This document discusses factors that influence individual variability in drug response and how they should guide dosing for patients. It covers differences in pharmacokinetics and pharmacodynamics based on age, organ function, genetics and other personal characteristics. Key points include how drug metabolism and excretion vary with age due to changes in liver, kidney and body composition. Dosing should be adjusted based on these patient-specific factors to ensure safety and efficacy of treatment.
Description on definition of pharmacogenetics, role of pharmacogenetics in drug response, role of polymorphism in drug metabolism, drug transporters and drug targets.
Pharmacogenomics, Pharmacogenetics and Pharmacokinetics Zohaib HUSSAIN
Introduction
With the information available about human genome and human proteome, it is now well understood that there are a lot of variations between individuals. These minor variations account for many differences like adverse drug reactions, which are responsible for many hospitalizations and casualties. The observed variable effect of drug is due to difference in sensitivity as some people need higher dose and some need lower dose to get similar therapeutic effect, but in some people drug has no therapeutic effects and in some it shows strong adverse reactions.
Pharmacogenomics: A new age drug technologyMahek Sharan
the pharmacogenomics require the pharmacology and genomic together to improve the drug responses and the new age drug potential according to individual need
Description on definition of pharmacogenetics, role of pharmacogenetics in drug response, role of polymorphism in drug metabolism, drug transporters and drug targets.
Pharmacogenomics, Pharmacogenetics and Pharmacokinetics Zohaib HUSSAIN
Introduction
With the information available about human genome and human proteome, it is now well understood that there are a lot of variations between individuals. These minor variations account for many differences like adverse drug reactions, which are responsible for many hospitalizations and casualties. The observed variable effect of drug is due to difference in sensitivity as some people need higher dose and some need lower dose to get similar therapeutic effect, but in some people drug has no therapeutic effects and in some it shows strong adverse reactions.
Pharmacogenomics: A new age drug technologyMahek Sharan
the pharmacogenomics require the pharmacology and genomic together to improve the drug responses and the new age drug potential according to individual need
Pharmacogenetics and pharmacogenomics is an upcoming branch in therapeutics. Various pharmacogenomic tests are currently available to aid in actual clinical practice. It has shown to have promising results in personalized medicine It is my attempt to compile the basic concepts from various books, articles, and online journals. Please feel free to comment.
Genetic polymorphisms are variations in gene sequences that occur in at least 1% of the general population, resulting in multiple alleles or variants of a gene sequence.
The most commonly occurring form of genetic variability is the single nucleotide polymorphism (SNP, often called “snip”)
Pharmacogenomics is the branch of biochemistry in which study how an individual’s genetic inheritance affects the body response to drug. Pharmacogenomics is the intersection of genetics and pharmaceutical industry.
In this presentation a brief note is given about what is pharmacogenomics. Why different drugs work differently in different people. today pharmacogenomics, future of pharmacogenomics. also describe the future of pharmacogenomics. challenges which have to pharmacogenomics.
Pharmacogenetics and pharmacogenomics is an upcoming branch in therapeutics. Various pharmacogenomic tests are currently available to aid in actual clinical practice. It has shown to have promising results in personalized medicine It is my attempt to compile the basic concepts from various books, articles, and online journals. Please feel free to comment.
Genetic polymorphisms are variations in gene sequences that occur in at least 1% of the general population, resulting in multiple alleles or variants of a gene sequence.
The most commonly occurring form of genetic variability is the single nucleotide polymorphism (SNP, often called “snip”)
Pharmacogenomics is the branch of biochemistry in which study how an individual’s genetic inheritance affects the body response to drug. Pharmacogenomics is the intersection of genetics and pharmaceutical industry.
In this presentation a brief note is given about what is pharmacogenomics. Why different drugs work differently in different people. today pharmacogenomics, future of pharmacogenomics. also describe the future of pharmacogenomics. challenges which have to pharmacogenomics.
Factors modifying drug action such as
Body size
Age
Sex
Species and Race
Genetics
Route of administration
Environmental factors
Psychological factors
Pathological factors
Other drugs
Cumulative
Tolerance
Variation in drug response
Difference in PK handling of drug
Variation in number of receptors
Neurogenic, hormonal tone variation
Host, environmental factors
Guide appropriate drug, dose for a patient
Modify drug action quantitatively, qualitatively
Quality use of medicines in geriatric patients with their Physiological changes with aging, altered Pharmacokinetics and Pharmacodynamics with ADR's, Guidelines for prescribing the older people and the role of clinical pharmacist in geriatric prescribing.
Detailed idea on nanotechnology, nanomedicine, types, uses, pharmacotherapy, and future prospects of the nanotechnology. Drug delivery systems, Pharmacokinetics and pharmacodynamics of the nanoparticles are dealt in detail
An intensive material on the anticancer agents. Detailed idea of the various classes of anticancer and recent advances in each class. Newer anticancer drug delivery systems and the anticancer vaccines are also dealt in detail.
An intensive material on recent advances on contraception including the current contraceptive methods and a brief overview on immunocontraception and contraceptive vaccines
A concise overview of pharmacoeconomics, health economics, various costs, various pharmacoeconomic study designs and its application in the field of medicine and drug development
A concise overview of biased agonism, mechanism, beta arrestin pathway, types, examples, GPCR, pros and cons of biased agonism, beta blockers and angiostensin receptor in biased agonism.
Receptor types, mechanism, receptor pharmacology, drug receptor interactions, theories of receptor pharmacology, spare receptors and new concepts like biased agonism
Regulation in clinical trial, Schedule Y and recent amendmentsDr. Siddhartha Dutta
Regulatory framework of India, Acts and Regulations for conduct of clinical trial in India, Schedule Y, approval of new chemical entity and recent amendments
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. (1) Individuals differ in pharmacokinetic handling of drugs: attain
varying plasma/target site concentration of the drug.
This is more marked for drugs disposed by metabolism (e.g.
propranolol) than for drugs excreted unchanged (e.g. atenolol).
(2) Variations in number or state of receptors, coupling proteins or other
components of response effectuation
(3) Variations in neurogenic/hormonal tone or concentrations of specific
constituents, e.g. atropine tachycardia depends on vagal tone,
propranolol bradycardia depends on sympathetic tone, captopril
hypotension depends on body Na+ status.
3. A multitude of host and external factors influence drug response
Genetic and non genetic including all environmental, circumstantial
and personal variables
Their understanding can guide the choice of appropriate drug and dose
for an individual patient
Final adjustments have to be made by observing the response in a
given patient on a given occasion
4. 1. Quantitatively --The plasma concentration and/ or the action
of the drug is increased or decreased. Most of the factors
introduce this type of change and can be dealt with by
adjustment of drug dosage
2. Qualitatively- The type of response is altered, e.g. drug
allergy or idiosyncrasy. This is less common but often
precludes further use of that drug in the affected patient.
5. 1. Body size
2. Age
3. Sex
4. Pregnancy
5. Species and race
6. Genetics
6.
7. Influences the concentration of the drug attained at the site of action
The average adult dose refers to individuals of medium built
For exceptionally obese or lean individuals and for children dose may
be calculated on body weight (BW) basis:
Individual dose =BW (kg)/70 x average adult dose
Body surface area (BSA) provides a more accurate basis for dose
calculation, because total body water, extracellular fluid volume and
metabolic activity are better paralleled by BSA
Individual dose = BSA (m2 )/1.7 x average adult dose
8.
9.
10. Prescriber should know the form in
which the drug will be dispensed and
provide proper instruction to
pharmacist and parent
Many drugs prepared for children are
in the form of elixirs and suspensions
Doses should always be given after
calculating using body weight/ age of
the child.
11. Infants and children are not small adults [Physiologically different]
Newborn has low G.F.R and tubular transport is immature
Drugs excreted by glomerular filtration(gentamicin) and tubular
secretion (penicillin) is prolonged by 3 to 5 times
Hepatic drug metabolizing system is inadequate in newborns –
Chloramphenicol(gray baby syndrome)
Blood-brain barrier is more permeable-drugs attain higher concen-
tration in the CNS (accumulation of unconjugated bilirubin causes
kernicterus)
12. Lower gastric acidity and slower intestinal transit -Drug absorption is
altered in infants
Transdermal absorption however, is faster because their skin is thin
and more permeable
Solid dosage forms and aerosol inhalations are difficult to administer
to young children
After the first year of life, drug metabolism is often faster than in
adults, e.g. theophylline, phenytoin, carbamazepine t 1/2 is shorter in
children
13. Children are growing and are susceptible to special adverse effects of
drugs, e.g.
Suppression of growth can occur with corticosteroids
Androgens may promote early fusion of epiphysis(stunting)
Tetracyclines deposited in growing teeth and discolour/ deform them
Dystonic reactions to phenothiazine are more common in children
Infant doses must be learned as such and not derived
14.
15.
16.
17. Age-related physiologic changes make the elderly susceptible to
adverse effects
Understanding the influence these changes have on the
pharmacokinetics and pharmacodynamics of the elderly is essential to
prevent harm
Renal function progressively declines (intact nephron loss) - 25% at 50
years and - 50% at 75 year compared to young adults
Elderly are also likely to be on multiple drug therapy for HTN, DM,
Arthritis, etc which increases many fold the chances of drug
interactions
18. Physiologic change
Decreased gastric acidity
Decreased gastrointestinal blood flow
Delayed gastric emptying
Slowed intestinal transit time
General clinical effect
None on passive diffusion or bioavailability for most drugs
Decreased active transport: Decreased bioavailability
Decreased first-pass effect: Increased bioavailability
Special considerations
Antacids decrease absorption of acidic drugs: digitalis, phenytoin,
tetracycline
Anticholinergics: Slow GI motility and absorption rate
19. Decreased Total body water
Decreased Volume Distribution
Increased Plasma Conc. of water soluble drugs
Lower doses are required: Lithium, digoxin, ethanol, etc
Decreased Lean body mass and Increased body fat
Increased Volume Distribution, Longer (t½) of water soluble drugs
Accumulation into fat of lipid soluble drugs: Bzd, etc
Decreased Serum Albumin
Increased unbound fraction of highly protein bound drugs
Binds acidic drugs: warfarin, phenytoin, digitalis, etc
Decreased Alpha 1 Acid glycoprotein
Increased unbound fraction of highly protein bound drugs
-Binds basic drugs: lidocaine and propranolol, etc
20. Aging Effect Vd Effect Examples
body water Vd for hydrophilic
drugs
ethanol, lithium
lean body mass Vd for for drugs that
bind to muscle
digoxin
fat stores Vd for lipophilic drugs diazepam, trazodone
plasma protein (albumin) % of unbound or free
drug (active)
diazepam, valproic acid,
phenytoin, warfarin
plasma protein
(1-acid glycoprotein)
% of unbound or free
drug (active)
quinidine, propranolol,
erythromycin, amitriptyline
21. Determined primarily by hepatic function and blood flow
Capacity of the liver to metabolize drugs does not appear to decline
consistently with age for all drugs
For drugs with extensive first-pass metabolism, bioavailability may increase
because less drug is extracted by the liver
Decreased liver mass
Decreased liver blood flow
Examples: morphine, meperidine, metoprolol, propranolol, verapamil,
amitryptyline, nortriptyline
22. Determined
Primarily by renal function
Declines with age and is worsened by co-morbidities
Decline is not reflected in an equivalent rise in serum creatinine since creatinine
production is reduced due to lower muscle mass
Physiologic change
Decreased GFR
Decreased renal blood flow
Decreased renal mass
General clinical effect
Decreased clearance, Increased (t½) of renally eliminated drugs
23. Renal blood flow, GFR, tubular secretion decrease with age above 55 years.
Creatinine clearance (CrCl) is used to estimate GFR
Serum creatinine alone not accurate in the elderly
lean body mass lower creatinine production
glomerular filtration rate
Serum creatinine stays in normal range, masking change in creatinine clearance
Creatinine clearance = (140-age) x wt (kg)
72 x S. Cr in mg/dl
For female it should be multiplied with 0.85
24. Pharmacodynamic changes in the elderly have been less extensively
studied
Evidence of enhanced end-organ responsiveness or “sensitivity” to
medications with aging
Enhanced “sensitivity” may be due
Changes in receptor affinity
Changes in receptor number
Post-receptor alteration
Age-related impairment of homeostatic mechanisms Example: decreased
baroreceptor reflexes
25. Drugs that act on the CNS appear to produce an exaggerated response than
that expected from their plasma concentration
Old people are more sensitive to the respiratory effect of opioid analgesic
because of age related respiratory changes
Baroreceptor sensitivity reduced– more risk of orthostatic hypotension with
antihypertensive drugs
Response to β adrenoreceptor agonist and antagonist reduced because of
smaller number of receptor and reduced affinity for adrenoreceptors
Prostatism in elderly males, even mild anticholinergic activity of the drug can
accentuate bladder voiding difficulty
26. CNS drugs
Sedative-hypnotics: Benzodiazepines and barbiturates
Analgesics: Opioids
Antipsychotic, antidepressants: Haloperidol, lithium, TCAs
Cardiovascular drugs
Antihypertensives: Thiazides, beta-blockers
Antiarrhythmic drugs
Quinidine and procainamide: clearance and (t½)
Antimicrobial drugs
Beta-lactams and aminoglycosides: clearance
Anti-inflammatory drugs
NSAIDs: GI bleed and irritation
27. Positive relationship between number of drugs taken and incidence of ADR
Overall incidence is estimated to be at least twice that in the younger
population
Prescribing errors
Polypharmacy
Drug interactions with other prescriptions
Unawareness of age related physiologic changes
Drug usage errors
“Hidden ingredients”: OTCs
28. There are several practical obstacles to compliance that the prescriber must
recognize
Forgetfulness
Prior experience
Physical disabilities
Recommendations to improve compliance
Take careful drug history
Prescribe only for a specific and rational indication
Define goal of drug therapy
High index of suspicion regarding drug reactions and interactions
Simplify drug regimen