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PHARMACODYNAMICS
Introduction
2
Pharmacodynamics is the study of drug
effects.
It starts with describing what the drugs do, and
goes on to explain how they do it.
Principles of Drug Action
3
The basic types
classed as:
Stimulation
Depression
Irritation
Replacement
Cytotoxic action
of drug action can be broadly
Stimulation
4
Selective enhancement
of specialized cells.
of the level of activity
Adrenaline stimulates heart.
Pilocarpine stimulates salivary glands.
Depression
5
Selective diminution of activity
cells.
Barbiturates depress CNS
Quinidine depresses heart
of specialized
Omeprazole depresses gastric acid secretion.
Irritation
6
A nonselective, often noxious effect and is
particularly applied to less specialized cells
(epithelium, connective tissue).
Strong irritation results in inflammation,
corrosion, necrosis and morphological
damage.
Replacement
7
Use of natural metabolites, hormones
congeners in deficiency states.
or their
Levodopa in parkinsonism
Insulin in diabetes mellitus
Iron in anaemia.
Cytotoxic action
8
Selective cytotoxic action on invading
parasites or cancer cells, attenuating them
without significantly affecting the host cells.
Utilized for cure/palliation of infections and
neoplasms.
e.g. penicillin, chloroquine, zidovudine,
cyclophosphamide, etc.
Mechanism of drug action
9
Only a handful of drugs act by virtue
or chemical property; examples are:
of their simple physical
Bulk laxatives (ispaghula)—physical mass
Paraamino benzoic acid—absorption of UV
Activated charcoal—adsorptive property
Mannitol, mag. sulfate—osmotic activity
rays
131 I and other radioisotopes—radioactivity
Antacids—neutralization of gastric HCl
Pot. permanganate—oxidizing property
Chelating agents (EDTA, dimercaprol)—chelation
metals.
of heavy
10
Majority of drugs produce their effects by
interacting with a discrete target biomolecule,
which usually is a protein. Such mechanism
confers selectivity of action to the drug.
Functional proteins that are targets of drug action
can be grouped into
Enzymes,
Ion channels,
Transporters and
Receptors.
four major categories, viz.
Enzymes
11
Almost all biological reactions are carried out
under catalytic influence of enzymes;
Drugs can either increase or decrease the rate
of enzymatically mediated reactions.
Enzyme inhibition
12
Selective inhibition of a particular enzyme is a
common mode of drug action.
Such inhibition is either competitive or
noncompetitive.
Ion Channels
13
Ligand gated channels
receptor)
(e.g. nicotinic
G-proteins and are termed G-protein
regulated channels (e.g.cardiac β1
adrenergic receptor activated Ca2+ channel).
Ion Channels
14
Drugs can also act on voltage operated and
stretch sensitive channels by directly binding
to the channel and affecting ion movement
through it, e.g. local anaesthetics which
obstruct voltage sensitive Na+ channels.
Ion Channels
15
Certain drugs modulate
the channels, e.g.:
opening and closing of
Nifedipine blocks L-type of voltage sensitive
Ca2+ channel.
Ethosuximide inhibits T-type of Ca2+ channels
in thalamic neurones.
Transporters
16
Several substrates are translocated across
membranes by binding to specific transporters
(carriers) which either facilitate diffusion in the
direction of the concentration gradient or pump the
metabolite/ion against the concentration gradient
using metabolic energy.
Transporters
17
Many drugs produce their action by directly
interacting with the solute carrier (SLC) class
of transporter proteins to inhibit the ongoing
physiological transport of the metabolite/ion.
function.
Receptors
18
Macromolecule or binding site located on the
surface or inside the effector cell that serves to
recognize the signal molecule/drug and initiate
the response to it, but itself has no other
describing drug-receptor
interaction:
19
Agonist: An agent which activates a receptor to produce
effect similar to that of the physiological signal molecule.
an
Inverse agonist: An agent which activates a receptor to
produce an effect in the opposite direction to that of the
agonist.
Antagonist: An agent which prevents the action of an
agonist on a receptor or the subsequent response, but does
not have any effect of its own.
Partial agonist: An agent which activates a receptor to
produce submaximal effect but antagonizes the action of a
full agonist.
20
Agonists have both affinity and
= 1), e.g. adrenaline, histamine,
maximal intrinsic activity (IA
morphine.
Competitive antagonists have affinity but no intrinsic activity
(IA = 0), e.g. propranolol, atropine, chlorpheniramine,
naloxone.
Partial agonists have affinity and submaximal intrinsic
activity (IA between 0 and 1), e.g. dichloroisoproterenol (on β
adrenergic receptor), pentazocine (on μ opioid receptor).
Inverse agonists have affinity but intrinsic activity with a
minus sign (IA between 0 and –1) eg. chlorpheniramine (on
H1 histamine receptor)
• Partial agonist :These drug have full affinity to
receptor but with low intrinsic activity (IA=0 to 1).
• These are only partly as effective as agonist
(Affinity is lesser when comparison to agonist)
Ex: Pindolol, Pentazocine
G protein coupled receptor
21
24
Gs : Adenylyl cyclase activation, Ca2+ channel
Opening
Gi : Adenylyl cyclase inhibition, K+ channel
opening
Go : Ca2+ channel inhibition
Gq : Phospholipase C activation
Ion channel receptor
25
Ion channel receptor
26
These cell surface receptors, also called ligand
gated ion channels, enclose ion selective
channels (for Na+, K+, Ca2+ or Cl¯) within their
molecules.
Agonist binding opens the channel and causes
depolarization/hyperpolarization/ changes in
cytosolic ionic composition, depending on the ion
that flows through.
The nicotinic cholinergic, GABAA, glycine
(inhibitory AA), excitatory AA-glutamate (kainate,
NMDA and AMPA) and 5HT3 receptors fall in this
category.
Transmembrane enzyme-linked
receptors
27
Utilized primarily by peptide hormones.
Made up of a large extracellular ligand binding
domain connected through a single
transmembrane helical peptide chain to an
intracellular subunit having enzymatic property.
Examples are—insulin, epidermal growth factor
(EGF), nerve growth factor (NGF) and many
other growth factor receptors.
Transmembrane
receptors
enzyme-linked
28
Model of receptor
linked receptor
tyrosine kinase, an enzyme-
Transmembrane JAK-STAT binding
receptors
29
Agonist induced dimerization alters the
intracellular domain conformation to increase its
affinity for a cytosolic tyrosine protein kinase JAK
(Janus Kinase).
On binding, JAK gets activated and
phosphorylates tyrosine residues of the receptor,
which now bind another free moving protein STAT
(signal transducer and activator of transcription).
This is also phosphorylated by JAK. Pairs of
phosphorylated STAT dimerize and translocate to
the nucleus to regulate gene transcription
resulting in a biological response.
Transmembrane
receptors
JAK-STAT binding
30
Many cytokines, growth hormone, prolactin,
interferons, etc. act through this type of receptor
Receptors regulating gene expression
(Transcription factors, Nuclear
receptors)
31
These are intracellular (cytoplasmic or nuclear) soluble
proteins which respond to lipid soluble chemical
messengers that penetrate the cell.
The liganded receptor diamer moves to the nucleus and
binds other co-activator/co-repressor proteins which
have a modulatory influence on its capacity to alter gene
function.
All steroidal hormones (glucocorticoids,
mineralocorticoids, androgens, estrogens, progeste-
rone), thyroxine, vit D and vit A function in this manner.
32
Drug potency and efficacy
33
Drug potency refers to the amount of
drug needed to produce a certain response.
Drug efficacy refers to the maximal
response that can be elicited by the drug.
Drug potency and efficacy
34
Drug
Drug
Drug
B is less potent but equally efficacious as drug A.
C is less potent and less efficacious than drug A.
D is more potent than drugs A, B, & C, but less efficacious than drugs
A & B, and equally efficacious as drug C.
Therapeutic index
35
where: Median effective dose (ED50) is the dose
which produces the specified effect in 50% individuals
And median lethal dose (LD50) is the dose which kills 50%
of the recipients.
Combined effect of Drugs
36
Synergism
When the action of one drug is facilitated or
increased by the other, they are said to be
synergistic.
Additive Synergism
37
The effect of the two drugs is in the same direction
and simply adds up:
Effect of drugs A + B = effect of drug A + effect of
drug B.
Side
may
effects of the components of an additive pair
be different—do not add up. Thus, the
combination is better tolerated than higher dose of
one component.
Supraadditive Synergism
38
The effect of combination is greater than the
individual effects of the components:
effect of drug A + B > effect of drug A + effect
of drug B
This is always the case when one component
given alone produces no effect, but enhances
the effect of the other (potentiation).
39
Antagonism
40
When one drug decreases or abolishes the
action of another, they are said to be
antagonistic:
effect of drugsA + B < effect of drugA + effect
of drug B
Response No response
Physical antagonism
41
Based on the physical property
e.g. charcoal adsorbs alkaloids
prevent their absorption—used
poisonings.
of the drugs,
and can
in alkaloidal
Chemical antagonism
42
The two drugs react chemically and form an
inactive product, e.g
Chelating agents (BAL, Cal. disod.
edetate) complex toxic metals (As, Pb).
Physiological/functional
antagonism
43
The two drugs act on different receptors or by
different mechanisms, but have opposite overt
effects on the same physiological function, i.e.
have pharmacological effects in opposite
direction.
Glucagon and insulin on blood sugar level.
agonist is shifted to the
Receptor antagonism
44
Competitive antagonism (equilibrium type)
The antagonist is chemically similar to the
agonist, competes with it and binds to the
same site to the exclusion of the agonist
molecules.
Because the antagonist has affinity but no
intrinsic activity , no response is produced
the log DRC of the
right.
and
Noncompetitive antagonism
45
The antagonist is chemically unrelated to the
agonist, binds to a different allosteric site
altering the receptor in such a way that it is
unable to combine with the agonist, or is unable
to transduce the response.
46
47
Thank You

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Pharmacodynamics: The Study of Drug Effects

  • 2. Introduction 2 Pharmacodynamics is the study of drug effects. It starts with describing what the drugs do, and goes on to explain how they do it.
  • 3. Principles of Drug Action 3 The basic types classed as: Stimulation Depression Irritation Replacement Cytotoxic action of drug action can be broadly
  • 4. Stimulation 4 Selective enhancement of specialized cells. of the level of activity Adrenaline stimulates heart. Pilocarpine stimulates salivary glands.
  • 5. Depression 5 Selective diminution of activity cells. Barbiturates depress CNS Quinidine depresses heart of specialized Omeprazole depresses gastric acid secretion.
  • 6. Irritation 6 A nonselective, often noxious effect and is particularly applied to less specialized cells (epithelium, connective tissue). Strong irritation results in inflammation, corrosion, necrosis and morphological damage.
  • 7. Replacement 7 Use of natural metabolites, hormones congeners in deficiency states. or their Levodopa in parkinsonism Insulin in diabetes mellitus Iron in anaemia.
  • 8. Cytotoxic action 8 Selective cytotoxic action on invading parasites or cancer cells, attenuating them without significantly affecting the host cells. Utilized for cure/palliation of infections and neoplasms. e.g. penicillin, chloroquine, zidovudine, cyclophosphamide, etc.
  • 9.
  • 10. Mechanism of drug action 9 Only a handful of drugs act by virtue or chemical property; examples are: of their simple physical Bulk laxatives (ispaghula)—physical mass Paraamino benzoic acid—absorption of UV Activated charcoal—adsorptive property Mannitol, mag. sulfate—osmotic activity rays 131 I and other radioisotopes—radioactivity Antacids—neutralization of gastric HCl Pot. permanganate—oxidizing property Chelating agents (EDTA, dimercaprol)—chelation metals. of heavy
  • 11. 10 Majority of drugs produce their effects by interacting with a discrete target biomolecule, which usually is a protein. Such mechanism confers selectivity of action to the drug. Functional proteins that are targets of drug action can be grouped into Enzymes, Ion channels, Transporters and Receptors. four major categories, viz.
  • 12. Enzymes 11 Almost all biological reactions are carried out under catalytic influence of enzymes; Drugs can either increase or decrease the rate of enzymatically mediated reactions.
  • 13. Enzyme inhibition 12 Selective inhibition of a particular enzyme is a common mode of drug action. Such inhibition is either competitive or noncompetitive.
  • 14.
  • 15. Ion Channels 13 Ligand gated channels receptor) (e.g. nicotinic G-proteins and are termed G-protein regulated channels (e.g.cardiac β1 adrenergic receptor activated Ca2+ channel).
  • 16. Ion Channels 14 Drugs can also act on voltage operated and stretch sensitive channels by directly binding to the channel and affecting ion movement through it, e.g. local anaesthetics which obstruct voltage sensitive Na+ channels.
  • 17. Ion Channels 15 Certain drugs modulate the channels, e.g.: opening and closing of Nifedipine blocks L-type of voltage sensitive Ca2+ channel. Ethosuximide inhibits T-type of Ca2+ channels in thalamic neurones.
  • 18.
  • 19. Transporters 16 Several substrates are translocated across membranes by binding to specific transporters (carriers) which either facilitate diffusion in the direction of the concentration gradient or pump the metabolite/ion against the concentration gradient using metabolic energy.
  • 20. Transporters 17 Many drugs produce their action by directly interacting with the solute carrier (SLC) class of transporter proteins to inhibit the ongoing physiological transport of the metabolite/ion.
  • 21. function. Receptors 18 Macromolecule or binding site located on the surface or inside the effector cell that serves to recognize the signal molecule/drug and initiate the response to it, but itself has no other
  • 22. describing drug-receptor interaction: 19 Agonist: An agent which activates a receptor to produce effect similar to that of the physiological signal molecule. an Inverse agonist: An agent which activates a receptor to produce an effect in the opposite direction to that of the agonist. Antagonist: An agent which prevents the action of an agonist on a receptor or the subsequent response, but does not have any effect of its own. Partial agonist: An agent which activates a receptor to produce submaximal effect but antagonizes the action of a full agonist.
  • 23. 20 Agonists have both affinity and = 1), e.g. adrenaline, histamine, maximal intrinsic activity (IA morphine. Competitive antagonists have affinity but no intrinsic activity (IA = 0), e.g. propranolol, atropine, chlorpheniramine, naloxone. Partial agonists have affinity and submaximal intrinsic activity (IA between 0 and 1), e.g. dichloroisoproterenol (on β adrenergic receptor), pentazocine (on μ opioid receptor). Inverse agonists have affinity but intrinsic activity with a minus sign (IA between 0 and –1) eg. chlorpheniramine (on H1 histamine receptor)
  • 24. • Partial agonist :These drug have full affinity to receptor but with low intrinsic activity (IA=0 to 1). • These are only partly as effective as agonist (Affinity is lesser when comparison to agonist) Ex: Pindolol, Pentazocine
  • 25. G protein coupled receptor 21
  • 26.
  • 27.
  • 28. 24 Gs : Adenylyl cyclase activation, Ca2+ channel Opening Gi : Adenylyl cyclase inhibition, K+ channel opening Go : Ca2+ channel inhibition Gq : Phospholipase C activation
  • 30. Ion channel receptor 26 These cell surface receptors, also called ligand gated ion channels, enclose ion selective channels (for Na+, K+, Ca2+ or Cl¯) within their molecules. Agonist binding opens the channel and causes depolarization/hyperpolarization/ changes in cytosolic ionic composition, depending on the ion that flows through. The nicotinic cholinergic, GABAA, glycine (inhibitory AA), excitatory AA-glutamate (kainate, NMDA and AMPA) and 5HT3 receptors fall in this category.
  • 31. Transmembrane enzyme-linked receptors 27 Utilized primarily by peptide hormones. Made up of a large extracellular ligand binding domain connected through a single transmembrane helical peptide chain to an intracellular subunit having enzymatic property. Examples are—insulin, epidermal growth factor (EGF), nerve growth factor (NGF) and many other growth factor receptors.
  • 33. Transmembrane JAK-STAT binding receptors 29 Agonist induced dimerization alters the intracellular domain conformation to increase its affinity for a cytosolic tyrosine protein kinase JAK (Janus Kinase). On binding, JAK gets activated and phosphorylates tyrosine residues of the receptor, which now bind another free moving protein STAT (signal transducer and activator of transcription). This is also phosphorylated by JAK. Pairs of phosphorylated STAT dimerize and translocate to the nucleus to regulate gene transcription resulting in a biological response.
  • 34. Transmembrane receptors JAK-STAT binding 30 Many cytokines, growth hormone, prolactin, interferons, etc. act through this type of receptor
  • 35. Receptors regulating gene expression (Transcription factors, Nuclear receptors) 31 These are intracellular (cytoplasmic or nuclear) soluble proteins which respond to lipid soluble chemical messengers that penetrate the cell. The liganded receptor diamer moves to the nucleus and binds other co-activator/co-repressor proteins which have a modulatory influence on its capacity to alter gene function. All steroidal hormones (glucocorticoids, mineralocorticoids, androgens, estrogens, progeste- rone), thyroxine, vit D and vit A function in this manner.
  • 36. 32
  • 37. Drug potency and efficacy 33 Drug potency refers to the amount of drug needed to produce a certain response. Drug efficacy refers to the maximal response that can be elicited by the drug.
  • 38. Drug potency and efficacy 34 Drug Drug Drug B is less potent but equally efficacious as drug A. C is less potent and less efficacious than drug A. D is more potent than drugs A, B, & C, but less efficacious than drugs A & B, and equally efficacious as drug C.
  • 39. Therapeutic index 35 where: Median effective dose (ED50) is the dose which produces the specified effect in 50% individuals And median lethal dose (LD50) is the dose which kills 50% of the recipients.
  • 40. Combined effect of Drugs 36 Synergism When the action of one drug is facilitated or increased by the other, they are said to be synergistic.
  • 41. Additive Synergism 37 The effect of the two drugs is in the same direction and simply adds up: Effect of drugs A + B = effect of drug A + effect of drug B. Side may effects of the components of an additive pair be different—do not add up. Thus, the combination is better tolerated than higher dose of one component.
  • 42. Supraadditive Synergism 38 The effect of combination is greater than the individual effects of the components: effect of drug A + B > effect of drug A + effect of drug B This is always the case when one component given alone produces no effect, but enhances the effect of the other (potentiation).
  • 43. 39
  • 44. Antagonism 40 When one drug decreases or abolishes the action of another, they are said to be antagonistic: effect of drugsA + B < effect of drugA + effect of drug B
  • 46. Physical antagonism 41 Based on the physical property e.g. charcoal adsorbs alkaloids prevent their absorption—used poisonings. of the drugs, and can in alkaloidal
  • 47. Chemical antagonism 42 The two drugs react chemically and form an inactive product, e.g Chelating agents (BAL, Cal. disod. edetate) complex toxic metals (As, Pb).
  • 48. Physiological/functional antagonism 43 The two drugs act on different receptors or by different mechanisms, but have opposite overt effects on the same physiological function, i.e. have pharmacological effects in opposite direction. Glucagon and insulin on blood sugar level.
  • 49. agonist is shifted to the Receptor antagonism 44 Competitive antagonism (equilibrium type) The antagonist is chemically similar to the agonist, competes with it and binds to the same site to the exclusion of the agonist molecules. Because the antagonist has affinity but no intrinsic activity , no response is produced the log DRC of the right. and
  • 50. Noncompetitive antagonism 45 The antagonist is chemically unrelated to the agonist, binds to a different allosteric site altering the receptor in such a way that it is unable to combine with the agonist, or is unable to transduce the response.
  • 51. 46

Editor's Notes

  1. Bulk laxatives – absorbs liquids in the intestines Potassium permanganate – by oxidation causes disinfection