PHARMACOLOGY

• MOAS


  Mechanism of action of substances
• Pharmacodynamics


  Branch of pharmacology that studies the effects of drugs on the body
• Pharmacokinetics


  What the body does to the drugs
• LADMER


  Absorption, distribution, metabolism, excretion, and response
• Autacoids


  Substances produced in the body that have local effects
• Pharmacotherapeutic


  Study of drugs in the treatment, diagnosis, and prevention of disease
• Pharmacogenetics


  Genetic variation affecting drug response
• Pharmacoeconomics


  Study of the economic use and management of drugs
• Receptors


  • Surface-bound proteins, enzymes or nucleic acids, proteins in the body or microbes, genome, microtubules
• Mechanism & specificity of drug binding

  Majority occurs through non-covalent interactions, folding of proteins and DNA, alteration of membranes, molecular recognition, reversible
• Drug-receptor interaction


  Dose-response relationship, mass action relationship, receptor occupancy, significance of KD (dissociation constant)
• Agonists


  Partial agonists have less than maximal efficacy, full agonists occupy all receptor space with maximal efficacy
• Antagonists


  Compete and displace full agonists, bind to the active site or allosteric site
• Hypertension (HTN)


  Sustained BP of 170/80 mmHg or higher
• Stages of HTN


  1. Pre-Hypertension

  2. Stage 1

  3. Stage 2
• Risk Factors of HTN

  • Family history
  • Diabetes
  • Age
  • Obesity
  • Hypothyroidism
  • Sodium intake
  • Hyperthyroidism
  • Smoking
  • Stress
  • Race
• Mechanisms for controlling BP


  Baroreceptor reflex, renin-angiotensin-aldosterone system
• Classes of Anti-HTN drugs

  • Diuretics
  • Renin-angiotensin antagonists
  • Calcium channel blockers
  • Sympatholytics
  • Vasodilators
• Diuretics


  Increase rate of urine flow and sodium excretion
• Mechanism of action of diuretics

  1. Carbonic anhydrase inhibitors

  2. Osmotic diuretics
• Toxicity of carbonic anhydrase inhibitors includes bone marrow depression, skin toxicity, drowsiness, and allergic reactions
• Osmotic diuretics


  Act as non-reabsorbable solutes that limit osmosis of water into the interstitial space
• Osmotic diuretics can cause electrolyte imbalance and dialysis disequilibrium syndrome
• Bilirubin


  Toxic product of red blood cell production
• Bilirubin is the reason


  Poop is yellow
• UDCA


  Ursodeoxycholic acid
• Calculus formation & ureteral colic

  1. Calcium phosphate salts in alkalic urine

  2. Increased chance of phosphate stones
• Worsening of metabolic or respiratory acidosis

  Increased chloride metabolic acidosis
• Reversal of COPD
• Reduction of urinary excretion rate of weak organic bases

  Increased ionized substance
• BA


  Osmotic diuretics
• Osmotic diuretic excretion


  1. Glycerin (PO)

  2. Isosorbide (PO)

  3. Mannitol (IV)

  4. Urea (IV)
• Site of action of osmotic diuretics

  • Proximal convoluted tubule, Loop of Henle (primary)
• Mechanism of action of osmotic diuretics


  • Act as non-reabsorbable solute which limits the osmosis of water into the interstitial space (proximal convoluted tubule)
  • Extract water from intra compartments
• Osmotic diuretics


  Decrease magnesium reabsorption in the thick ascending limb
• Osmotic diuretics


  • Mannitol
• Mannitol powder is hygroscopic
• Osmotic diuretics


  Increase risk of bronchial hyperreactivity
• Urea


  Converted to ammonia, causes death of neurons in hepatic encephalopathy
• Increased hydrogen and oxygen excretion impact loop diuretics, high-ceiling diuretics (strongest diuretics)