أسئلة الثانية فارما PPPM (قبل التعديل)
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Questions and Answers

Adrenaline's ability to counteract histamine-induced hypotension and bronchoconstriction exemplifies which type of antagonism?

  • Pharmacokinetic antagonism
  • Chemical antagonism
  • Physical antagonism
  • Physiological antagonism (correct)

Protamine's mechanism of action in reversing heparin overdose is an example of what kind of antagonism?

  • Pharmacokinetic antagonism
  • Chemical antagonism (correct)
  • Physical antagonism
  • Physiological antagonism

Which of the following scenarios exemplifies pharmacokinetic antagonism?

  • Protamine neutralizing heparin's charge.
  • Adrenaline counteracting histamine's effect.
  • Blocking of sodium channels by local anesthetics.
  • Antacids reducing iron absorption. (correct)

Rifampicin reduces the effectiveness of oral contraceptive pills. This interaction is an example of which type of antagonism?

<p>Pharmacokinetic antagonism (A)</p> Signup and view all the answers

Sodium bicarbonate ($\text{NaHCO}_3$) increases the excretion of aspirin by alkalinizing the urine. This interaction exemplifies:

<p>Pharmacokinetic antagonism (B)</p> Signup and view all the answers

Local anesthetics block sodium channels, preventing nerve signal transmission. This mechanism of action best illustrates which of the following?

<p>Physical block of ion channels (D)</p> Signup and view all the answers

In pancreatic beta cells, increased intracellular ATP leads to the closure of ATPase-sensitive potassium channels. This is an example of:

<p>Ion channels modulated by intracellular ATP (B)</p> Signup and view all the answers

Neostigmine inhibits cholinesterase, increasing acetylcholine levels at the synapse. This is an example of a drug acting as a:

<p>Competitive inhibitor of an enzyme (C)</p> Signup and view all the answers

A drug is considered a full agonist when it:

<p>Elicits the maximal possible response at full receptor occupancy. (A)</p> Signup and view all the answers

Which of the following statements accurately describes the ED50 of a drug?

<p>The dose that gives the desired effect in 50% of a test population of subjects. (B)</p> Signup and view all the answers

A reversible competitive antagonist's effect can be overcome by:

<p>Increasing the concentration of the agonist. (D)</p> Signup and view all the answers

A drug with a lower ED50 compared to another drug that produces the same effect can be described as:

<p>More potent. (A)</p> Signup and view all the answers

Why is the efficacy of a drug considered more clinically important than its potency?

<p>Because a less potent drug can be administered in higher doses to achieve the effect of a more potent one, provided it's not toxic. (B)</p> Signup and view all the answers

What distinguishes an irreversible antagonist from a reversible antagonist?

<p>Irreversible antagonists form covalent bonds with the receptor. (C)</p> Signup and view all the answers

The toxic dose 50 (TD50) is defined as:

<p>The dose needed to cause a harmful effect in 50% of a test population of subjects. (C)</p> Signup and view all the answers

How does a non-competitive antagonist inhibit the action of an agonist?

<p>By binding to a different site on the receptor, preventing the action of the agonist. (B)</p> Signup and view all the answers

A drug's therapeutic index (TI) is calculated as the ratio of:

<p>TD50 to ED50. (A)</p> Signup and view all the answers

Why does the body need to synthesize new receptors after irreversible antagonist binding?

<p>Because the occupied receptors are permanently blocked. (D)</p> Signup and view all the answers

What is the primary mechanism by which a reversible competitive antagonist inhibits the action of an agonist?

<p>By binding to the same receptor site as the agonist, preventing agonist binding. (B)</p> Signup and view all the answers

A drug with a narrow therapeutic index...

<p>Requires careful monitoring due to the proximity of the effective and toxic doses. (A)</p> Signup and view all the answers

Which of the following drugs requires careful therapeutic monitoring because of its narrow therapeutic index?

<p>Warfarin (A)</p> Signup and view all the answers

What characterizes the duration of block caused by a reversible competitive antagonist?

<p>Short, because the antagonist can be easily washed off receptors. (A)</p> Signup and view all the answers

What is the result of adding gentamycin (a basic drug) to carpenicillin (an acidic drug) together in the same syringe?

<p>Complex chemical reaction. (A)</p> Signup and view all the answers

In chemical antagonism, what is the primary mechanism of action?

<p>Causing the agonist to precipitate. (B)</p> Signup and view all the answers

An antagonist that binds to the same site as the agonist on a receptor but forms weak bonds, allowing the agonist to still achieve a maximal response at high concentrations, is best described as:

<p>A reversible competitive antagonist. (C)</p> Signup and view all the answers

What is the primary characteristic of an irreversible antagonist's binding to a receptor?

<p>It forms a covalent bond, leading to a long-lasting block. (A)</p> Signup and view all the answers

Which scenario best describes an irreversible antagonist's effect on the maximal response to an agonist?

<p>The maximal response is reduced, regardless of agonist concentration. (A)</p> Signup and view all the answers

An antagonist binds to a different site on the receptor than the agonist, preventing receptor activation. This type of antagonism is known as:

<p>Non-competitive antagonism. (B)</p> Signup and view all the answers

Which of the following is a key characteristic of the duration of block produced by a reversible competitive antagonist?

<p>The duration depends on the rate of antagonist metabolism and excretion. (D)</p> Signup and view all the answers

How does the body typically overcome the effects of an irreversible antagonist?

<p>By synthesizing new receptors to replace the blocked ones. (D)</p> Signup and view all the answers

Mixing an acidic drug with a basic drug in the same solution can lead to what type of drug interaction?

<p>Chemical complex formation and precipitation. (C)</p> Signup and view all the answers

Why might administering gentamycin and carbenicillin in the same intravenous solution be clinically problematic?

<p>A chemical complex may form, reducing the effectiveness of both drugs. (A)</p> Signup and view all the answers

Which of the following scenarios exemplifies physiological antagonism?

<p>Drug A causes vasodilation through nitric oxide release, while Drug B causes vasoconstriction through alpha-1 adrenergic receptor activation. (D)</p> Signup and view all the answers

A patient overdoses on an acidic drug. Which of the following strategies would leverage pharmacokinetic antagonism to enhance the drug's elimination?

<p>Administering sodium bicarbonate to alkalinize the urine. (C)</p> Signup and view all the answers

A drug interaction occurs where Drug A reduces the bioavailability of Drug B by forming a non-absorbable complex in the gastrointestinal tract. This is best described as:

<p>Pharmacokinetic antagonism. (A)</p> Signup and view all the answers

A novel drug is designed to irreversibly bind to and block a specific enzyme's active site. This mechanism of action is an example of:

<p>Irreversible inhibition. (A)</p> Signup and view all the answers

A drug binds to a receptor site distinct from the agonist-binding site on an ion channel-linked receptor, enhancing the ion channel's response to the endogenous agonist. This mechanism is an example of:

<p>Allosteric modulation. (D)</p> Signup and view all the answers

A drug inhibits an enzyme by forming a covalent bond with it. Which characteristic is most likely to be observed with this drug?

<p>A prolonged duration of action, often requiring the synthesis of new enzyme molecules. (B)</p> Signup and view all the answers

A drug binds to a specific receptor, preventing the binding of endogenous ligands. However, the receptor's downstream signaling pathway remains inactive. This drug is best described as:

<p>A competitive antagonist with no intrinsic activity. (A)</p> Signup and view all the answers

A new drug selectively inhibits the reuptake of a neurotransmitter, leading to increased neurotransmitter concentration in the synapse. This mechanism of action directly affects:

<p>The duration of neurotransmitter activity in the synapse. (E)</p> Signup and view all the answers

Which scenario best illustrates the concept of a partial agonist?

<p>A drug that, even at full receptor occupancy, cannot produce the maximal response. (C)</p> Signup and view all the answers

Drug X has an ED50 of 5mg, while Drug Y has an ED50 of 10mg for the same effect. However, Drug Y has a significantly higher Emax. What can be definitively concluded?

<p>Drug X is more potent, but Drug Y is more efficacious. (A)</p> Signup and view all the answers

A new drug undergoes preclinical testing. The LD50 is determined to be 200mg/kg, and the ED50 is 2mg/kg. What is the therapeutic index (TI) of this drug, and what does it suggest about its safety?

<p>TI = 100; suggests a wide margin of safety. (D)</p> Signup and view all the answers

A drug has a narrow therapeutic index. What implications does this have for its clinical use?

<p>The drug requires careful monitoring to avoid toxicity, as the effective dose is close to the toxic dose. (A)</p> Signup and view all the answers

Which statement accurately describes the relationship between drug potency and clinical utility?

<p>Efficacy is generally more clinically important than potency, as dosage can be adjusted to compensate for lower potency. (A)</p> Signup and view all the answers

A drug company is developing a new analgesic. In clinical trials, Drug A provides pain relief with an ED50 of 10 mg, while Drug B requires 50 mg for the same effect. However, Drug B's maximum pain relief score is significantly higher than Drug A's. From this data, what can be concluded?

<p>Drug A is more potent, but Drug B is more efficacious. (C)</p> Signup and view all the answers

During drug development, a compound shows promising efficacy but also has a TD50 very close to its ED50. Which course of action would be MOST appropriate?

<p>Prioritize further investigation into the compound's safety profile and potential for dose optimization. (B)</p> Signup and view all the answers

A research team discovers a new compound that binds to a receptor with high affinity but produces no measurable effect, even at high concentrations. How would this compound be classified?

<p>Competitive Antagonist (D)</p> Signup and view all the answers

Flashcards

Drug Efficacy

Ability of a drug to produce a response after binding to its receptor.

Emax

The maximal response a drug can elicit at full concentration.

Full Agonist

A drug that produces the maximal possible response at full receptor occupancy.

Partial Agonist

A drug that produces a submaximal response even when all receptors are occupied.

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ED50 (Effective Dose)

Dose of a drug that produces 50% of the maximal effect (Emax).

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Potency

Measure of the amount of drug needed to produce a certain effect.

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TD50 (Toxic Dose)

Dose required to produce a toxic effect in 50% of the population.

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LD50 (Lethal Dose)

Dose required to cause death in 50% of a group of animals.

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Antagonist Definition

A ligand that binds to a receptor but does not activate it, blocking the effect of endogenous substances or other drugs.

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Competitive Antagonist

An antagonist that binds to the same site as the agonist on the receptor.

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Reversible Competitive Antagonist

Forms weak bonds; block can be overcome with high agonist doses; effect is surmountable; block duration is short.

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Irreversible Competitive Antagonist

Forms covalent bonds; block can't be overcome by increasing the dose of agonist; effect is non-surmountable; block duration is long; body needs to synthesize new receptors.

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Non-Competitive Antagonist

Binds to a different site on the receptor, preventing agonist action.

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Chemical Antagonism

Antagonism resulting from two drugs interacting chemically, leading to inactivation.

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Chemical Complex

When an acidic and basic drug are mixed in same syringe which causes chemical complex.

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Drug Antagonism

A drug or chemical which blocks, reduces or neutralizes the effects of another drug.

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Adrenaline as a Physiological Antagonist

Adrenaline's counteraction of histamine's effects.

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Physical Antagonism

Antagonism due to drugs with opposite charges binding together.

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Protamine Use in Heparin Overdose

Protamine neutralizes heparin due to opposite charges.

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Pharmacokinetic Antagonism

When one drug affects another's absorption, metabolism, or excretion.

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Antacids and Absorption

Antacids reducing iron or aspirin absorption.

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Rifampicin and Oral Contraceptives

Rifampicin increasing metabolism of oral contraceptives.

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Ion Channel Modulation by Drugs

Drugs modulating ion channels through physical blocks.

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Therapeutic Index (TI)

Ratio of LD50 to ED50; indicates drug safety.

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High Therapeutic Index

A large difference between effective and toxic doses.

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Narrow Therapeutic Index

A small difference between effective and toxic doses.

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Warfarin's Therapeutic Index

Needs therapeutic blood monitoring.

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ED50

Effective dose of drug in 50% of a test population.

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Efficacy

A drug's ability to produce a biological response upon binding to its target receptor.

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Antagonist

A ligand that binds to a receptor but does not activate it.

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Acidic/Basic Drug Interaction

When an acidic and basic drug are mixed in same syringe which causes chemical complex.

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Physiological Antagonism

Antagonism where two drugs with opposite effects act on different receptors.

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Protamine & Heparin

Protamine (+) neutralizes heparin (-) overdoses.

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Absorption Interference

One drug prevents the absorption of another.

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Metabolism Increase

One drug increases the metabolism of another.

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Excretion Increase

Increased urine alkalinity enhances excretion of acidic drugs.

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Physical Ion Channel Block

Drugs can block ion channels physically.

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Competitive Enzyme Inhibition

Enzymes blocked by drug occupying the same site.

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Irreversible Enzyme Inhibition

Drug binds irreversibly which makes the enzyme permanently inactive.

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Study Notes

Effectiveness and Safety

  • The drug response to a receptor indicates its effectiveness.
  • Emax is the maximal response a drug elicits at full concentration.

Full Agonist

  • The drug binds and gives a maximal response at full concentration and occupancy.

Partial Agonist

  • The drug provides a submaximal response, never reaching Emax, even at full concentration.

ED50 (Effective Dose)

  • The drug dose gives 50% of the Emax.
  • Effective dose achieves preferred effect on 50% of subjects.
  • Smaller doses to achieve ED50 indicate a "potent" drug.
  • Drug potency is clinically less important than efficacy. Dose adjustments can achieve effects of more potent drugs, assuming there is no toxicity.

TD50 (Toxic Dose)

  • Represents the dose causing harmful effects on 50% of subjects.

LD50 (Lethal Dose)

  • The dose causes death in 50% of animals in testing.
  • Lethal dose is experimental and determined in animals.

Therapeutic Index (TI): LD50/ED50

  • LD50 divided by ED50 indicates ratio.
  • Therapeutic index measures drug safety.
  • A significant difference between effective and toxic doses indicates a high therapeutic index.
  • Higher therapeutic index values indicate safer drugs. Warfarin requires monitoring due to its low therapeutic index.

Antagonist Effect

  • The ligand combines with the receptor without activating it.
  • Pharmacological responses stem from inhibition of endogenous substances or other drugs.

Pharmacological Antagonism

  • Pharmacodynamics and pharmacokinetic antagonism are included

Physiological Antagonism

  • Histamine and adrenaline are involved.

Physical Antagonism

  • Protamine and heparin are examples

Chemical Antagonism

  • Gentamycin and carpenicillin are examples.

Types of Competitive Antagonists

  • Antagonist binding to the agonist's site is either reversible or irreversible.

Reversible Antagonist

  • Weak bonds allows overcoming with high agonist doses.
  • Maximal response is still possible (surmountable).
  • The block duration is short, and the antagonist washes away.

Irreversible Antagonist

  • Covalent bond prevents increased agonist doses from overcoming effects (nonsurmountable).
  • Occupied receptors are permanently impacted. The body needs to create receptors to restore function.

Non-Competitive Antagonism

  • The antagonist acts on a different receptor site and prevents action.

Other Types of Drug Antagonism

Chemical Antagonism

  • Acidic drugs cause precipitation with basic d drugs
  • Gentamycin (basic) plus carpenicillin (acidic) cause a chemical complex.

Physiological Antagonism

  • Activation of different receptors from two opposing drugs causes antagonism.
  • Adrenaline is the physiological antagonist of histamine.
  • Through histamine H1 receptors, histamine induces hypotension and bronchoconstriction.
  • Adrenaline causes hypertension and bronchodilation using adrenergic a and B receptors.

Physical Antagonism

  • Interaction of drugs carrying opposite charges resulting in antagonism.
  • Treating heparin overdose using protamine. Protamine is positively charged, neutralising the negatively charged heparin.
  • One mg of protamine neutralizes 100 units of heparin.

Pharmacokinetic Antagonism

  • Drug absorption is prevented by antagonists.
  • Antacids reduce absorption of iron and aspirin.
  • Metabolism is increased by antagonists.
  • Rifampicin induces hepatic enzymes which increases metabolism for oral contraceptive pills.
  • Drug excretion can be increased by antagonists.
  • Sodium Bicarbonate causes alkalinization of urine and enhanced excretion of acidic medications such as aspirin.

B. Ion Channels

  • Drugs influence ion channels through physical blockage as part of a receptor, via G-protein modulation, or with intracellular ATP.
  • Physical block: Sodium channel blocking done by local anesthetics.
  • Ion channels can be a receptor component for ion channel-linked receptors.
  • G-protein modulation is possible.
  • Intracellular ATP modulates channels.
  • The increase of intracellular ATP closes ATPase-sensitive Potassium channels inside pancreatic beta cells.

C. Enzymes

  • Competitive/irreversible inhibitors, false substrates, and induction/inhibition of hepatic microsomal enzyme activity are ways that drugs can affect enzymes.
  • Neostigmine functions as a competitive inhibitors on cholinesterase.
  • Organophosphates operate as irreversible inhibitors of cholinesterase.
  • Alpha-methyldopa is utilized as a false substrate for Dopa decarboxylase.
  • Hepatic microsomal enzymes undergo induction or inhibition.

D. Carrier Molecules

  • Proteins carry organic molecules across cell membranes when too large or polar.
  • Medications can disrupt carrier molecule function via recognition site blocking.

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