Lecture one and two Flashcards

1
Q

2 characteristics of a drug and explanation ?

A

A drug will contain 2 characteristics, affinity which is the ability of the drug to bind to the site on the receptor, as well as efficacy, which is a measure of the ability of the drug to produce a measurable response. These values can be zero , positive or negative.

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2
Q

John Newport Langley ?

A

“The receptive substance” was a quote said by John Newport Langley in 1905 when he was analysing the pharmacology of muscarinic agonists and antagonists. It describes that drugs must bind to a specific constituent of a cell to produce their effects, for example the receptor.

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3
Q

what do binding drugs to a receptor share qualities with and give example ?

A

The drugs that are able to bind to the receptors on a cell often share structural similarities to the natural endogenous ligand of the cell and they have specific affinity to the receptor. An example of this salbutamol, a selective beta 2 agonist which shares similarities in it’s structure to adrenaline.

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4
Q

describe salbutmol

A

Salbutamol is a selective beta 2 agonist which dilates the airways in asthmatic patients whereas, adrenaline is a nonselective adrenaline receptor agonist. Salbutamol has been designed to only effect one receptor class. Whereas adrenaline binds to all beta and alpha receptors as it is unable to discriminate the receptors.  

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5
Q

describe the beta 2 adrenergic receptor ?

A

The Beta 2 adrenergic receptor is embedded in the membrane of cells, it is bound via a synthetic ligand within the cell. The structure of the receptor is a 7 transmembrane domain which associates with a G protein, with alpha beta and gamma subunits. This G protein can activate an intracellular enzyme which can facilitate changes to the cell physiologically through a signal cascade. 

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6
Q

what do receptors normal contain ?

A

Receptors tend to have a high degree of drug (ligand) specificity as a result the receptors bind only to molecules with a unique three dimensional topography and chemistry , the receptors do not bind to closely related molecules they tend to vary in structures and discriminate between closely related molecules.

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7
Q

describe dopamine , noradrenaline and adrenaline similarities and consequences

A

The 3 receptors for dopamine , noradrenaline and adrenaline are similar in structure , but dopamine will not bind to receptors associated with noradrenaline or adrenaline as it is a selective agonist that only interacts with dopamine receptors. However, the differences between noradrenaline and adrenaline are not too similar and as a result will interact with similar receptors as they are nonselective adrenergic agonists.

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8
Q

why do drugs exert side effects ?

A

When considering the side effects of a drug it is the drugs ability to bind to multiple receptors that accounts for the side effects.  No drug has a complete specificity for one type of receptor, this is the case for drugs that have a low potency, there will need to be a high dose of the drug to have a pharmacological effect. This is due to these drugs tending to bind to a wide range of receptors and this is when unwanted side effects occur

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9
Q

thalidomide scandal ?

A

Thalidomide was produced in the 1950’s for morning sickness in pregnancy , it is a racemic mix so they look identical but are mirror images of each other. When distributed it was unknown that it interacted with enzymes and receptors and caused teratogenic effects in the unborn child such as shortening the limbs. Although thalidomide is termed a bad drug it also has some benefits such as it’s use in leprosy and some cancers. After the thalidomide scandal, there was a tightening in regulations around drug productions.

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10
Q

explain epinephrine ?

A

Epinephrine ( adrenaline) is also a racemic mix , epinephrine is found in EpiPen’s for the treatment of anaphylaxis shock. It had an R and a S form depending on the orientation of the hydroxyl group. It contains a charged nitrogen and a flat ring structure and these bind to the sites on the enzyme shown below. If the orientation is not correct , this produces a poor fit and less of the receptor is activated and the downstream physiology is not as efficient as it is less active.  The R form contains the correct orientation of the hydroxyl group and interaction can occur between the 3 sites on the receptor , the fit is better and as a result more of the receptor is activated and this increases the downstream physiological activation of the cell. In the liver the R form can be converted to the less active form of the S , so this needs to be considered so prevent unwanted side effects.

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11
Q

what does acetlycholine act on ?

A

Acetylcholine acts on nicotinic and muscarinic receptors, the nicotinic receptors are located in the skeletal muscle, ganglia and CNS. The muscarinic receptors are more widely distributed but they are not located in the skeletal muscles

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12
Q

nicotinic receptor type ?

A

The nicotinic receptors have an integrated ligand gated ion channel, which opens to allow ions to flow in such as sodium, this causes depolarisation to occur which is excitatory.

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13
Q

muscarinic receptor type ?

A

The muscarinic receptors have an ion channel which is associated with a G protein coupled receptor , there are 5 subtypes ( M1 – M5).

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14
Q

agonists for the nicotinic receptor ?

A

The agonists include acetylcholine and nicotine

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15
Q

antagonists for nicotinic receptors ?

A

normally naturally occurring such as atracurium and tubocurarine.  

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16
Q

describe the associated G protein for odd numbered muscarinic receptors?

A

For the muscarinic receptors, the odd numbers, M1 M3 and M5 have the Gq/PLC coupled receptors , it is the Gq protein that sets the nature of the downstream signalling in the cell. It leads to the generation of phospholipase C.

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17
Q

even number muscarinic receptor G proteins ?

A

The even numbers M2 and M4 have the Gi/o cAMP receptors and these lead to the decrease in the cAMP levels.

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18
Q

agonists for muscarinic receptors ?

A

The agonist is acetylcholine , muscarine and bethanocol 

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19
Q

antagonists for muscarinic receptors ?

A

The antagonists include atropine, hyoscine ( found in over the counter medicine such as stomach upsets) .

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20
Q

what does noradrenaline act on and location ?

A

Noradrenaline acts on alpha and beta adrenoreceptors which are widely distributed in the body. The beta receptors are found in the airways and they are G protein coupled while alpha receptors are found in blood vessels and they are also G protein coupled. 

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21
Q

Alpha 1 subtype of receptor ?

A

he alpha one and Gq/PLc coupled activating phospholipase C

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22
Q

alpha 2 subtype of receptor ?

A

alpha 2 are Gi/o/cAMP and again leads to a decrease in cAMP.

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23
Q

how many subtypes of beta receptors ?

A

There are 3 subtypes of beta receptors

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24
Q

beta 1 and 3 ?

A

beta 1 and 3 are Gs/adenylate cyclase which are activated by cAMP and this has a target for protein kinase A

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25
Q

beta 2 ?

A

beta 2 the receptors are Gi/ cAMP coupled and they cause a decrease in the cAMP production.  

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26
Q

agonists for both beta and alpha receptors and what is the preferential agonist?

A

noradrenaline ( preferential agonist for beta )and adrenaline ( preferential for alpha)

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27
Q

antagonists for beta ?

A

propanol , sotalol normally

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28
Q

antagonists for alpha ?

A

phenoxybenzamine and phentolamine normally ( MINE).

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29
Q

verpamil ?

A

erapamil is a cardiac calcium channels blocker which reduce contractive force and the rate of contraction used in the treatment of high blood pressure.

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30
Q

ibuprophen ?

A

Enzymes are aslo targets for drugs and they are often inhibited. Ibuprofen inhibits the enzyme cyclo -oxygenase to reduce inflammation.

31
Q

prosac ?

A

Transporters and carriers are also targets, prosac blocks the uptake of 5-HT used to treat depression.  

32
Q

cimetidine ?

A

Antagonists such as cimetidine will block histidine receptors in the stomach to treat peptide ulcers.  

33
Q

cell based system for testing ?

A

cell based system. This is high throughput screening by setting up cell lines which express receptors and ion channels that are of interest and screen 100,000 of compounds a day looking for targets and hits. These allows us to look for chemical entities of interest. Some cell lines express receptors and ion channels of the disease models while others express a drug interaction that they are looking to exclude from their approach.

34
Q

in vitro pharmacological mehtod?

A

In vitro pharmacological methods takes whole tissues in organ baths for example and can record tension and you can alter the environment to test different experiments to look at mechanisms of actions in a more controlled environment than cell based screening.  

35
Q

in vivo ?

A

In vivo uses the whole animal and introduces the drug so you can give a single dose to the animal , which allows us to see the changes in the animals behaviour and global toxicity.  

36
Q

pre clinical phase allow ?

A

The preclinical phase allows the testing of drugs on non-human subjects such as mice and rats to gather evidence on the efficacy , toxicity and pharmacokinetic information. The dose is unrestricted and the person carrying this out can be a graduate level researchers such as a Ph.D. There are no humans allowed so number of patients is not applicable here.  

37
Q

clinical testing bad case ?

A

Clinical trials do not always go to plan however and the TGN1412 humanised monoclonal antibody trail highlighted some changes that needed to take place in clinical trials. The phase 1 trial resulted in hospitalization of all six volunteers who administered the drug, at least four of whom suffered multiple organ dysfunction as well as losing some limbs due to autonomic storm generated from antibody. Bizarre trial as all volunteers received the drug simultaneously. Rather than phased deployment of drug to see reactions

38
Q

quote for paracelsus ?

A

“All things are poison , for there is nothing without poisonous qualities. It is the dose which makes a thing poison” this is a quote from Paracelsus in 1493 which highlighted that all drugs have the potential to produce unwanted side effects it is the dosage that prevents or causes this.

39
Q

what type of graph does a dose theraputic response relationship show ?

A

A sigmoidal shape graph shows the dose therapeutic response relationship and the second shows the dose adverse response relationship.

40
Q

theraputic range ?

A

The therapeutic range is the distance between the minimum useful effect and the maximum tolerated adverse effect.  Ideally the therapeutic range should be infinite and quite large as no adverse effects

41
Q

dose ?

A

It is the dose that generates the adverse effects as the higher the dose the more likely to interact with other receptors. Some drugs have a narrow or non-existent margin between therapeutic (desired) and toxic (undesired) effects. `

42
Q

latrogenicity ?

A

Iatrogenicity is the capacity to produce disease from the side effects or inappropriate prescribing of drugs e.g. anti-malarial drug mefloquine (Lariam) associated with neuropsychiatric side effects such as suicidal thoughts.  

43
Q

teratogenicity?

A

Teratogenicity is the capacity to produce abnormalities of the unborn child or foetus  

e.g. thalidomide (late 1950’s) suffer from phocomelia:  Phoco- (seal) melia (limb).  

44
Q

botulinum toxin ?

A

Botulinum Toxin is used for temporary removal of facial wrinkles , severe underarm sweating in very low doses. It works by preventing the release of acetylcholine from receptors. 

45
Q

cervical dystonia ?

A

cervical dystonia - a neurological disorder that causes severe neck and shoulder muscle contractions.

46
Q

blepharospasm ?

A

 Blepharospasm - uncontrollable blinking

47
Q

strabismus ?

A

Strabismus - misaligned eyes. 

48
Q

agonists ?

A

Agonists are drugs or naturally occurring body substances such as neurotransmitters or hormones that contain affinity and efficacy, they produce a measurable response. This response can be inhibitory or excitatory.

49
Q

concentration response curves ?

A

An agonist can provide functional information as a concentration response curve can be derived from the agonist. Increasing the concentration of an agonist leads to larger and larger responses until a maximum response is reached (Emax). At Emax, no matter how much more agonist you add there will be no greater response as the acetylcholine receptors are occupied at maximum.

50
Q

why are CRC beneficial ?

A

Concentration response curves are useful as they can be used to compare the potencies of different drugs that produce qualitatively similar responses. This allows comparison of Ec50’s which are often different. The most potent agonist is the one that produces the highest response with the lowest concentration. The agonist concentration response curves in different tissues can be used to identify the different receptors subtypes present.

51
Q

rectangular hyperbola ?

A

A linear plot of the agonist concentration against response produces distinctively shaped curve called a rectangular hyperbola. Where there’s an exponential change at the start and levels off at the end where no further response occurs as at maximum rate. You can estimate the concentration required to produce 50% of the maximum response (or EC50).

52
Q

does one tissue contain only one type of receptor ?

A

The same tissue can contain receptors for more than one agonist, e.g. the guinea pig ileum can be contracted by acetylcholine, histamine, and 5-hydroxytryptamine.

53
Q

m receptor in ileum ?

A

M3

54
Q

Muscarinic receptor in heart ?

A

M2

55
Q

acetylcholine effect in ileum ?

A

The acetylcholine causes an excitatory response to the M3 subtypes in the ileum and contraction is increased.

56
Q

acetylcholine effect on heart ?

A

the acetylcholine causes an inhibitory effect to the M2 receptors in the heart and the contractions are decreased

57
Q

noradrenlaline effect on ileum alpha 2 ?

A

Noradrenaline causes the ileum alpha 2 receptors to have an inhibitory effect

58
Q

noradrenaline effect on blood vessel alpha 1 ?

A

alpha 1 receptors in the blood vessels have an excitatory response.

59
Q

can the agonist CRC be used to calculate the affininty of the drug for it’s receptor ?

A

nope , Agonist concentration curves cannot be used to calculate the affinity of the drug for its receptor. This is because the physiological response is usually not directly proportional to the number of occupied receptors , in fact only a small proportion (20%) of the receptors need to be occupied to elicit a maximum response.

60
Q

law of mass action ?

A

In order to better define the relationship between an agonist molecule and its receptor a receptor theory has evolved to relate drug binding to receptors (receptor occupancy) and drug concentration. This theory is based on applying the Law of Mass Action to the drug receptor interaction.

61
Q

definition of law of mass action ?

A

The law of mass action in definition is that the rate of a chemical process is proportional to the concentrations of the reacting substances. The reversible interaction between an agonist and it’s specific receptor obeys the law of mass action. If it is not reversible then this does not obey the law of mass action. The agonist molecules will normally exceed the receptor concentration , the binding to the receptors does not significantly reduce the agonist concentration. The size of the response is related to the number of receptors activated.

62
Q

receptor occupation (Pa)

A

The law of mass action equation can be rearranged to determine the proportion of receptors occupied (PA )

63
Q

Kd - dissocation constant ?

A

The dissociation constant (KD) is expressed in units of concentration, molarity. As the value of KD gets smaller the affinity for the receptors increases.A smaller Kd value for a drug is favourable as this will require a smaller dose to elicit a response.

64
Q

Hill langmuir equation allow ?

A

he Hill Langmuir equation is the bottom Pa equation and this allows us to calculate the 50% receptor occupancy at a particular concentration

65
Q

partial agonist ?

A

Some agonists are called partial agonists , they will have low efficacies and cannot produce the maximal response in the tissue no matter how high of a concentration is applied. Despite having a low efficacy the partial agonists are able to occupy a large proportion of receptors and as a result can reduce the action of full agonists. In the presence of a partial or full agonist the equilibrium will move towards the right towards the activated receptors. The greater affinity for the activated state over the resting state will produce a greater efficacy of the agonist.

66
Q

full and partial agonist effect onCRC ?

A

When a full agonist and partial agonist are present at the same time then there will be a rapid baseline and there will be a right shift in the agonist log concentration response curve.

67
Q

inverse agonist ?

A

An inverse agonist is a drug that can be described as having a negative efficacy as opposed to agonists that contain positive efficacy and antagonists that contain zero efficacy. The effects of inverse agonists are only observed when receptors are active even in the absence of an agonist, usually associated with GPCR which contain intrinsic enzyme activity. In the presence of an inverse agonist the affinity is greater for the resting state of the receptor rather than the activated receptor conformation. This traps the receptor into resting and no physiological response is seen.

68
Q

2 types of conformation of receptors ?

A

Receptors contain 2 conformations , a resting state and an activated state.

69
Q

no agonist effect on equilibrium ?

A

When there is no agonist present the equilibrium lie far to left as most receptors will be in their resting state.

70
Q

inverse agonists list for beta adrenergic agonists ?

A

H1 and H2 antihistamines

propanolol and nadolol

71
Q

inverse agonists dopamine receptors?

A

Haloperidol and clozapine are inverse agonists for the dopamine receptors

72
Q

inverse agonists for opiod ?

A

naloxone

73
Q

allosteric ligand ?

A

An allosteric ligand binds to a site and changes the affinity of the orthosteric agonist to either increase or decrease signalling events

74
Q

biased ligand ?

A

A biased ligand can drive the physiological response towards a cell signal for example GRK or G protein event