Pharmacology - Targets For Drug Action Flashcards

1
Q
What’s :
Pharmacology ?
Toxicology ?
Therapeutics ? 
(3)
A

Pharmacology : study of the way in which the function of living things is altered by chemical agents !

Toxicology : The study of toxic or harmful effects of chemicals , their mechanisms and conditions of occurrence

Therapeutics :The branch of medicine concerned with the use of drugs to treat a disease of its symptoms

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2
Q

Where do drugs come from ?

5

A

1) individual chemicals purified from cells and tissues (PLANTS)
2) ANIMALS
3) chemical synthesis
4) large scale production of recombinant human proteins ie : human insulin
5) antibodies to human proteins : Cytokines mediators

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3
Q

What are the molecular targets for drug Action?

3

A

1) Proteins :
- ions channels
- membrane proteins
- enzymes
- non-cellular proteins
- receptors

2) nucleic acids
3) miscellaneous targets ( metal ions and GI contents)

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4
Q

What’s an agonist drug ?

1

A

Chemical which binds to a receptor and causes a biological response !!
It mimics the natural chemical mediator

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5
Q

What’s an antagonist drug?

2

A

Inhibits the physiological effect of chemical mediator or agonist !

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6
Q

What’s a blocker drug?
What’s an allosteric modulator ?
What’s an inhibitor modulator ?
facilitator modulator ?

Can u give examples ?

(6)

A

1) blocker= beta blocker ie : Lidocaine which is a local anaesthetic, it blocks V-G Na+ channels so depolarisation doesn’t occur= no AP =No contraction !
2) Allosteric modulator = binds to allosteric site and these can be inhibiting like Amplodipine ( targets V-G ca2+ channels = less contraction in muscle = so vessel dilates , very useful in treating High BP and preventing Angina and hypertension.

3)Facilator modulators = binds to allosteric sight and increases function ie : Diazepam which causes GABA receptors CL- gate to be opened wider and for a longer time = HYPERPOLARIZATION so the cell Is less excitable ; this DECREASES neuronal activity in brain and relieves Anxiety / acts as a sedative !
Diazepam acts as a facilitator OF GABA which is a inhibitory neurotransmitter .

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7
Q

What is an inhibitor drug? (2)
-cl channel example
what’s a false substrate? (3)

A

Binds to channel and causes loss of function ie:
FUROSEMIDE =binds to the chloride transport channel, thus causing sodium, chloride, and potassium loss in urine. ( loop diuretic)
so REABSORBTION DECREASES= OFFLOADS FLUID!

False substrate : accumulation of unnatural compounds which compete with the natural substrate ie: AMPHETAMINE (ecstasy) which has a similar shape to noradrenaline, serotonin and dopamine. this can be a short term performance enhancer providing wakefulness, foes and euphoria.

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8
Q

what is a pro drug ? (2)
what is a an example of a non cellular target site?(2)
what is an example of a nucleic acid drug ?(2)

A

1- They require conversion by an enzyme in liver to become activated
ie : ACE inhibitor = perindoperil –> Perindoprilat ( which is activated form and can act on ACE inhibitor )

2- non cellular target site ie: antibodies and cytokines ie :
Heparin which act on glycoproteins in blood

3-CISPLATIN- cross links DNA , STOPS TRANSCRIPTION, replication and is used as an anticancer drug

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9
Q

How are receptors divided into categories ?
broad overview of pharmacological and molecular biology approach …

(4 )

A

There is a pharmacological approach which classifies the adrenoceptors, demonstrating that their are ALL different: they all have different potency , and different agonists and antagonists too !

-Receptors can also be classified according to the molecular biology approach which illustrates that they can be divided into 4 SUPER FAMILIES :

1) Ligand gated channels ie : acetylcholine
2) G-protein coupled receptors ie: muscarinic Ach receptor
3) Kinase linked receptor ie: RTK
4) Nuclear receptors which cause gene transcription

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10
Q

using the adrenoceptor family illustrate the general principles of receptor classification
give an example of a selective agonist
give an example of a selective antagonist

(6) case study of adrenoceptors

New research ? ( 2)

A

Adrenoceptor family –> Alpha and Beta adrenoceptors
1) Alpha Adrenoceptors : split into Alpha 1 and alpha 2
2)Beta is split into 3 : b1/b2/b3
they both have Selective agonists and selective antagonists
All receptors are DIFFERENT which enables selective drug use and they are ENCODED BY DIFFERENT GENES , HENCE they differ slightly in the binding sites ie :

3)Salbutamol (selective agonist )can identify the sub groups of the beta receptor - B2 . It has a higher potency in the airways where the B2 receptor is , compared to in the heart where there is B1 receptors .( causes bronchodialation)

4)selective antagonist : ATENOLOL(competitively reversible antagonist of the B1 adrenoceptor)
it causes a greater decline of adrenaline function in the HEART, ( B1 receptor ) compared to the airways (b2 receptors )

new research shows many more sub groups in the adrenceptor family meaning we can develop much more specific drugs ie: TAMSULOSIN which is a novel selective antagonist of the Alpha 1A adrenoceptor = it’s an alpha blocker which allows relaxation of smooth muscle ( remember noradrenaline constricts smooth muscle )- this improves urine flow !

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11
Q

what does each receptor need to be linked to ?

3

A

1-SIGNAL TRANSDUCTION PATHWAY :

  • Ion influx
  • enzyme activity
  • gene expression
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12
Q

Outline the SUPERFAMILY 1 CASE STUDY - nicotinic acetylcholine receptor
(6)
competitive reversible antagonist examples
Competitive irreversible antagonist examples

A

=>AGONIST called Nicotine
=>ligand gated ion channels

1) competitive REVERSIBLE ANTAGONIST: Tubocuraine, vecuronium = neuromuscular blocking agents, they bind to orthosteric site competing with acetylcholine/nicotine. They prevent skeletal muscle contraction during surgery! It is used to treat muscle spasm

2) Competitive IRREVERSIBLE ANTAGONIST: Alpha Bungarotoxin from (Bungaras multicinctus= Indian snake )
It binds to the orthosteric site irreversibly causing muscle paralysis, respiratory failure, death!

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13
Q

what are the subtypes of the nicotinic cholinoreceptors
(3)
overview

A

-17 lego blocks are available! each is encoded by different gene .
-Each receptor is made of 5 subunits = PENTAMETERS=HETERO OR HOMOPENTAMETERS
The subunit composition determines the the physiological and pharmacological properties of the the receptor : affinity to agonist etc .

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14
Q

outline the GABA a receptor case study SUPERFAMILY 1 and the chloride channel ?
(3)

A
  • GABA is an inhibitory neurotransmitter found in CNS
    -Facilitator modulator - diazepam (valium) , which enhances GABA. activity by making CL- gate open more readily and for longer , increasing the period of hyperpolarization ( decreasing the neuronal activity )
    this is why diazepam is used as a sedative !
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15
Q

Outline the G-protein mediated receptor (GPMR) case study (SUPERFAMILY 2 ):
MUSCARINIC ACETYLCHOLINE RECEPTOR FAMILY (Parasympathetic Ns)
-what is the agonist? what does it do?
-what is the antagonist?
-How does the competitive antagonist work?

(4)

A

Remember that the G-protein isn’t part of the RECEPTOR, it’s just attached!
GPCR - Heterotrimeric (remember it contains alpha, beta, gamma subunits)

-high affinity for acetylcholine :
agonist =muscarine
-slows down heart rate, bronchoconstriction, peristalsis ( parasympathetic rest and digest)

ANTAGONISTS A: Atropine (atropa belladona)

Atropine is a competitive reversible inhibitor that blocks the muscarine/acetylcholine binding site! - hence suppressing the actions of the parasympathetic system!
- atropine treats bradycardia , speeding up HR

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16
Q

what are the factors that affect size and response to a receptor antagonist ?
3 main factors
(6)

A

1-Concentration of drug ( which depends on dose, administration , distribute, metabolisms and excretion )
2-Characteristics of the agonist receptor ie : affinity and intrinsic efficacy (ability to activate a response within the cell )
3-Characteristics of tissue : nature of receptor-response to the SINGAL TRANSDUCTION MECHANISM and total number of receptors present !

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17
Q

what’s fractional occupancy ? (3)

what effects It ?

A

1- fraction of receptors occupied by agonist and it depends on :
-agonist concentration =Xa
-strength of bonding (Affinity ) =Ka
FO equation : agonist concentration / (agonist concentration+ka equ constant )

A high Ka would mean a lower fractional occupancy ! (because the denominator would be larger )

18
Q

how do we tend to measure ka? (1)

A

measure the circuit marker and downstream response ie : contraction of muscle !

19
Q

Whats EC50?

3

A

Effective concentration to produce 50% of maximum response possible on stimulation of that receptor !

A higher EC50 means a lower Potency , because It means you would require a larger concentration of the drug to produce the same effect !

look at graph in notes ! log concentration response curve

20
Q

what are the receptor -response coupling mechanisms?
(4)
-4 subtypes

A

1-chemical gating and ion channels
2-activation of G-proteins
3-Direct activation of enzymes
4-Regulation of gene transcription

21
Q

what is the equation that links all the points which affect the response of receptor agonist ? (3)

A

R= N of receptors x transducer function x intrinsic efficacy x agonist concentration / (agonist concentration +ka)

22
Q

Give an example of a reversible ANTAGONIST DRUG ?
outline the major properties !
( properties on graph
intrinsic efficacy , max response , type of bonding )
(5)

A

Competative reversible inhibitor =ATENOLOL B-blocker (which stops the effects of noradrenaline causing vasodilation and slows down the heart ) = good for managing angina and managing hypertension !

1-Intrinsic efficacy is ZERO ( doesn’t cause a response in cell - it just blocks noradrenaline and adrenaline )
2- reversible means it has weak bonds such as : ionic bonds , H-bonds , VDWs
3-causes a RHS shift on the log response curve and can be overcome by increasing agonist concentration !
4-MAX response is still achievable !

23
Q

Give an example of Competitive Irreversible Antagonists
graph shift?
max response?
(3)

A
  • bonded with covalent bonds and are usually toxins or poisons
    -ie: CLOPIDOGREL or alpha-bungarotoxin ( less used clinically, used to inhibit thrombus formation )
    1- graph doesn’t shift
    The 2-Max response can’t be reached, so it is lowered!
24
Q

Give an example of a NON competitive Antagonist
(2)
2 examples

A

They can be reversible or irreversible
example 1: Binds to allosteric site causing conformation change in orthosteric site , hence agonist and chemical mediator can’t fit into the orthosteric site ie:Palonsetron . prevents vomitting!)
example 2: Interference downstream in signal transduction pathway ie :local Anaesthetic - Lidocaine which blocks the V-G na+ channels to prevent Depolarisation , AP hence muscle contraction !

25
Q

What is an example fo physiological antagonism

2

A
1- both noradrenaline and acetylcholine 
they have opposite functions !
noradrenaline = increases heart rate 
Ach = decreases heart rate 
they are both technically AGONISTs but they are enemies of one another hence act as ANTAGONISTS to each other !
26
Q

What is a pharmacokinetic antagonist ?

3

A

One drug decreases the concentration of another drug by interfering with its A,D,M,E!
ie: Rifampicin = induces the expression of the liver enzyme which breaks down WARFARIN (which is an anti coagulant drug)
so more enzyme will mean less warfarin !

27
Q

how is heParin overdose managed?
(4)
1- How does Heparin work and what is it
2-What is the antidote called, how does it work?

A

The chemical reaction between 2 drug molecules.

1) Heparin- binds to Glycoprotein, which is extracellular! It is an anti-coagulant drug!
2) Protamine sulphate - reacts with Heparin to prevent it from acting with Glycoprotein =used to treat Heparin overdose

28
Q

what is the difference between the drugs generic name and brand name ?

A

1-brand name chosen by company

doctors should use generic name !

29
Q

what does cAMP regulate ?

2

A

1-in B1 (heart)= contractility of heart
and strength and force of contraction (agonist =dobutamine =increases heart rate)
2-B2 adrenoceptor (airways) =causes smooth muscle relaxation
(agonist=salbutamol=bronchodialate)

30
Q

how is cAMP concentration bought back to normal ?

3

A

enzyme called : cAMP phosphodiesterase ( adds WATER )
cAMP–>AMP
This is inhibited by caffeine and theophylline !

31
Q

A1 adrenergic receptor example
what is the action of phospholipase C-beta ?

where is it found ?

what do the sub parts do ?

(6)

A

They are found in the alpha 1 adrenoceptor which controls vasoconstriction of smooth muscle .
THEY BELONG TO Gq receptor family
Phospholipase C =different type of enzyme which makes two secondary messengers out of PIP2
PIP2–>DAG + IP3
- DAG activates protein kinase C -> phosphorylates proteins (protein kinase C)–>which then cause contractions
- IP3->water soluble so it diffuses through cytoplasm to sarcoplasmic reticulum = activating channels which release ca2+ , causing AP –>This causes contraction !

Remember IP3 /DAG cause vasoconstriction
cAMP = vasodilation

32
Q

what drugs target the PLC-beta pathway ?
phospholipase c pathway
(4)

A

Alpha 1 adrenoceptors : has Gq g protein/IP3 AND DAG

  • agonist= vasoconstrictor (noradrenaline and phenyphrine)
  • antagonists=vasodialators =prazosin , doxazosin

Muscarinic Cholinoceptors -Gq protein and IP3/DAG
found in airways, smooth muscles,salivery glands
AGONIST -bronchoconstrictors (acetylcholine , puocarpine =saliva secretion )
Antagonist =Bronchodialators (ipratropium bromide)

33
Q

how is termination of the IP3 and DAG manged

2

A

1) IP3 has intracellular enzyme -intacellular phospitase which removes the phosphates ->inositol ->eventually back to PIP2
2) DAG->Phospatidic acid ->PIP2 eventually

34
Q

what is the type 3 receptors family called?
outline tyrosine kinase receptor.
(4)
what can it go on to do?

A

enzyme linked receptor
these use Tyrosine kinase and Guanylate cyclase .
Tyrosine kinase enzyme :

1)ligand attaches ->dimer>phosphorylated ACTIVATED receptor (ATP gives phosphate to tyrosine )–>SH2 domain protein binds and become phosphorylated
It can become GLUT4 (uptakes glucose) or MAPK(causes cell proliferation , differentiation , survival , pathways).

35
Q

what drugs target tyrosine kinase?
(4)
two types of drugs

A

1-Renal cancer drug -sunitinib ( small molecule binder which blocks ATP site on tyrosine phosphate )

2-Breast cancer drug-Herceptin/trastuzumab = monoclonal antibody which binds to the extracellular part of HER2 (human growth receptor)- so that RTK receptor doesn’t work, hence loss of growth

36
Q

Outline the guanylate cyclase pathway!

How is cGMP cleared?

(6)

What does a high BNP indicate?

A

1-ANP receptor (atrial naturistic peptide -causes sodium loss by kidney =blood vessel, vascular tubes)
BNP-released from the ventricle (same receptor protein)
-When BP and BV increases, BNP and ANP bring it back to normal, which causes VASODILATION
HIGH BNP = heart failure

2-Gyuanylate cyclase converts GTP–>cGMP

3-Increased cGMP goes on to activate Protein kinase G (PKG)

4.ATP–>ADP and proteins are phosphorylated causing:

Relaxation of smooth muscle and Vasodilation.

cGAMP–>GMP via cyclic GMP phosphodiesterase

37
Q

what is super family 4?
(4)
structure?

A

1-Cytoplasmic receptors !
single protein with NH2 and COOH terminals
Zn fingers bind to nucleic acids =hinge region
-Chemical mediator binds to COOH terminal - activation function 2 site (AF2)
-NH2 site =activation function 1 receptor site (AF1) is where co activators bind .

38
Q

how does the nuclear receptor work

4

A

1-resting state the receptor is boud to heat shock 2 protein
2-ligand binds =conformational change
3-receptor becomes a dimer , enters nucleus , binds Upstream to promoter region of gene ( binds with zinc teeth)
4-receptor binds as a transcription factor

39
Q

what is an antagonist of a type 4 receptor?

what is an agonist of the Glucocorticoid steroid receptor?

A

A 1-Aldosterone receptor which regulates k+ concentration
=Spironolactone (diuretic ) which prevents the body from absorbing too much salt.
(maintains k+ concentration )

2.Budesonide, hydrocortisone, beclamethasone, dexamethasone - prevents inflammation by regulating gene expression causing less inflammation in the airways!

40
Q

Aspirin case study
( how does it work = overview )
Side effects
ASPIRIN

A
1- NSAID + ANTIPLATLET 
(cox inhibited, Thromboxane and PG12 = inhibited, less pain and platelet aggregation )
2-Side effects include :ASPIRIN 
Allergy reaction
Susceptibility 
Peptic ulcer
Idiosyncratic reaction 
Reye's syndrome (rash +vomit)
Irritation of the ears 
Nephropathy
41
Q

Aspirin case study
( how does it work = overview )
Side effects
ASPIRIN

A
1- NSAID + ANTIPLATLET 
(cox inhibited, Thromboxane and PG12 = inhibited, less pain and platelet aggregation )
2-Side effects include:ASPIRIN 
Allergy reaction
Susceptibility to bleeding 
Peptic ulcer
Idiosyncratic reaction 
Reye's syndrome (rash +vomit)
Irritation of the ears 
Nephropathy