
Partial eg buspirone
Alosteric inhibitor/activator can change the sensitivity of a receptor for a specific agonist
Competitie inhibitor can be overcome by increasing the agonist concentration
Direct agonist vs indirect agonist
- Direct- Binds to receptor and produces max effect
- Indirect- enhances release/action of neurotransmitter but has no specific agonist activity at the neurotransmitter receptor itself
- can cause receptor block/induction of transmitter release/inhibits receptor breakdown
Mixed agonist
Partial agonist
- Mixed - Both agonist and antagonist activity
- Partial - trigger a response that is lower than that of full agonist ( touted forthwir reduced dependency and withdrawal effects)
Inverse agonist
Reverse activity of receptor
Produces effect less than the contstitutive effect(baseline effect/response normally found in body)
Functionally selective drug
Can act as full or partial agonist/antagonist depending on its interaction with receptors
Can act as full/partial agonist or antagonist through induced structural changes in G-protein coupled receptors which affect actions of Intracellular G-proteins depending on specific cellular milieu
Antagonist binding site selectivity
- Competitive-competes with agonist for binding (reversable/irreversible)
- Non-competitive -allosteric, unaffected by agonist dose. Binds to site distinct from agonist binding site, causes changes in agonist binding site
- Uncompetitive -require agonist. Locks receptor with agonist attached so agonist cannot disassociate and restimulate
Spare receptor theory
Therapeutic effect vs drug dose
Body has many extra receptors, to overcome competitive antagonists- increase agonist dose. Max effect can still be reached up until the critical nr of receptors are are bound by antagonists. Then only the max effect starts to decrease
Only with noncompetative agonists can agonists not produce full effect
How can you modify a patient’s drug plasma level with regard to dosing
Dose modulation(increase amou tof drug)
Dose frequency
Or both
With appropriate dosing the trough should meet the MEC (min effective concentration)
Dose before levels are too low
Drug metabolism
Most drugs metabolised after entering circulation, becoming highly polarised molecule eliminated via kidneys
Liver(main), GIT,skin.,kidneys,brain can contribute to metabolism
Bio transformation of drugs involves 2 phases
Phase 1 converts drug into more polar metabolite
When phase 1 does not produce highly polarised molecule, phase 2 reaction follows
Cytochrome P450 based drug metabolism
CYP450 cytochromes form versatile group of biocatalysts that are not involved in electron transport
Found throughout body but concentrated in liver
Recognised for hormone synthesis and xenobiotic metabolism (xenobiotic-foreign chemicals,drugs, pollutants that have been introduced in the body
Carries out phase 1and 2 reactions
