Pharmacodynamics

is the study of the effect of drugs on the body.

Drugs act within the body to mimic the actions of the body’s own chemical
messengers.

Dose-Response Relationship
is the body’s physiological response to changes in drug concentration at
the site of action.
Potency – refers to the amount of drug needed to elicit a specific
physiologic response to a drug.

Efficacy – magnitude of effect a drug can cause when exerting its

maximal effect.
Maximal efficacy – the point at which increasing a drug dosage no longer
increases the desired therapeutic response.

Parameters of Drug Action

Therapeutic Index – (TI) describes the relationship between the

therapeutic dose of a drug (ED50) and the toxic dose of a drug (TD50)

Therapeutic dose of a drug – is the dose of a drug that produces a

therapeutic response in 50% of the population.
Toxic dose of a drug – is the dose that produces a toxic response in 50% of
the population.
Parameters of Drug Action

If the ED50 and TD50 are close- drugs have a narrow therapeutic index.
require close monitoring to ensure patient safety.

Onset – is the time it takes for a drug to reach the minimum effective
concentration (MEC) after administration.
Time from drug administration to first observable effect (T0-T1)

Peak – occurs when it reaches its highest concentration in the blood/plasma

concentration. T0-T2

Duration of action – is the length of time the drug exerts a therapeutic effect.
period from onset until the drug effect is no longer seen. T1-T3

Therapeutic Drug Monitoring

Drug concentration can be determined by measuring peak and trough drug levels.
peak – highest plasma concentration. 30 minutes after infusion. trough – lowest plasma concentration. 30
minutes prior to the next infusion.

Theories of Drug Action

A.Drug-Receptor Interaction
Certain portion of drug molecule (active site) selectively combines with
some molecular structure (reactive site) on the cell to produce a biologic
effect

Receptor site- drugs act at specific areas on cell membranes; react with
certain chemicals to cause an effect within the cell

“Lock and Key Theory”- specific chemical (key) approaches a cell

membrane and finds fit (the lock) at receptor site- affects enzyme
system within cell- produce certain effects.
Drug+Receptor=Effect

B. Drug-Enzyme Interaction
Interferes with enzyme systems that act as catalyst from various
chemical reactions

If single step in one of enzyme system is blocked- normal function is

disrupted
C. Nonspecific Drug Interaction
Act by biophysical means that do not affect cellular/enzymatic
reactions.
drugs do not bind to receptors but instead saturate the water or lipid
part of a cell- drug actions occur based on the degree of saturation.
Neutralization of stomach acid by antacids.

D. Selective Toxicity
Specific action on cellular structures that are unique to the microbe. All
chemotherapeutic agents would act only in one enzyme system needed for life of a pathogen or neoplastic
cell. It is essential to the pathogen but not to the host.

Drug Response

Drug Response may be:

1.Primary- always desirable/physiologic effects

2.Secondary- desirable or undesirable

Example: Diphenhydramine (Benadryl)
Primary effect: antihistamine; treat symptoms of allergy
Secondary: Drowsiness
Classification of Drug Action

1.Rapid- few seconds to minutes

- IV, SL, Inhalations

2. Intermediate- 1-2 hours after administration

- IM, SC

3. Delayed/Slow- several hours after administration

- Oral, rectal

Categories of Drug Action 1.Stimulation/Depression

Stimulation- increased rate of cell activity/ secretion from the gland

T3/T4 for hypothyroidism
Depression- decreased cell activity and function of a specific organ.
Iodine, propylthiouracil

2. Replacement- replaces essential body compounds

Example: Insulin

3. Inhibition/Killing of Organism
¡Interfere with bacterial cell growth
¡Example: Antibiotics

4. Irritation
Example: Laxative- irritate the inner wall of colon---increased peristalsis---
increased defecation

Drug-Drug Interaction
1.Additive Effect-2 drugs with similar actions are taken for
a doubled effect
1+1=2
Ibuprofen + paracetamol= added analgesic effect
Codeine with acetaminophen = better pain control

2. Synergistic- combined effect of 2 drugs is greater than

the sum of the
effect of each drug given alone; 1+1=3 Aspirin = 30%
analgesic effect codeine – 30% analgesic effect
combination = 90% analgesic effect

3. Potentiation- a drug that has no effect enhances the

effects of the second drug 0+1=2
Alcohol enhances the analgesic activity of aspirin.
Prozac + Zestril

4. Antagonistic- one drug inhibits the effect of another

drug 1+1=0
Tetracycline + antacid= decreased absorption of
tetracycline
Charcoal in alkaloidal poisoning

Adverse Drug Effects 1.Side Effects

Results from the pharmacologic effects of the drug

Most common as a result of lack of specificity of action within the therapeutic
range.

2. Allergic Reactions
Unpredictable adverse drug effects; more serious
Response to patient’s immunological system to the presence of the drug Do not
occur unless the patient has been previously exposed to the agent/ chemical
related compound

3. Idiosyncratic Reaction
Occurs when the patient is first exposed to the drug
Abnormal reactivity to the drug caused by a genetic difference
between the patient and normal individual. a patient with G6PD
deficiency will have anemia by using antioxidants.

4. Toxicity
The degree to which a drug can be poisonous and thus harmful to
the human body.

5. Iatrogenic responses
Unintentional responses as a result of medical treatment
Nephrotoxicity; ototoxicity

Pharmacodynamics - is the study of the effect of drugs on the body.

● Dose-Response Relationship - is the body’s physiological response to changes in drug concentration
at the site of action.
● Potency - refers to the amount of drug needed to elicit a specific physiologic response to a drug.
● Efficacy - magnitude of effect a drug can cause when exerting its maximal effect.
● Maximal efficacy – the point at which increasing a drug dosage no longer increases the desired
therapeutic response.
● Therapeutic Index – (TI) describes the relationship between the therapeutic dose of a drug (ED50)
and the toxic dose of a drug (TD50)
● Therapeutic dose of a drug – is the dose of a drug that produces a therapeutic response in 50% of the
population.
● Toxic dose of a drug – is the dose that produces a toxic response in 50% of the population.
● Onset – is the time it takes for a drug to reach the minimum effective concentration (MEC) after
administration.
● Peak – occurs when it reaches its highest concentration in the blood/plasma concentration. T0T2
● Duration of action – is the length of time the drug exerts a therapeutic effect. ● Trough – lowest
plasma concentration. 30 minutes prior to the next infusion.
● Additive Effect - Two drugs with similar actions are taken for a doubled effect
● Synergistic- combined effect of two drugs is greater than the sum of the effect of each drug given
alone.
● Potentiation- a drug that has no effect enhances the effects of the second drug
● Antagonistic- one drug inhibits the effect of another drug
● Side Effects - results from the pharmacologic effects of the drug
● Allergic Reactions - unpredictable adverse drug effects; more serious
● Idiosyncratic Reaction - abnormal reactivity to the drug caused by a genetic difference between the
patient and normal individual.
● Toxicity - the degree to which a drug can be poisonous and thus harmful to the human body.
● Iatrogenic responses - unintentional responses as a result of medical treatment