The document discusses pharmacodynamics and how drugs act on the body. It describes how most drugs bind to receptors and the different types of receptors that exist. It explains drug-receptor binding kinetics using equations and graphs of dose-response curves. Different types of drugs are described like agonists that activate receptors, and antagonists that block receptor activation. The key signaling pathways of receptor activation are also summarized.

1. 2004-2005

2. Module 2
#1
Pharmacodynamics
Kash Desai
966-2723
HSc A120
k.desai@usask.ca
2004-2005

3. Drug Receptors and Pharmacodynamics
(how drugs work on the body)
The action of a drug on the body,
including receptor interactions, dose-
response phenomena, and mechanisms
of therapeutic and toxic action.
2004-2005

4. 2
Pharmacodynamics
(how drugs work on the body)
 many drugs inhibit enzymes
Enzymes control a number of metabolic processes
A very common mode of action of many drugs
 in the patient (ACE inhibitors)
 in microbes (sulfas, penicillins)
 in cancer cells (5-FU, 6-MP)
 some drugs bind to:
 proteins (in patient, or microbes)
 the genome (cyclophosphamide)
 microtubules (vincristine)
2004-2005

5. 3
Pharmacodynamics
 most drugs act (bind) on receptors
 in or on cells
 form tight bonds with the ligand
 exacting requirements (size, shape,
stereospecificity)
 can be agonists (salbutamol), or
antagonists (propranolol)
 receptors have signal transduction
methods
2004-2005

6. Drug Receptor
• A macromolecular component of a cell
with which a drug interacts to produce
a response
• Usually a protein
2004-2005

7. Types of Protein Receptors
• Regulatory – change the activity of
cellular enzymes
• Enzymes – may be inhibited or
activated
• Transport – e.g. Na+ /K+ ATP’ase
• Structural – these form cell parts
2004-2005

8. 5
dose response curves
k1 α
[D] + [R] [DR] effect
k -1
at equilibrium: k1/k-1 = affinity const.
[D] x [R] x k1 = [DR] x k-1 k-1/k1 = dissociation
const.(kd)
so that: [DR] = k1
[D] [R] k-1 the lower the kd the
more potent the drug
2004-2005

9. Drug - Receptor Binding
D+R DR Complex
Affinity
Affinity – measure of propensity of a drug to bind
receptor; the attractiveness of drug and receptor
– Covalent bonds are stable and essentially
irreversible
– Electrostatic bonds may be strong or weak, but
are usually reversible
2004-2005

10. Drug Receptor Interaction
DR Complex Effect
Efficacy (or Intrinsic Activity) – ability of a
bound drug to change the receptor in a way
that produces an effect; some drugs possess
affinity but NOT efficacy
2004-2005

11. Drug-receptor interaction
k1
Drug + Free Receptor Drug-receptor Complex
D (100 - DR) k-1 DR
Where:
D = drug concentration
DR= concentration of drug-receptor complex
100 - DR = free receptor concentration
2004-2005

12. Drug-receptor interaction
• At equilibrium:
[D] x [R] x k1 = [DR] x k-1
so that: [DR] = k1
[D] [R] k-1
k-1/k1 = dissociation constant (kd)
2004-2005

13. • At equilibrium:
[D] x [R] x k1 = [DR] x k-1
so that: [DR] = k1
[D] [R] k-1
What can we learn?
k-1/k1 = dissociation constant (kd)
• Ke (k1/k-1) is called the affinity constant
• DR is the response; D is concentration of drug
• when DR = 50 percent (effect is half
maximal), D (or EC50) is equal to kd or the
reciprocal of the affinity constant
• response is a measure of efficacy
• drugs that have parallel dose-response curves
often have the same mechanism of action
2004-2005

14. 6
dose response curves-2
effect = α [DR] = Emax * [D]/([D]+EC50) % occupancy
α
Concept: spare
2004-2005
receptors

15. Arithmetic Dose Scale
• Rate of change is rapid at first and becomes
progressively smaller as the dose is increased
• Eventually, increments in dose produce no
further change in effect i.e., maximal effect for
that drug is obtained
• Difficult to analyze mathematically
2004-2005

16. Log Dose Scale
• transforms hyperbolic curve to a sigmoid
(almost a straight line)
• compresses dose scale
• proportionate doses occur at equal
intervals
• straightens line
• easier to analyze mathematically
2004-2005

17. Arithmetic vs log scale of dose
% fall in blood pressure
50
50
40
% fall in blood
40
pressure
30
30
20 Control 20
Control
L-NAME
10 10 L-NAME
0 0
0.1
0.31 3 10 -2 -1 0 1 2
Acetylcholine nmol/kg 0.1 0.3 1 3 10
Acetylcholine nmol/kg
2004-2005

18. Potency
Relative position of the dose-effect curve along
the dose axis
Has little clinical significance for a given
therapeutic effect
A more potent of two drugs is not clinically
superior
Low potency is a disadvantage only if the dose
is so large that it is awkward to administer
2004-2005

19. Relative Potency
hydromorphone
morphine
Analgesia codeine
aspirin
Dose
2004-2005

20. 7
Why are there spare receptors?
 allow maximal response without
total receptor occupancy – increase
sensitivity of the system
 spare receptors can bind (and
internalize) extra ligand preventing
an exaggerated response if too
much ligand is present
The receptor theory assumes that all receptors should be occupied to
produce a maximal response. In that case at half maximal effect
EC50=kd. Sometimes, full effect is seen at a fractional receptor
2004-2005
occupation

21. 10
Agonists and antagonists
 agonist has affinity plus intrinsic activity
 antagonist has affinity but no intrinsic activity
 partial agonist has affinity and less intrinsic activity
 competitive antagonists can be overcome
2004-2005

22. Agonist Drugs
• drugs that interact with and activate
receptors; they possess both affinity and
efficacy
• two types
– Full – an agonist with maximal efficacy
– Partial – an agonist with less then
maximal efficacy
2004-2005

23. Agonist Dose Response Curves
Full agonist
Partial agonist
Response
Dose
2004-2005

24. Antagonist Drug
• Antagonists interact with the receptor
but do NOT change the receptor
• they have affinity but NO efficacy
• two types
– Competitive
– Noncompetitive
2004-2005

25. Competitive Antagonist
• competes with agonist for receptor
• surmountable with increasing agonist
concentration
• displaces agonist dose response curve
to the right (dextral shift)
• reduces the apparent affinity of the
agonist i.e., increases 1/Ke
2004-2005

26. Noncompetitive Antagonist
• drug binds to receptor and stays bound
• irreversible – does not let go of receptor
• produces slight dextral shift in the agonist
DR curve in the low concentration range
• this looks like competitive antagonist
• but, as more and more receptors are bound
(and essentially destroyed), the agonist drug
becomes incapable of eliciting a maximal
effect
2004-2005

27. 11
Desensitization
 agonists tend to desensitize receptors
 homologous (decreased receptor
number)
 heterologous (decreased signal
transduction)
 antagonists tend to up regulate
receptors
2004-2005

28. 8
dose response curves-3
quantal dose response curves (used in populations, response is yes/no)
Therapeutic index =Toxic Dose50/Effective Dose50
2004-2005
(TD50/ED50)

29. DR Curve: Whole Animal
• Graded – response measured on a
continuous scale
• Quantal – response is an either/or event
– relates dose and frequency of response in
a population of individuals
– often derived from frequency distribution
of doses required to produce a specified
effect
2004-2005

30. Effectiveness, toxicity, lethality
• ED50 - Median Effective Dose 50; the dose
at which 50 percent of the population or
sample manifests a given effect; used with
quantal dr curves
• TD50 - Median Toxic Dose 50 - dose at
which 50 percent of the population
manifests a given toxic effect
• LD50 - Median Toxic Dose 50 - dose which
kills 50 percent of the subjects
2004-2005

31. Quantification of drug safety
TD50 or LD50
Therapeutic Index =
ED50
2004-2005

32. Drug A
100 sleep
death
Percent 50
Responding
0
ED50 LD50
dose
2004-2005

33. Drug B
100 sleep
death
Percent 50
Responding
0
ED50 LD50
dose
2004-2005

34. 9
The therapeutic index
 The higher the TI the better the drug.
 TI’s vary from: 1.0 (some cancer drugs)
to: >1000 (penicillin)
 Drugs acting on the same receptor or enzyme system
often have the same TI: (eg 50 mg of
hydrochlorothiazide about the same as 2.5 mg of
indapamide)
2004-2005

35. 4
Signal transduction
1. enzyme linked
(multiple actions)
1. ion channel linked
(speedy)
1. G protein linked
(amplifier)
1. nuclear (gene) linked
(long lasting)
2004-2005

36. Structure:
1. G protein-linked receptors
•Single
polypeptide
chain threaded
back and forth
resulting in 7
transmembrane
å helices
•There’s a G
protein
attached to the
cytoplasmic
side of the
membrane
(functions as a
2004-2005
switch).

37. 2004-2005

38. 2. Tyrosine-kinase receptors
Structure:
•Receptors exist as individual polypeptides
•Each has an extracellular signal-binding
site
•An intracellular tail with a number of
tyrosines and a single å helix spanning the
membrane
2004-2005

39. 2004-2005

40. 3. Ion channel
receptors
Structure:
•Protein pores
in the plasma
membrane
2004-2005

41. Intracellular receptors
Not all signal receptors are located on the plasma membrane.
Some are proteins located in the cytoplasm or nucleus of
target cells.
• The signal molecule must be able to pass through
plasma membrane.
Examples:
~Nitric oxide (NO)
~Steroid (e.g., estradiol, progesterone, testosterone)
and thyroid hormones of animals).
2004-2005

42. B. Second Messengers
•Small, nonprotein, water-soluble
molecules or ions
•Readily spread throughout the cell by
diffusion
•Two most widely used second messengers
are:
1. Cycle AMP
2004-2005
2. Calcium ions Ca2+

43. 2. Calcium Ions (Ca2+) and Inositol
Trisphosphate
•Calcium more widely used than cAMP
•used in neurotransmitters, growth
factors, some hormones
•Increases in Ca2+ causes many possible
responses:
•Muscle cell contraction
•Secretion of certain substance
•Cell division
2004-2005

44. Two benefits of a signal-transduction pathway
1. Signal amplification
2. Signal specificity
A. Signal amplification
•Proteins persist in active form long
enough to process numerous molecules
of substrate
•Each catalytic step activates more
products then in the proceeding steps
2004-2005

45. 2004-2005

46. 12
Summary
 most drugs act through receptors
 there are 4 common signal transduction methods
 the interaction between drug and receptor can be described
mathematically and graphically
 agonists have both affinity (kd) and intrinsic activity (α)
 antagonists have affinity only
 antagonists can be competitive (change kd) or
 non-competitive (change α) when mixed with agonists
 agonists desensitize receptors.
 antagonists sensitize receptors.
2004-2005