Beruflich Dokumente
Kultur Dokumente
Approach
Fifth Edition
Chapter 5
Pharmacodynamics
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Pharmacodynamics and Interpatient
Variability
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Frequency Distribution Curve
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Figure 5.1 Frequency Distribution Curve:
Interpatient Variability in Drug Response
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Median Effective Dose (ED
E D sub 50)
50
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Nurse’s Skill Critical in Determining if
Average Dose is Effective
• Patient observation
• Taking of vital signs
• Monitoring lab data
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Median Lethal Dose (LD
L D sub 50)
50
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Median Toxicity Dose (TD 50 )
T D sub50
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Therapeutic Index
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Calculating Therapeutic Index
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Example of Therapeutic Index
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Figure 5.2 Therapeutic Index
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Graded Dose-Response Relationship
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Three Phases of Graded Dose–Response
Curve (1 of 2)
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Three Phases of Graded Dose–Response
Curve (2 of 2)
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Figure 5.3 Dose–Response Relationship
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Two Ways to Compare Medications
• Potency
• Efficacy
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Potency
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Efficacy
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Figure 5.4 Potency and Efficacy
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Receptor Is Macromolecule
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Drug Attaches to Receptor
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Figure 5.5 Cellular Receptors
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Receptor Subtypes Still Being Discovered
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Nonspecific Cellular Responses
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Drugs That Act as Agonists
• Bind to receptor
• Produce same response as endogenous chemical
• Sometimes produce greater maximal response
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Drugs That Act as Partial Agonists
• Bind to receptor
• Produce weaker, less effective response than agonists
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Drugs That Act as Antagonists
• Occupy receptor
• Prevent endogenous chemical from acting
• Often compete with agonists for receptor
• Functional antagonists inhibit the effects of an agonist
not by competing for a receptor, but by changing
pharmacokinetic factors
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In the Future: Customized Drug Therapy
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Copyright
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