Pharmacology Flashcards
what is the process by which a drug enters the body from its site of administration?
absorption
what is the process by which a drug leaves the circulation and enters tissues perfused by blood?
distribution
what is the process by which tissue enzymes (principally in the liver) catalyze the chemical conversion of a drug to a more polar form that is more readily excreted from the body?
metabolism
what is the process that removes the drug from the body (principally the kidneys)?
excretion
metabolism + excretion =
elimination
what are the 4 physicochemical factors that control drug absorption?
- solubility
- chemical stability (ie will it be destroyed by stomach acid or enzymes?)
- lipid to water partition coefficient
- degree of ionisation
what does the lipid to water partition coefficient mean?
the relative solubility of the drug in lipid compared to water.
as the partition coefficiant increases (ie the lipid solubility increases), the rate of diffusion across a membrane will increase
why does the degree of ionisation affect the drug absorption?
because most drugs exist in equilibrium between ionised and unionised forms, but only unionised forms readily diffuse across the lipid bilayer
what is pKa?
the pH at which 50% of drug is ionised and 50% unionised
What is the henderson-hasselbalch equation to work out the ionisation ratio for a base?
pH - pKa = log(B/BH+)
What is the henderson-hasselbalch equation to work out the ionisation ratio for an acid?
pH - pKA = log(A-/AH)
in an acid environment, what happens to the ionisation ratio of an acidic drug?
less ionised
and so more readily absorbed
in an acid environment, what happens to the ionisation ratio of a basic drug?
more ionised
and so less readily absorbed
in a basic environment, what happens to the ionisation of an acidic drug?
more ionised
and so less readily absorbed
in a basic environment, what happens to the ionisation of a basic drug?
less ionised
and so more easily absorbes
ionisation ratio depends on what 2 factors?
pKa of the drugs
pH of the loval environment
compare absorption of strong and weak acids/bases.
weak acids and weak bases are well absorbed
strong acids and strong bases are poorly absorbed
what are the 5 factors for drug absorption in the gut?
- gastrointersinal motility
- pH at absorptive site
- blood flow to the stomach and intestines
- the way in which the drug is manufactured ie is it slow release
- physiochemical interations (eg the rate of absorption might be affected by some foods)
what is oral availability?
the fraction of drug that reaches systemic circulation after oral ingestion
what is systemic availability?
the fraction of drug that reaches the systemic circulation after absorption
what route of administration provides 100% systemic availability?
IV
what are the 8 routes of drug administration?
- inhalation (INH)
- oral (PO)
- Sublingual (SL)
- Subcutaneous (subcut)
- Intravenous (IV)
- Rectal (PR)
- Intramuscular (IM)
- topical (top.)
what are 3 the advantages of the oral route of administration?
convenient
non-sterile
good absorption generally
what are the 4 disadvantages of the oral route of administration?
inactivation of some drugs by acid/enzymes
variable absorption
first pass metabolism
GI irritation
what are the 2 advantages of the sublingual and rectal route of administration?
by-passes portal system and so avoids first pass metabolism
avoids gastric acid
what is the main disadvantage of the sublingual route of administration?
few preparations are actually available
what are the 2 disadvantages of the rectal route of administration?
variable absorption
aesthetically unacceptable in UK
what are 4 advantages of the IV route of administration?
rapid onset
continuous infusion
complete systemic availablity
can be used for drugs that cause local tissue damage
what are the 3 disadvantages of the IV route of administration?
sterile preparation required
risk of sepsis or embolism
high drug levels at the heart
what are the 2 advantages for intramuscular and subcutaneous routes of administration?
rapid onset of lipid soluble drugs
slow prolonged release possible
what are the 3 disadvantages of intramuscular and subcutaneous routes of administration?
painful
tissue damage with some drugs
absorption variable
What are the 3 advantages of the inhalational route of administration?
lungs have high surface area
good for volatile agents (such as anaesthetic gases)
ideal fo local effect
what is the main advantage of the topical route of administration?
ideal for local effect
what type of drug (free or bound) is allowed to move between body fluid compartments)?
free drug
what is the volume of distribution? (Vd)
the apparent volume in which a drug is dissolved in
for a drug administered intravenously what is Vd?
dose/ plasma concentration
what does a Vd >15L imply?
distribution throughout total body of water OR concentrated in certain tissues
reason: highly lipid soluble drug
what does pharmacodynamics mean?
what a drug does to the body
what does pharmacokinetics mean?
what the body does to a drug
what is an agonist?
a drug that binds to a receptor to produce a cellular response
what is an antagonist?
a drug that blocks that actions of an agonist
inhibits receptor
what is affinity?
the strength of association between ligand and receptor
as affinity increases, what happens to dissociation rate?
decreases
what is efficacy?
the ability of an agonist to evoke a cellular response
as the efficacy increases, what happens to the response rate?
response rate increases
compare antagonists and agonists in terms of affinity and efficacy.
agonists have affinity and efficacy
antagonists have affinity but lack efficacy
what type of relationship exists between the agonist concentration and the response?
hyperbolic relationship
as the concentration of agonist increases, the percentage of receptors occupied increases (and therefore response increases) until it levels our and all receptors are occupied
what is EC(50)?
effective concentration at 50%
the concentration of agonist that elicits a half maximal response
what type of graph expands the lower range of the x axis and so gives a more acurate reading?
logarithmic graph
relationship becomes sigmoidal
what does equipotent mean?
the drugs have the same EC(50)
ie the drugs have the same concentration for which they elicit half a maximal response (it doesnt matter if one has a better percentage response than the other- efficacy)
what is competitive antagonism?
binding of agonist and antagonist occur at the same orthosteric site, so they are in competition with each otehr
what is non competitive antagonism?
agonist binds to orthosteric site but antagonist binds to separate allosteric site.
both may occupy the receptor simutaneously but activation cannot occur when the antagonist is bound.
what does a competitive antagonist do to potency of the agonist?
reduces potency
what does a non competitive antagonist do to potency of the agonist?
nothing
what does a competitive antagonist do to efficacy of the agonist?
nothing
what does a non competitive antagonist do to efficacy of the agonist?
decreases efficacy
compare the efficacy of partial agonists and full agonists.
partial agonists have a lower efficacy than full agonists
how many glycoprotein subunits are there in a Nicotinic Acetylcholine (ACh) receptor?
5
what type of channel is a nicotinic acetylcholine (Ach) receptor?
cation conducting channel
what are the 9 steps of cholinergic transmission at a synapse?
- uptake of choline
- synthesis of ACh
- Storage of ACh
- Depolarisation by action potential
- Ca2+ influx
- Ca2+ induced release ACh
- Activation of ACh receptors (either nicotinic or muscularis)
- Degradation of Ach to choline and acetate
- Reuptake and use of choline
within the nerve terminal of the pre-synaptic neurone, how is choline uptake achieved?
via transporter
within the nerve terminal of the pre-synaptic neurone, how it ACh synthesised?
Choline + AcCoA
via choline acetyltransferase (CAT)
Within the nerve terminal of the pre-synaptic neurone, what happens to ACh as it is stored in transporters?
becomes more concentrated
Within the nerve terminal of the pre-synaptic neurone, how does the Ca2+ influx come about?
Ca2+ influx through voltage-activated Ca2+ channels
remember the cell has just become depolarised
what does depolarisation mean?
the membrane potential becomes positive
for volatage-activated Ca2+ channels to become open, what must the membrane potential be?
positive
how does the Ca2+ induced release of ACh occur from the pre-synaptic neurone?
exocytosis
what does activation of the nicotinic ACh receptors on the post-synaptic cell cause?
Na+ influx into post-synaptic cell, causing depolarisation
What enzyme degrades ACh to choline and acetate?
acetylcholinesterase (AChE)
what 2 types of ACh receptors are there?
nicotinic
muscarinic
what kind of action potential is formed from the post-synaptic depolarisation?
all-or-none action potential
along the post-synaptic neurone how is the AP (depolarisation wave) sent?
voltage-activated Na+ channels
a wave of Na+ influx
what type of molecular mechanism dows hexamethonium use?
open channel block
a form of non-competitive antagonism
in parasympathetic neuroeffector junction, what particular receptors are stimulated by ACh?
g-coupled muscarinic ACh receptors
subtypes M1-M3
what G protein does M1 receptor have coupled to it?
Gq
What does activation of Gq protein cause?
stimulation of phospholipase C
What type of muscarinic receptor is involved in the stimulation of increased stomach acid secretion?
M1
what G protein does M2 receptor have coupled to it?
Gi
what does activation of Gi protein cause?
inhibition of adenylyl cyclase
opening of K channels
what type of muscarinic receptor is involved in decreasing heart rate?
M2
what G protein does M3 receptor have coupled to it?
Gq
what type of muscarinic recptor is involved in the contraction of the bronchiole smooth mucle?
M3
describe the 8 steps of Noradrenerigc (NA) transmission?
- synthesis of NA
- storage of NA
- depolarisation by action potential
- Ca2+ influx
- Ca2+ induced release of NA
- Activation of adrenoceptor subtypes on effector cell
7, reuptake of NA by transporters - metabolism of NA