test 2 part 3 Flashcards

1
Q

Pharmacodynamics

A
  • The actions of a drug on the body
  • The influence of drug concentrations on the magnitude of the response
  • Signal Transduction
    • Alterations in biochemical and/or molecular activity of a cell initiated by the drug-receptor complex
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2
Q

what is a Drug

A
  • Any substance that brings about a change in biologic function through its chemical actions
    • Must have appropriate
    • Size- small are less likely to be selective (can fit a lot of different receptors)
    • Electrical charge
    • Shape
      • More than half of all drugs are chiral molecules
    • Atomic composition
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3
Q

Drug Electrical Charge: Drug-Receptor Bonds

A
  • Covalent (electron sharing)
    • Very strong
    • Not reversible
  • Electrostatic
    • More common than covalent
    • Vary from strong to weaker hydrogen bonds to van der Waals forces
  • Hydrophobic (most common)
    • Relatively weak
    • Important in highly lipid soluble drugs within lipids of cell membranes
  • Drugs that bind through weak bonds are generally more selective than drugs that bind through very strong bonds
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4
Q

Drug Shape: Racemic Mixtures

A
  • Majority of drugs available as racemic mixtures (2 different isomers)
  • Potency and duration of action different in many cases
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5
Q

Receptor

A
• Any biologic molecule to which a drug binds and produces a measurable response
  • Enzymes
  • Nucleic acids
  • Structural proteins
-1. needs to be selective for a ligand
-2. pharmacological response
-needs both to be a receptor
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6
Q

albumin as a binding site

A
  • inert binding site
  • does not have a direct biological effect
  • drug binding to albumin does effect the volume of distribution and the amount of free drug in the bloodstream
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7
Q

Signal Transduction

A
  1. unoccupied receptor does not influence intracellular processes
  2. receptor with bound agonist is activated. It has altered physical and chemical properties, which leads to interaction with cellular molecules to cause a biologic response
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8
Q

The Drug-Receptor Complex

A
  • Cells have many types of receptors
    • Specific for particular agonist
    • Produce unique response once activated
  • Magnitude of response proportional to number of drug-receptor complexes
  • Most receptors named for the type of agonist it interacts best with
  • Not all drugs exert their effect through receptors
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9
Q

Receptor States

A
  • Inactive (R)
  • Active (R*)
  • Reversible equilibrium usually favoring inactive state unless ligand bound to it
  • Equilibrium shifts to R* when agonist binds
    • Magnitude of effect directly related to fraction of R*
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10
Q

Major Receptor Families

A
  • Ligand-gated ion channels
  • G protein-coupled receptors
  • Enzyme-linked receptors
  • Intracellular receptors
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11
Q

Ligand-gated Ion Channels

A
  • Ligand binding site on extracellular portion
  • Opens channel for a few milliseconds
  • Ions then move in or out
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12
Q

G Protein-coupled Receptors

A
  1. unoccupied receptor does not interact with G protein
  2. Occupied receptor changes shape and interacts with G protein. G protein releases GDP and binds GTP
  3. Alpha subunit of G protein dissociates and activates adenylyl cyclase
  4. When hormone is no longer present, the receptor reverts to its resting state. GTP on the alpha subunit is hydrolyzed to GDP, and adenylyl cyclase is deactivated.
    - largest receptor family
    - response lasts minutes
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13
Q

Enzyme-linked Receptors

A
• When activated, phosphorylate tyrosine residues on themselves and then other specific proteins
  • Acts as a molecular switch
  • Multiplication of initial signal
  • Response lasts minutes to hours
-activates enzymes inside of the cell
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14
Q

Intracellular Receptors

A

• Ligand must diffuse into the cell to interact with receptor
• Primary target: transcription factors in cell nucleus
• Response lasts hours to days
-takes a little for a response and once the proteins are formed then the response lasts hours to days
-not easily reversible

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15
Q

Two Important Features of Signal Transduction

A
  1. The ability to amplify signals

2. Mechanisms to protect the cell from excessive stimulation

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16
Q

Signal Amplification

A
  • G protein-linked and enzyme linked receptors
  • Amplify signal INTENSITY and DURATION
  • Ligand binding may only last milliseconds, but activated G proteins last longer
  • Spare Receptors
    • Only a fraction of total receptors needed to elicit maximal response
17
Q

Protection from Excessive Stimulation

A
  • Desensitization
    • Results in diminished effect (tachyphylaxis)
  • Down-regulation
    • Receptors are internalized within the cell
      • Recycled back to surface
      • Degraded
  • Refractory period
    • Finite time required before receptors can be activated again (ion channels)
18
Q

Potency

A

• The amount of drug necessary to produce an effect of a given
magnitude
• EC50: concentration producing 50% of maximal effect
-Potency differences can be overcome by simply giving more drug

19
Q

Efficacy

A

• Magnitude of response a drug causes when it interacts with a receptor
• Dependent on
• number of drug-receptor complexes formed
• Intrinsic activity of the drug
-Efficacy is more clinically useful than potency
-we are trying to get to a certain point and if a drug won’t get there it is worthless

20
Q

Law of Mass Action and Drug-Receptor Interactions

A

Drug + Receptor ↔ Drug-receptor complex → Effect

  1. The drug and receptor combine reversibly
  2. Occupancy of receptors by the drug is proportional to the dose of the drug and the number of the free receptors
  3. Magnitude of response is directly proportional to the fraction of total receptor sites occupied by drug molecules
  4. Effects plateau because they are limited by the total number of receptors
21
Q

Agonist

A
  • Binds to a receptor and produces a biologic response
  • Intrinsic activity determines its degree of receptor activation
    • Full agonist
    • Partial agonist
    • Inverse agonist
22
Q

Full agonist

A

• Maximal biologic response
• Mimics endogenous ligand
-intrinsic activity of 1

23
Q

Partial agonist

A
  • Cannot produce same Emax

* Affinity can be >,

24
Q

Inverse agonist

A

• Stabilizes receptors in inactive state to prevent spontaneous activation
• Opposite pharmacological effects of agonists
-intrinsic activity = <0

25
Q

Antagonists

A
  • Bind to a receptor with high affinity
  • Zero intrinsic activity
  • Block
    • Drug binding to receptor
    • Drug’s ability to activate the receptor
26
Q

Competitive Antagonism

A

• Both the agonist and the antagonist bind to the same site reversibly
• Shift the dose response curve to the right
• Same Emax
• Increased EC50
-Inhibition can be overcome by increasing the concentration of agonist
-shifts dose response curve to the right
-just add more agonist to overcome effects

27
Q

Non Competitive Antagonism

A

• Irreversible Antagonist
• Covalently binds to the receptor site (so not coming off)
• Decreases the # of available receptors for agonist
• Allosteric Antagonist (reversible)
• Binds to site other than the agonist binding site
• Prevents receptor from being activated
-changes shape of receptor
• Decreased Emax
• Same EC50
-Inhibition cannot be
overcome by increasing the
concentration of agonist

28
Q

Functional Antagonism

A

• Drug acts at a completely different receptor to initiate an effect opposite to that of the agonist

29
Q

Chemical Antagonism

A

• Drug binds the agonist itself (not the receptor) to counter its effects

30
Q

Quantal Dose-Response Relationships

A
  • Relationship between dose of a drug and proportion of a population that has a response
  • Useful for determining appropriate doses (safety profile of drugs)
31
Q

Therapeutic Index (TI)

A

TI = TD 50 / ED 50
• The ratio of dose that produces toxicity in 50% of the population and the dose that produces a specific therapeutic effect in 50% of the population
-TD = toxic dose
-ED = effective dose

32
Q

Therapeutic Index

A
  • Higher TI: safer
  • Low TI (<2): used only to treat serious diseases
  • risk of side effects outweighs risk of leaving disease untreated