This document discusses key concepts related to pharmacology including:
- Pharmacodynamics which examines how drugs act on the body and their effects
- Pharmacokinetics which examines what the body does to drugs including absorption, distribution, metabolism, and excretion
- Factors that determine a drug's effects such as efficacy, potency, therapeutic index, onset and duration of action
- Common types of drug interactions and responses a patient may have to medications including side effects, allergic reactions, and toxicity
This document discusses key concepts related to pharmacology including:
- Pharmacodynamics which examines how drugs act on the body and their effects
- Pharmacokinetics which examines what the body does to drugs including absorption, distribution, metabolism, and excretion
- Factors that determine a drug's effects such as efficacy, potency, therapeutic index, onset and duration of action
- Common types of drug interactions and responses a patient may have to medications including side effects, allergic reactions, and toxicity
This document discusses key concepts related to pharmacology including:
- Pharmacodynamics which examines how drugs act on the body and their effects
- Pharmacokinetics which examines what the body does to drugs including absorption, distribution, metabolism, and excretion
- Factors that determine a drug's effects such as efficacy, potency, therapeutic index, onset and duration of action
- Common types of drug interactions and responses a patient may have to medications including side effects, allergic reactions, and toxicity
is the study of the effect of drugs on the body. Drugs act within the body to mimic the actions of the body’s own chemical messengers. is the body’s physiologic response to changes in drug concentration at the site of action. Potency – refers to the amount of drug needed to elicit a specific physiologic response to a drug. Efficacy – magnitude of effect a drug can cause when exerting its maximal effect. Maximal efficacy – the point at which increasing a drugs dosage no longer increases the desired therapeutic response. Therapeutic Index – (TI) describes the relationship between the therapeutic dose of a drug (ED50) and the toxic dose of a drug (TD50) Therapeutic dose of a drug – is the dose of a drug that produces a therapeutic response in 50% of the population. Toxic dose of a drug – is the dose that produces a toxic response in 50% of the population. If the ED50 and TD50 are close- drug has a narrow therapeutic index. require close monitoring to ensure patient safety. Onset – is the time it takes for a drug to reach the minimum effective concentration (MEC) after administration. Time from drug administration to first observable effect (T0-T1) Peak – occurs when it reaches its highest concentration in the blood/plasma concentration. T0- T2 Duration of action – is the length of time the drug exerts a therapeutic effect. period from onset until the drug effect is no longer seen. T1-T3 Drug concentration can be determined by measuring peak and trough drug levels. peak – highest plasma concentration. 30 minutes after infusion. trough – lowest plasma concentration. 30 minutes prior to next infusion. A. Drug-Receptor Interaction Certain portion of drug molecule (active site) selectively combines with some molecular structure (reactive site) on the cell to produce a biologic effect
Receptor site- drugs act at specific areas on
cell membranes; react with certain chemicals to cause an effect within the cell “Lock and Key Theory”- specific chemical (key) approaches a cell membrane and finds fit (the lock) at receptor site- affects enzyme system within cell- produce certain effects. Drug+Receptor=Effect B. Drug-Enzyme Interaction Interferes with enzyme systems that act as catalyst from various chemical reactions If single step in one of enzyme system is blocked- normal function is disrupted C. Nonspecific Drug Interaction Act by biophysical means that do not affect cellular/enzymatic reactions. drugs do not bind to receptors but instead saturate the water or lipid part of a cell- drug actions occurs based on the degree of saturation. Neutralization of stomach acid by antacids. D. Selective Toxicity Specific action on cellular structures that are unique to the microbe. All chemotherapeutic agent would act only in one enzyme system needed for life of a pathogen or neoplastic cell. It is essential to the pathogen but not to the host. Drug Response may be: 1. Primary- always desirable/physiologic effects 2. Secondary- desirable or undesirable Example: Diphenhydramine (Benadryl) Primary effect: antihistamine; treat symptoms of allergy Secondary: Drowsiness 1. Rapid- few seconds to minutes - IV, SL, Inhalations 2. Intermediate- 1-2 hours after administration - IM, SC 3. Delayed/Slow- several hours after administration - Oral, rectal 1. Stimulation/Depression Stimulation- increased rate of cell activity/ secretion from the gland T3/T4 for hypothyroidism Depression- decreased cell activity and function of a specific organ. Iodine, propylthiouracil 2. Replacement- replaces essential body compounds Example: Insulin 3. Inhibition/Killing of Organism Interfere with bacterial cell growth Example: Antibiotics 4. Irritation Example: Laxative- irritate the inner wall of colon---increased peristalsis--- increased defecation 1. Additive Effect-2 drugs with similar actions are taken for a doubled effect 1+1=2 Ibuprofen+ paracetamol= added analgesic effect Codeine with acetaminophen = better pain control 2. Synergistic- combined effect of 2 drugs is greater than the sum of the effect of each drug given alone; 1+1=3 Aspirin = 30% analgesic effect codeine – 30% analgesic effect combination = 90% analgesic effect 3. Potentiation- a drug that has no effect enhances the effects of the second drug 0+1=2 Alcohol enhances the analgesic activity of aspirin. Prozac + Zestril 4. Antagonistic- one drug inhibits the effect of another drug 1+1=0 Tetracycline+ antacid= decreased absorption of tetracycline Charcoal in alkaloidal poisoning 1.Side Effects Results from the pharmacologic effects of the drug Most common as a result of lack of specificity of action within the therapeutic range. 2. Allergic Reactions Unpredictable adverse drug effects; more serious Response to patient’s immunological system to the presence of the drug Do not occur unless the patient has been previously exposed to the agent/ chemical related compound 3. Idiosyncratic Reaction Occurs when the patient is first exposed to the drug Abnormal reactivity to the drug caused by a genetic difference between the patient and normal individual. patient with G6PD deficiency will have anemia by using antioxidants. 4. Toxicity The degree to which a drug can be poisonous and thus harmful to the human body. 5. Iatrogenic responses Unintentional responses as a result of medical treatment Nephrotoxicity; ototoxicity