pharmacodynamics part I

so hello there everyone i'm nurse don and welcome to pharma college class in previous video
we discuss about your pharmacokinetics we discuss about the absorption digestion metabolism
and how drugs are being excreted so we discuss about the elimination expression and we also
discuss about volume distribution clearance it's also essential to compute the half-life first pass
metabolism first order kinetics and zero-order kinetics now let's jump to pharmacodynamics so
what about your pharmacodynamics so this video will be a topic about your pharmacodynamics
okay what is a pharma co-dynamics it's also an essential part or aspect of your pharmacology
pharmacodynamics okay again derived from the term pharma meaning the word pharmacon
refers to drug and the term dynamics refer to power so what is a pharmacal dynamics
pharmacodynamics is simply described as the study it is the study of the effects study of the
effects of drugs effects of drugs on the body effects of drugs on the body so your
pharmacodynamics it is the study of the mechanism by which drug dosages they act to produce
biochemical or physiological changes in the body so that's the action of the drug in the body
why this drug is given what is this drug doing to the body so it causes mostly the desired effect
the drug acts within the body in order to mimic action body's own chemical messengers so
those response of the drug can cause a primary or secondary physiologic effects or both it could
be desirable or undesirable now going back to what pharmacodynamic is pharmacodynamics is
the mechanism by which the drug they produce by chemical or physiological changes so
pharmacodynamics is simply includes the physiological biochemical effects of the drugs
mechanism of action at organ system or maybe to the subcellular or cellular level center stage
so in simple terms your pharmacodynamics is simply the study of what is study of what the drug
do to the body what the drug what the drug do to do sorry what the drug do to the body as
contrast to what we call your pharmacodynamics as what the body does to the drug on
pharmacodynamics it is simply related to what the drug does to the body what the drug does to
the body what the drug do how the drug do how the drug do okay and what are the actions of
the drug which refers to the mechanism of action mechanism of actions and also includes the
mechanism mechanism of actions also includes what also includes the yes physiological and
biochemical effects of the drug also included the physiological speciological physiological what
else biochemical okay physiological or the biochemical effects of the drug okay effects of drugs
okay so that is a that is the concept of your pharmacodynamics again pharmacodynamics it
refers to the study of the effects of the drug in the body what the drug does to the body and in
contrast to your pharmacokinetics what the body does to the drug here pharmacodynamics is
what the drug does to the body so the response of a drug can cause primary or secondary
physiologic effect or both so a primary effect that is the desirable response and a secondary
effect that is desirable or undesirable let me give you an example um diphenhydramine
diphenhydramine as you know that diphenhydramine is an antihistamine so its primary effect
guys is to treat the symptoms of an allergy the secondary effect my dear nurse says since your
diaphragm diphenhydramine is an antihistamine as you know that the secondary effect it causes
depression of your cns your central nervous system because the nature of diphenhydramine as
an antihistamine is a cns down seen as depression causes depression of your cnns it causes what
drowsiness so it's secondary effector it is either desirable or undesirable it is undesirable when
the patient drives a car because it causes drowsiness at enroll as a nurse when a patient receive
this particular drug specifically antihistamine you have to instruct the patient that this drug
causes drowsiness you have to give the side effect or the adverse effect and the desirable effect
of this drug it could be desirable at bedtime because it causes a mild sedation okay so that is
about your pharmacodynamics what the drug do to the body how the drug do what is the
action the effect of sequence the dose effect relationship so those are pertaining to what we call
as your pharmacodynamics so that is about the concept of your pharmacodynamics so we
started with what with number one okay the definition of your pharmacodynamics so we started
with the definition of your pharmacon analytics now we proceed to other other concepts of your
pharmacodynamics which are very essential important they are notable in your exams as well
other other concept that you should know about your pharmaco dynamics is your number two
we're done it with the definition now we go to the aspects of your pharmacodynamics aspects
of pharmacodynamics there are no numerous aspects of your pharmacodynamics we'll go them
by one one by one pharmacodynamics okay excuse me one the concept of your dose response
relationship okay or those relationship those response relations let me just change the color
there okay what is a dose response relationship those response relationships simply describe as
the bodies it is the body's physiologic response efficiologic response it is the normal it is the
internal response of the body is the body's physiologic response body's physiologic response to
changes two changes in drug concentration in drug concentration at the site of action at the site
of action site of action the body's facial logic so that's the normal to the internal response of the
body in a particular changes with the amount of drug concern concentration not a specific side
of your action now to further understand your dose response relationship there are two
concepts the further describe this relationship so we have the concept of your what we call your
potency and what we call your the other one is your efficacy so to understand further the
concept of your dose response relationship which is the physiologic response that's the normal
response of the body to certain changes to amount of a drug at the action at the specific side of
the action to understand the relationship here those response we need to understand what is a
potency and what is efficacy what is the difference between so under your number one we have
your potency and your efficacy what is the difference between potency and your efficacy we
need to understand differentiate the two because if you um going to see the potency and your
what we call efficacy [Music] but the what is the line of demarcation between your potency and
your efficacy let's discuss perturb discuss first what is the potency potency this term it refers to
the amount it refers to the amount of drug amount of drug needed or necessary in order to
what in order to elicit a response in order to create create a physiologic response to a drug okay
to a drug remember that class okay refers to the amount of drug that is necessary to elicit a
responsible logic response schedule so potency simply means a mountain drug to create or to
bring out that physiologic response that in a tower so potency guys it is related to the dosage
that produces a given physiologic response in a specific amplitude it is the power of a drug at a
specific concentration okay that is usually measured by the effective concentration of a drug
designated as your ac50 leading to half its maximal effect 50 let me write that one class potency
class in other words in simpler terms okay it is the power of a drug power of a drug at a specific
art specific concentration specific concentration specific concentration usually usually measured
usually measured by the effective concentration usually measured by the effective concentration
of drug effective concentration of drug usually designated as one okay usually designated as
oops okay let me change the color usually designated as your ec50 after your ec50 leading to
half leading to half its maximal its maximal effect of your 50 percent responses of your 50
percent responses now what is your e c 50 or your effective concentration of a drug your ec50
class this is the needed amount of a drug how much the drug is needed to reach 50 of the
maximum response okay so what is your easy 50 easy 50 refers to how much okay how much
the drug how much the drug is needed to reach the 50 percent of the maximum response of the
maximum response so in short your potency class it refers to the dosage amount of drug in
order to produce in order to create a physiologic response in a specific amplitude how much the
drug is needed to reach 50 percent the maximum response so the more potent the drug the
easier to achieve 50 percent of the maximum response obviously because impotency it is
actually the needed amount of drug dosage that can elicit i you know that can elicit that can
produce that can create a facial logic response in a specific amplitude so the more potent the
drug the easier for the drug to achieve the 50 maximum response which is designated by your
ec50 which can be directly obtained in a dose response curve which will which i will illustrate it
later so the more potent the drug it requires a lower dosage to produce the same effect as a
higher dose of the other drug so meaning the more the potent the drug remember this class the
more potent the more potent the drug the more potent the drug the lower the ec50 i the more
potent the drug the lower the ec50 meaning the more potent the drug the easier for that to run
to achieve the 50 maximum response the more potent the drug it requires lower dosage ion the
more potent the drug the lower the ec50 and the lower dosage okay to produce the lower
dosage to produce the same effect the same effect let me give you an example class let me give
you an example okay let me give you an example like for instance drug a okay we have this
sorry drug a drug a an effect of 500 milligram okay drug a has an effect of 500 milligram while
drug b drug b has the same effect to 5 milligram i'll repeat your drug a has an effect of 500
milligram whereas your drug b has the same effect to 5 milligram solution most potent by
applying the concept of your potency i'll repeat class potentially first of the amount of drug
dosage of drug okay impotency illness a mountain drug dosage of drug which can produce
okay which can produce that is necessary for me to elicit a specific physiological response to a
drug a mountain drug to create to produce to illicit a particular specific physiologic response in
a specific amplitude the more the potent the drug the lower the ac50 potent and drug it would
be easier for the drug to achieve the 50 maximum response which can be obviously obtained in
a dose response curve so the more potent the drug the lower dosage to produce the same
effect obviously it's drug b why drug b is more potent remember the more potent the drug the
lower the dosage to produce the same effect so drug b is more potent like languages more
potent meaning drug b is 100 times more potent okay 100 times more potent than drug a you
have to remember class as a nurse you have to remember for example a drug with high potency
example fentanyl it produces significant therapeutic response of higher or lower concentration
remember the more potent the drug the lower the ec50 the more potent the drug the lower
dosage so effentanil has high potency produce produces significant therapeutic response of low
concentration or high concentration low con centralization now the other concept that you
should know about your drug response relationship aside from your potency is your efficacy
okay what about your efficacy anonymous efficacy because potency it refers to the amount of
drug dosage that produces give response your efficacy class sorry efficacy it is the ability of a
drug to elicit a response okay ability of a drug to cause expected responses efficacy is the ability
it is simply the ability ability of a drug ability of a drug to here your efficacy it is the ability of a
drug to elicit a physiologic response okay take note subpotency dosage amount of drug that is
needed to produce a physiologic response eto hindi and when it interacts with a receptor okay
this receptor might be commonly protein similar could be ion channels ligand um ion channels
it could be chemical enzymes and so forth we'll go there okay so this is dependent on the
number of drug receptors amount of drugs in efficacy since it interacts with the receptor it
would now depend dependent on the number of drug receptor complexes and the efficiency of
the coupling of receptor that will activate a cellular response so efficacy is the ability of drug to
induce a functional change in receptor one union difference effect of drug as a function of
binding and efficacy is the ability of a drug the mukbang bindings are different receptors mostly
more proteins okay if we can say in simple terms it is the ability of drug tokus expected
response let me write that one okay cause expected response unity efficacy okay efficacy okay
yeah oh yeah it's not even writing so efficacy again is the ability of a drug in order to induce a
functional change in receptor when it binds to a particular receptor it is the effect of a drug as a
function of binding now um your efficacy is the ability okay it is the ability of drug ability of drug
to induce ability of drug to induce functional to induce a functional change in receptor okay
functional change in receptor so obviously it is simply described as the effect of a drug effect of
a drug as a function as a function of binding [Music] efficacy so that is the difference between
your efficacy and your what we call this potency for you to understand what is a dose response
relationship so we are discussing guys the aspects of your pharmacodynamics we started with
number one that's those response those response for us to understand i discussed the terms
potency and efficacy now let's proceed [Music] another term okay another aspect okay number
two another aspect number two what is affinity after what is affinity what is your affinity what
about your affinity affinity is simply described as the attractiveness of the attractiveness of a
drug productiveness of a drug to its receptor attractiveness of a drug to its receptor so this is a
force of attraction between drug and your receptor how attracted the drug to the protein to the
binding to receptor to enzymes and so forth so affinity refers to the strength of the interaction it
is the strength of binding between a ligand and its receptor it's simply stated as the ability of
drug to bind ability of a drug ability of a drug to bind to receptor to bind to receptors the
strength of the binding between a ligand and its receptor let me show you what is a ligand class
i thought mama will go there okay ligand ligand where are you later a bit of a drug to bind to a
particular receptor so how attracted the drug to the protein binding the receptor enzymes and
represented by dissociation constant it is represented okay represented by what we call a kd in
we will illustrate those of a constant so the lower the dissociation constant the higher the affinity
of the drug so they are inversely proportional okay what is a kd or dissociation constant so
technically your kd technically your kd is simply okay simply describe as the concentration
described as the concentration of a drug concentration of a drug needed that is needed to
occupy that is needed to occupy 50 percent of the receptors of the receptors concentration of a
drug needed to occupy 50 of the receptors so again affinity is the strength okay the ability the
capability this the strength of binding the strength of interaction between a ligand and its
receptor okay so that's about your affinity other aspects that you should know of about your
pharmacodynamics we have so we're done with um those response relationship subdivided into
um terms response we have your potency and your efficacy now we are done with your affinity
now we go to number three number three what is a maximum okay what is a maximal efficacy
maximal efficacy okay or designated as your emacs that is the point the point at which
maximum okay the point at which increasing point at which increasing a direct dose a drugs
dosage no longer increases no longer increases the desired okay no longer increases the desired
therapeutic the desired therapeutic response no longer increases the desired therapeutic
response and we can appreciate this class by illustrating what is a drug dose curve okay so what
is a maximal efficacy or what we call your e-max the point at which increasing the point at which
increasing a drug dose no longer increases the desired therapeutic response what do you mean
by that class maximal efficacy or e-max that is the point in which there's no further increase in
response okay there is no further increase in the response effects okay let me show you a drug a
response curve for you to appreciate about the effect of a drug the dose the maximal efficacy
and so forth okay let me show you an illustration okay number four other concept that you
should know aspects of your pharmacodynamics those response affinity maximal efficacy
number four drug response curve okay drug response okay what is a drug response curve drug
response curve a drug response curve class it's also very important aspect of your
pharmacodynamics it is simply a curve or a graph that is used to provide i'm sorry it is used to
provide information information about the dosage about the dosage range over which okay
over which the drug over which the drug is effective over which the drug is effective as well as
the peak response as well as the peak response that can be expected from the drug so your
drug response curve has two types your type one and your type 2 drug response curve your
type 1 and your type 2 response curve let me illustrate your particular graph class let me
illustrate your particular graph okay okay so we have the effect of a drug here effect of a drug
lack of a drug okay so this is the high effect of a drug this is the low effect of a drug and then
then we have here the dose of a drug after those of drug so here your high dose of a drug and
know those of a drug okay now um this is about a graph your dose versus efficacy of the drug
those versus the efficacy of a drug so your type one so this is your type one this is simple
illustration of your type one dose response curve type one those response curve okay so your x-
axis indicates your dose of a drug well as your y-axis indicates a response which is the efficacy or
the effect of a drug which can be either um a sigmoid form okay or a log form okay nasa and
john young not in the remember that your um efficacy of a drug it can be either hyperbolic it
could be sigmoid or lag form so oh foreign your your graph it could be a hyperbolic it could be
a log form or a sigma let me illustrate yan okay so this point class i am this point i am that is
actually what we call the maximum efficacy that is actually what we call your max maximal
efficacy or what we call your e-max the point at which increasing a drugs dosage no longer
increases the desire throughput response so that is the ceiling point the point in which there's
no further increased aim response so if it's obvious after this point increasing after this point
and after this point increasing doses do not produce now a stronger effect you know maximal
efficacy so after this point class after this point increasing dosage it does not produce now a
stronger effect so that is what we call a drug response curve illustrating your maximal efficacy
straightening your maximal efficacy so we are done closely related to those response and
efficacy is the therapeutic index and your therapeutic index so we are discussing the aspects of
pharmacodynamics we are done with number one you have your those response curves we
discuss about under your dose response curve your potency and your affinity sorry potency and
efficacy rather and then number two we have your affinity correct and then number three we
have your maximal efficacy and then we have number four we have your drug response curve
now we go to your therapeutic index which are closely related to those response and efficacy
they are closely related class number five you are not number five aspect of your
pharmacodynamics what about so your therapeutic index nothing therapeutic index or
commonly designated as your ti your therapeutic index therapeutic index class it describes the
relationship it describes the relation relationship between describes the relationship between
the therapeutic dose between the therapeutic dose of a drug therapeutic dose of a drug
commonly designated commonly designated as your ed50 and the toxic dose of a drug again
therapeutic index it describes the relationship between therapeutic dose of a drug indicated by
the et50 and the dose and the toxic those of a drug toxic dose of a drug commonly indicated as
your td 50 okay indicated by a td50 toxic drug those relationship okay describes the relationship
between therapeutic dose of a drug and the toxic dose of a particular drug so it is simply the
difference between these two points it is the difference between two points difference between
the therapeutic dose and the toxic dose of a drug that is your therapeutic index what is ed50
and what is td50 [Music] the difference between your ed50 and your td50 union tina
tawagnatina therapeutic index now what is an ed50 what is ed50 and what is your td50 okay be
nothing 8050 it simply refers okay to the dose it is simply the dose of a drug dose of a drug that
produces that produces what that produces a therapeutic okay that is the expected effect of a
drug okay therapeutic effect that's the decide effect of a drug therapeutic effect or therapeutic
response okay in 50 of the population in 50 of the population so that's an estimation while your
td50 [Music] td50 okay the toxic uh dose of a drug your td50 class it your td50 is the dose it is
simply described as the dose of a drug dose of a drug that produces therapeutic it produces a
toxic response obviously a toxic response in 50 of the population 50 of the population so 1850
that is the dose of a drug in order to produce a therapeutic response while your td50 dose of a
drug that produces what a toxic response so again therapeutic index is the relationship between
the therapeutic dose and the toxic dose in simple terms class your therapeutic index that is
simply the difference between therapeutic dose and the toxic dose so why this therapeutic index
is very important so if the ed15 and td50 are close the drug is said to have a narrow therapeutic
index the difference of the difference between two points that's the triplet index so if the ed50
and td50 are close already big subinon the drug is said to have a narrow therapeutic index a
particular drug that has a narrow therapeutic index narrow therapeutic index what are those
okay narrow therapeutic of the narrow therapeutic index okay narrow therapeutic index we have
warfarin okay we have warfarin we have digoxin after we have your digoxin and we have your
phenytoin phenytoid okay those are the examples of drugs there is a narrow therapeutic index
so as a nurse if the patient receives this particular drug numero naruto index such as your
warfarine digoxin your fanny point what would be your nursing responsibility that is important
in pharmacology okay you know important and nursing process is very important in your
pharmacology it's not about knowing the drugs not knowing about only the effect of a drug you
have that nursing responsibility that's very important nursing responsibility what would be your
nursing responsibility when the patient received warfarin digoxin fanny coin as you know that
this particular examples of drugs they have that narrow therapeutic index a bean buster pugnaro
therapeutic index see evicts a bigger patient is at risk if that particular drug has a narrow
therapeutic index nursing responsibility what is your nursing responsibility it requires what yes
close monitor not okay available would be your nursing responsibility the patient receives
warfarin digoxin and phenytoin because those medications have that narrow therapeutic index
in a tower now let me illustrate a non-therapeutic index what's 8050 if you can still remember
after when we discuss about your drug dose response curve we have two types type one those
curves so that the uh illustration of the um dose of a drug dosage of a drug and the efficacy and
then you determine what is maximal efficacy or your e-max now this time we have what we call
as your type 2 dose response curve your type 2 dose response curve what about your type 2
response curve so this is about your it's more of a dose versus a response of a patient so this is
more of holistic and more practical response than your type one because in type one it
illustration of your type one those curve is your dosage and the efficacy while in type 2 it's
about those versus the response of the patient so this is more holistic and more practical
response so we need an illustration again perfect okay so we have here a 50 percent class okay
so here 50 australian and then we have your and here is your 100 so this is the percentage of
individual that is responding to the um those percentage of individual percentage of individual
responding to um the particular dose responding to particular those who have 50 and then
you're 100 now this is about your human study so we will illustrate what is your ed and what is
your td-15 okay so that's your blue one let's take one or not in class okay and then [Music]
foreign and then yeah okay okay so between this line class between this line and between that
particular line of your so this is your ed50 this is your ed50e and you call a yellow class that is
your td50 and the toxic drug dose nothing and the ed50 what is secondary 50 that's the
therapeutic dose of a drug so this is the therapeutic dose of a drug in color color blue this is the
toxic dose of a drug so if you're going to put the line demarcation of your line this one okay line
relationship between ed50 and your td50 the distance or the difference between your 8050 and
your td50 is termed us yes very good that is what we call the therapeutic index difference
between your 8050 and your td50 relationship with your ed50 and td50 that is your therapeutic
index it's a therapeutic index in color blue nyan class that indicates your therapeutic effect
indicates your therapeutic effect of a drug that is so what does your td50 represent that is the
toxic effect of a drug any part so we have this therapeutic effect we have also your toxic sorry
those effect young difference then 1850 and td 50 angkor wat therapeutic index the relationship
between eddie 50 and td 15. now a particular drug doesn't only have a therapeutic effect toxic
effect what do you mean sir by ld50 that is what we call the lethal effect okay lethal effect of a
particular drug again i'll repeat therapeutic index that is the ratio between the toxic dose of a
drug and the therapeutic dose of a drug so your ed50 that is the effective dose where 50
percent of population and 50 percent of population responded effectively meaning they are
your 80 50 that is the effective dose were 50 percent of population responded effectively
meaning they are being treated your td 50 that is the toxic dose where 50 of the population
experienced fif experience toxic side effects and then your ld50 here of the 50 is the little dose
where 50 of the population responded lethally or died again therapeutic index is the ratio
between the toxic dose and the therapeutic dose of a drug okay your ed50 it is the effective
dose where 50 of the population responded effectively meaning they were treated and then
your td50 that is a toxic dose where 50 of the population experience toxic side effect your ld50
that is the little dose where 50 of the population responded lethally or died so that is all about
your type 2 dose response curve

PHARMACODYNAMICS PART II
okay everyone welcome to pharmacology class and we go to your part two of the discussion of
your pharmacodynamics so your previous video about your pharmacodynamics part one we
discuss about the definition of your pharmacodynamics which is described as what the drug
does to the body why this drug is given what is this drug what the drug does to the body how
the drug its physiological and biochemical effects and software and we also discuss about the
aspects of pharmacodynamics which include one dose response relationship and under dose-
response relationship of your potency and your efficacy two is we have the term affinity three
maximal efficacy fourth your drug response curve wherein we discuss about your type one in
your type two those response curve and lastly is your therapeutic index number five now we
move to your part two of the discussion of the aspects of your pharmacodynamics so another
important aspects of pharmacodynamics to understand include a drugs onset the peak and
duration of action okay so let's continue discussion guys so that's number six okay that's already
number six the onset peak duration of an action which is a way important another important
aspect of your pharmaco dynamics okay so this is number six there you have it okay so number
six another aspect of your pharmacodynamics we have your onset your peak okay and your
duration okay and duration of action and duration of action duration of your action now what is
the difference between unsafe peak and duration of reaction this concept is really necessary in
order to understand the information in relation to drug administration some drugs because
some drugs produce effects in minutes but others may take hours or dates to take effect if the
drug plasma concentration is decreasing below the minimum effective concentration of your
neck adequate drug dosing is not really achieved because it is actually decreasing to the
minimum effective concentration that is too high of a drug concentration can result in toxicity
so we need to differentiate what is an onset what is the peak and duration of reaction first what
is an onset okay what is an onset onset class it refers to the time is the time it takes it is the time
it takes for a drug for a drug it is the time it takes for a drug in order to work in order to reach in
order to reach the time it takes for a drug to reach the minimum okay to reach the mech okay
the minimum effective minimum effective concentration minimum effective concentration
concentration after administration after an administration so that is the description for your
onset it is the time it takes to reach or achieve your mac after your administration so simply your
onset when the drug is when the drug first begins to act okay in the body nothing onset when
the drug first begins to act in the body that is what we call your onset how about sir your pick
we will illustrate it later class okay how about your pick of a particular drug if we say pig it
occurs okay it occurs when when it reaches okay when it reaches its highest its highest
concentration highest concentration in the blood highest concentration in the blood so what do
you mean sir when it reaches its highest concentration in the blood so peak occurs when it
reaches its highest condensation in the blood onset is the time it takes for a drug to reach the
minimum effective concentration of administration so simply an onset is when a drug first
begins to act in the body while peak it only occurs when it reaches its highest concentration in
the blood meaning when the drug is exerting the maximum action okay when the drug is
exerting its maximum action and what is the difference of the difference between peak your
onset and your duration what about your duration your onset it refers when the drug first
begins to act in the body while you're pick it refers to what it occurs when the drug is exerting
its maximum action when it reaches maximum action how about sir your duration duration is
the length of time it is actually the length of time length of time the drug length of time the
drug exerts a therapeutic a therapeutic effect a therapeutic effect it is actually the length of time
the drug remains in effect in the body this this is very important class understand the concept of
your onset your peak and duration i'll repeat it is necessary for us to understand as nurses in
relation to drug administration some drug because some drugs produces effect in minutes but
others may take out hours or days like for example you administered a particular drug an insulin
to a diabetic patient which is insulin obviously is used as you know is used to diabet diabetes
needles what is the onset of a particular rapid acting insulin the intermediate acting and selling
and the long-acting insulin so we need to determine its onset the peak and the ratio why is it
important class to know the onset the peak and duration of particular drug because by simply
knowing this concept once at peak and duration the nurse can determine okay when to
intervene in a particular time okay so as you know nurse has their research that can prolong the
therapeutic effect of a particular insulin to a um the particular patient diabetic patients so
sometimes we add zinc okay in order to prolong the therapeutic effect of that insulin and suffer
and suffer let me give an example okay let me give you an example of a drug okay the most
common okay let me give you an illustration rather class okay illustration let's see this is the
illustration of your onset of a drug action its peak and its duration hmm okay so what is again
an onset of your action so onset of action here okay starts from uh first begins from the
administration of your drug okay when the drug first begins to act in the body so the onset of
action is up here okay so when insulin is administered the diabetic patient and then it's already
absorbed into the body when the drug first begin to act in the body so in this particular line that
is the onset of the action of a particular drug now what is a peak level if we say peak again it
occurs when it reaches its highest concentration okay highest concentration in what in the blood
highest concentration in the blood meaning when the drug is exerting its maximum action you
can say that the drug is a spit letter and then the duration of the action of a drug is the length of
time when the drug exerts ethernet effect so it refers to the length of time the drug remains in
effect that's why when you administer your insulin we are also administering your zinc what is
the purpose of administering your zinc if the if the patient receiving insulin in order to prolong
okay the effect of an insulin to to remain okay to exert a therapeutic effect length of time the
drug remains in effect it refers to the duration of the duration of your action so at your number
six class your number six obviously this line that is your minimal effective concentration okay in
which that onset it takes for a drugs onset it takes for a drug to reach the minimum effective
concentration after it is being administered now this is the the toxic level the toxic level so the
difference again if you can still remember in the previous video that i uploaded glass what is a
therapeutic index again that is the difference between the 80 50 and the td 15 okay difference
between the ed50 and your td50 which is the difference between these two points that is your
therapeutic dose of a drug ad50 and the toxic dose of a drug that is the therapeutic range the
difference between and difference difference between two points okay whatever be the
difference between toxic level and minimal effective concentration that is what we call your
therapeutic index or your therapeutic range or your t or what we call your ti okay now let me
give you class a classic example of your onset your peak what is very important what is it
necessary for nurses to know this concept it is also commonly asked in your exam so we have a
drug okay your insulin okay we have your onset your peak and the duration sometimes it is
asked in your exams okay so there are three types of your insulin so we have your rapid acting
insulin rapid acting insulin so that's your regular insulin your human in our and your similanting
and we have your intermediate okay we have your intermediate acting which is your humidity n
and your lenti or your nph that is your neutral protamine hydrogen just what you should know
and we have your long acting insulin okay your lung acting insulin that is your human l that's
actually your ultra lens or your protamine zinc injury as i haven't mentioned earlier okay so what
is the onset of your rapid acting insulin okay why is this important because if you encounter this
in your actual setting this is very important so the onset is one hour for the peak is for four
hours and you're eight how to memorize again the onset of your intermediate the peak duration
long acting peak and duration of your long acting respectively so it's very very simple you have
to multiply it by by what by two by two by two just bring it down 1 times 2 is 2 4 times 2 is 8 8
times 2 is 16 how about here still times 2 multiplied by 2 multiply by 2 so two times two multiply
two times two that's four eight times two that's sixteen sixteen times so that's thirty two so
that's it that's very simple now it's not simply about memorizing okay the onset the peak the
duration of the ties of your insulin your rapid intermediate and long acting be very careful class
okay because memorizing this particular discussion is important but you have to also
understand the peak level of this particular drug the onset and the duration again let me repeat
to you what is an onset is when the drug first begins to act in the body pic is when the drug is
exerting its maximum action while duration is the length of time the drug remains in in the body
now always remember guys you have to remember this you have to remember this is very very
important so we're talking about insulin talking about your diabetic patient you have to always
remember class that the patient so you're the nurse the patient is at highest list of what highest
risks to develop is to develop hypoglycemia hypoglycemia during what during very good during
peak action of your insulin that's why it's very very important to know the peak of a particular
pack so if you administer the rapid acting it's big is four hours so meaning the patient if you
administer rapid acting the patient it is highest risk to develop hypoglycemia during what during
the peak hour so that is your four hours which is a very important okay concept to take into
consideration so that is all about your onset your peak and your duration pick your dreams so
that is your number number six now moving on okay that's number six okay we another aspects
of your pharmacodynamics still we're discussing your aspects of your pharmacodynamics
another number six numbers uh sorry number seven number six is on septic and duration now
we go to your number seven number seven talks about um how a drug interacts with its target
to produce a therapeutic toxic effect so we need to discuss about your drug interaction drug
interaction drug interaction with its target okay this is very important okay with its target though
this is very basic we need to understand after what about this concept how a drug interacts with
its target to produce a therapeutic or toxic effect so what are the terms that we need to take
into consideration okay one okay number one we have your ligand okay you're like your ligand
your receptor your agonies though this is very basic guys okay your ligand is simply described
as any molecule of any molecule which attaches any molecule which attaches selectively touches
selectively to a particular to a particular receptor site the particular receptor sacrosite okay so
that is the description for your what we call as your ligand it is simply any molecule which
attaches selectively to a particular receptor the particular receptor that's your ligand okay and
another term we will illustrate it later guys okay another term is we have receptor what's the
difference between receptor and your ligand okay number two we have your receptor if ligand
is any molecule which is actually a neural transmitter that is normally present to your body what
about your receptor receptor it refers to a component of a components components of a cell or
an organism a cell or an organism that interacts that interacts that interacts with a drug okay
that interacts with a drug okay so drug interaction involves your ligand your receptor agrees
antagonists and so forth so let's discuss first your ligand and your receptor ligand is any
molecule which attaches selectively the particular suffer side so this molecule it could be a
particular neurotransmitter it's naturally occurring in the body neurotransmitter like epinephrine
or also known as adrenaline it binds of course to adrenergic receptors estrogen binds to
estrogen receptor like the concept by analogy of luck and key and if that particular ligand okay
bind to any component of a cell and then they will interact with it with a particular drug and
then something happens it will create a particular happenings and that's how a in drug
interaction with target occurs let me illustrate guys okay so obviously this is a ligand there so
again ligand again is naturally occurring in the body such as your neurotransmitter like your
epinephrine when epinephrine or your adrenaline it should be binding to your normally
receptors adrenergic receptors another example is that your estrogen binds to your estrogen
receptor binder estrogen receptor yeah okay so imagine this is an estrogen this is a
neurotransmitter your epinephrine this is a ligand and then it binds a particular receptor which
receptor again is described as any component of cell and organism that interacts with the drug
now when ligand binds the particular receptor it will produce a particular response it will
produce a particular response so that's the drug interaction now in a regular life your
testosterone okay testosterone testosterone obviously that's a male hormone okay it will bind
so imagine this is a testosterone it will bind to a particular okay receptor which is it will bind to
what into an androgen receptor and the site of action the site of action let's say side of your
action is your mustache your upper lip rather sorry side of your action is your upper lip what
would be the response that is a testosterone obviously that's the main hormone it will bind to
nitrogen androgen receptor the side of your action would be your upper lip and then bind into
your androgen receptor to your hair follicle and then you grow your mustache as simple as that
grow your mustache that's how a ligand bind the particular receptors it's basically it's actually
under your anatomy speciality during your first year now going back to the drug interacts with
its target in order to produce a therapeutic or toxic effect aside from ligand and your receptor
okay we should know also the difference between an agonist and your antagonist okay also
includes in number seven number three number one is like that right number two is your
receptor number three is your agonist okay what is an agonist agonist okay are drugs that
activate drugs that activate receptors that will activate receptors and produce and it will produce
a desired okay desired response take note of that drugs that activate agonist is a drug that
activate receptors to produce a therapeutic or a desired response so this is an engine which
activates a receptor to produce an effect similar to that of the physiological signal molecules it
mimics your physiological signal molecule same type of response as the endogenous substance
indulgence substance that's naturally that's the neurotransmitter internally occurring in the body
it mimic the induction reaction it mimics the action of the original ligand on the receptor such as
your norepinephrine and b1 receptor of the heart to produce taken out of that class to produce
a desired response it may mix the action of the original ligand to produce a physiological signal
of the under receptor such as a norepinephrine on b1 receptor of the heart so an agonist an
agonist is divided into three subcategories we have your full agonist and we have your partial
agonist and we have your inverse i will say full agonies it can produce obviously from its term it
can produce 100 percent of its desire can produce 100 of its desired effect while you're partial it
cannot obviously it cannot produce 100 percent okay obviously of its therapeutic or it's desired
of its desired effect so in partial agonies guys drugs it can attach and it will elicit only a small
response there's no there's a there's a response but what kind of response it's only a small okay
response but also it also block other responses we will illustrate that later class and your inverse
inverse an agent by which it activates a receptor it activates a receptor to produce okay to
produce an effect what kind of effect of it does this inverse agonist produce that is opposite
okay that is opposite direction of the opposite direction so those are the three types of your
agonist you have your full agonist that can produce 100 percent with this artifact partial it can
actually elicit a small it produces small response but also block other response an inverse agent
which activates a receptor but the effect it is in the opposite direction to that of the agonists
okay let me illustrate that class okay here's an illustration of your agonies and your antagonists
agonies again drugs that occupy receptor and activates them antagonist drugs that occupy
receptor but do not activate them okay we are not still done i did not all discuss your antagonist
let me first describe what is an antagonist i forgot to discuss it sorry okay let me just erase this
one sorry four what about sir your antagonist okay what about sir your antagonists antagonists
obviously are drugs that prevent drugs that prevent receptors prevent receptor activation and
block a response and block a response it will block a particular response so that is a molecule
that opposes the effect of the indigenous agonist or your endogenous agonist feather it it is a
molecule that opposes the effect of a neurotransmitter it inhibits its correct term inhibits the
normal function of the neurotransmitter so it blocks okay a particular response it will actually
block a particular response so your antagonist again is divided into two categories your agonies
is this um divided into two categories we have your competitive and your um non-competitive
competitive okay antagonist is divided into two subcategories we have your competitive
antagonist and your um non-competitive what is a competitive and patterns competitive
antagonist it will compete okay competes with agonists will compete with agonies for the same
bonding site for the same bind b the same binding site on the receptor on the receptor they will
bind again to a particular they will compete with agonies for the same binding site on the
receptor while your non-competitive binds to a similar or different difference okay different
non-overlapping banding side none overlapping abandoned side but still it prevents the
binding of your analysts okay competitive it will competes your antagonist and it will complete
one it will compete to an agonist for the same binding site into the same binding site whereas
your non competitive it will bind the different non-overlapping boundaries but still though it's
different than overlapping binding site but still prevents the binding of your agonists now let me
illustrate class okay let me illustrate that phrase okay so we have here an agonist we have here
an agonist so we have here a receptor [Music] sorry perfect and agonist and your antagonists so
we have here an antagonist wow okay so this is your agonist this is your antagonist let me use
other color for your antagonist so that you can determine its difference so this is an illustration
of your competitive competitive antagonist going back to the description of competitive it will
competes with agonies for the same the same band the binding site on the receptor so here if
this particular agonist your ligand or your neurotransmitter bind to a particular receptor again
by the particular receptor competitive antagonist okay so in this particular illustration class
obviously okay just to illustrate class you have to remember that a competitive antagonist
competitive antagonist is they will bind they will compete with the agonist for the same and for
the same binding site on the receptor in a similar in the same binding site on the receptor so in
this illustration class imagine it will create does this create a response yes probably most
probably but only a less activation that's this is an illustration wherein the agonist is trying to
bind and then this okay agnes is trying to bind and antagonist is getting their way inhibiting the
binding how about sir your non-competitive versus your non-competitive how about your non-
competitive antagonist a non-competitive antagonist you have to look at the difference
important difference okay so we have here again uh an agonist very particular receptor perfect
and then we have a contrabeda an antagonist perfect we have here an antagonist same
illustration class antagonist and we have here and agonists yeah so here the agonist is trying to
bind okay trying to buy okay trying to buy in competitive they will bind this antagonist will bind
to the same binding side of the receptor non-competitive obviously it will bind to what into a
different different overlapping binding differential means it does not prevent the binding of
others no still bind why it will bind to the other part with to the other part say big submission
and okay i am it will bind to a different take out of that binding to the other part so if this
particular antagonist non-competitive bind to a different binding site which is non-overlapping
as it did to some baby binding to the other part it changes now the morphology of the cell the
protein indirectly okay so obviously here it will does this will create a response it will create a
response but more of a lot less activation not a full activation because there's an involvement of
your antagonists not only a not only an agonist now let me take you back to the illustration of
here agonist and your antagonist so as we as you know that an agonist is divided into three
your full your full agonist your partial agonist and your um what you call this inverse so here is
an example of your others i like that it will bind the receptor similar to that of the and by
analogy your luck and key again imagine um imagine [Music] full activation i am this is the
receptor site eating ligand which is an agonist alone full activation that's 100 so that's full
agonist okay let me give you an example class let me show you an example let me show you an
example perfect so imagine this is an illustration letter a illustration b [Laughter] illustration c
wow perfect how did you do that illustration [Music] okay so imagine this is a drum imagine this
is a drug okay a drugs that will act by forming chemical bind bonds with specific receptor sites
that is similar receptor if it's perfectly fit okay but perfectly fit yeah perfectly fit a drugs up by
forming chemical bonds with specific receptor sites similar to illustration letter a now we go to
your illustration letter b if it's perfectly fit okay this ligand perfectly fit your illustration letter a i
repeat that this is an illustration where drug drugs act by forming chemical bonds with specific
receptor site that is similar to key and black now in illustration letter b the better defeat the
better the fit the better the response drugs with complete attachment and response is what we
call an agonist if that is can produce 100 percent response that's one that's full agonist now in
drug c drugs that attach but do not elicit a response is an antagonist oh antagonist [Music] okay
it does not fit so if you drug this drugs that attach it will attach obviously but it will not elicit a
response it blocks the endogenous response it blocks the neural transmitter now in illustration
letter d drugs that attach and elicit a small okay it will only elicit a small response convenient
achieving response tito it will only create a small response but also this since it is a small
response it blocks other responses small responses blocks other responses it is not fit unlike but
perfect is not in its feet like that's agonists it can produce 100 percent that's it will never elicit a
response it will block a neurotransmitter and that is what we call antagonists for example um
let's it will only create a small response compared to full response so if it zabihan there's a small
response if you elicit a small response pero in a black pattern in other response and double gen
class a person agonist there's a response it's not it does not produce 100 respects okay so that
is the illustration for what we call as your um how a drug interacts with its target to produce a
therapeutic or produce its toxic effect okay toxic effect so full agonist has its um intrinsic activity
of 100 your partial is between 50 to 75 an antagonist has an intrinsic activity of what of a zero y
zero it blocks obviously the response let me illustrate let me draw a particular graph let me draw
a particular draft for that discussion so we have here okay perfect you have here a drug and
then we have here a responses responses okay so we have 100 we have 75 50. 25 0 negative 25
negative 50. okay okay okay now in this illustration class we have this concept of your intrinsic
activity okay which reflects again your intrinsic activity is equivalent to your maximal okay your
maximal effect of the drug okay so remember your emacs okay that is your e-max maximum
maximal effect of a drug so your full agonists this is your full agonist remember the full agonist
has intrinsic activity in this case 100 response and your partial agonists your partial agonists
your partial agonist is between its intrinsic activity is between 75 and 50. that's exactly 50 not
exactly 75 it's between 50 and 75 your antagonists okay your neutral after your neutral
antagonists neutral antagonist since it blocks responses obviously its intrinsic activity or value is
zero obviously it has an intrinsic activity of zero because it blocks the responses and your
inversed inverse agonist what is the intrinsic activity of your inverse agonist it's at it's zero it's in
50 it's at 75 it's not actually 100 it's actually between negative 25 and negative 50 y inverse
agonist is an agent which activates a receptor to produce an effect that is in or possible it's
paradoxical actually in opposite direction to that of the agonists okay so that is the concept of
how a drug interacts that is a ligand okay let me repeat what is a ligand it is an any molecule
which attaches selectivity to particular receptor that particular ligand is naturally occurring in the
body that's a neurotransmitter like epinephrine adrenaline binds into adrenergic receptors
estrogen binds to estrogen receptors like ian luck and then something happens it will create a
particular response like in regular life your inner example a while ago your testosterone is a male
hormone and then it will bind to the androgen receptor your hair follicle so the site of action is
your upper lip and then you grow your mustache as simple as that your receptor is a
component of a cell organism that interacts with the drug and software okay so we're done with
number seven aspects of your pharmaco dynamics now we proceed to other aspects of your
pharmacodynamics which is also very very important your non-specific we are down to number
eight let me just erase this class we are down to your number eight aspects of your
pharmacodynamic which is your non-specific of your non-specific and none selective okay none
specific and your non-selective drug effects non-specific and your non-selective drug effect
okay if we say non-specific what is non-specific compared to your non-selective many agonists
and antagonists they lack specific and selective effects so your receptors produce a variety of
facial logic response depending on where the receptor is located so let me first discuss what is
non-specific okay what is non-specific none specific is actually drugs that affects drugs that
affects multiple drugs that affects multiple receptor sites it affects multiple receptor sites affects
multiple receptor sites that's your non-specific while you're non-selective okay while you're non-
selective what about so you're non-selective non-selective non-selective some drugs affect
multiple okay some drugs affect multiple receptors multiple receptors okay non-specific drugs
that affects multiple receptor sites whereas you're non-selective non-selective some not all
drugs some drugs affect multiple receptors let me illustrate that class let me give you an
illustration you are non-specific for your non-specific in which a particular drug okay that affects
the multiple receptor sites so a particular example class is your cholinergic receptors okay
remember that your cholinergic receptors they are located in the bladder your heart the blood
vessels stomach your bronchi in your eyes so that is a drug that stimulates or blocks the
cholinergic receptor which affects all the anatomical signs so let me give you an example
example of a drug and it's cholinergic receptor called lynergic or receptor sites for their located
anatomical sites and the responses that we may elicit we have here beth and nicole okay your
botanical that's on your calendar decrease after what is the effect of this particular drug this
receptor site energy receptor site is your eyes your heart your blood vessels your stomach your
bronchus or your bronchi and your bladder so calling jerk receptors they're located in your
bladder your heart blood vessels stomach your bronchi in your eyes so that is a drug that
stimulates or blocks the cholinergic receptor it affects actually all anatomical sites so remember
that your bath nicole it is used for post-operative patient for urinary retention to increase the
bladder contraction remember it is used for your post-operative patient in order to increase a
bladder contraction to increase your bladder contraction it stimulates your cholinergic receptor
in the bladder and urination of hearts how by strengthening the blood contraction okay
however botanical is non-specific because other cholinergic sites are also affected other
cholinergic sites are also affected i'll repeat you have a post-operative patient so there's a
doctor's order botanical so what is the use of your breath nicole it increases the bladder
contraction how it stimulates your cholinergic receptor in the bladder and then if it stimulates
the receptor in the bladder urination occurs so it strengthens the bladder contraction however
the drug botanical botanical is non-specific it is actually non-specific in what sense that it is non-
specific non-specific it is not only stimulates your bladder see it also stimulates other cholinergic
sites they're also affected such as your eyes so what will what will happen so your pupil will
constrict your heart it will decrease your heart rate your blood vessels it will decrease your blood
pressure how about your stomach it will increase its gastric secretion how about your bronchi it
will constrict your bronchials your bladder it will increase your bladder contraction yes that is
non-specific so if botanical is administered it is not only specific it does not only stimulate your
bladder it is not only stimulate on the receptor in the bladder and specific hindi lung bladder
and stimulate but others are being stimulated such as your eyes your heart your blood vessels
your stomach your bronchi and your bladder so that is a good example for your non-specific
how about so your non-selective drug okay how abouts are your non-selective drugs okay so
we have here an illustration your drug your receptor [Music] then the sites and the different
responses that we can analyze it okay let me give an example your adrenaline or also known as
your epinephrine after your epinephrine your epinephrine class non-selective it is not only select
okay some drugs affect multiple receptors also so we have here an example your epinephrine
which is used for treatment obviously of your severe asthma uh should be a severe asthma
exacerbation or treatment used for treatment for of anaphylaxis so the axe to what epinephrine
acts on your alpha one okay it doesn't only act alpha one also acts to better one and also your
beta two so the site of receptor the site rather of a receptor alpha one is under your blood
vessels your better one is in your heart and your beta2 is your broncos which is also again in
your anatomy you have to remember this class the site for receptor alpha one is your blood
vessels your site for your receptor better one is your heart your bronchos to your beta too so
what will happen what would be the response it will increase its blood pressure heart better one
increase is heart rate and bronchus they will relax your bronchus so that is a good example of
your non-selective drug okay so that is the aspects of your pharmacodynamics so we'll discuss
about those response relationship and in which under this those response we discuss about the
difference between potency and efficacy and then two we have your affinity and then three we
have your um what we call this maximal efficacy your emacs your therapeutic index what else we
discuss about the aspects of your pharmaco dynamics your drug response curve and then we
have your therapeutic index and then followed by the interaction of a interaction [Music] of a
drug with its target in order to produce tripolitic and toxic effects we'll discuss about the
concept of your ligand your receptor your agonist and your anti-agonist and then we have your
non-specific and your non-selective drug effects so those are the aspects of your pharmaco
dynamics that you should know of

PHARMACODYNAMICS PART III TYPESOF

RECEPTORS
hey there everyone welcome to part two of the discussion of your pharmacodynamics so we'll
be talking talking about your types of your drug receptors i want to correct things class um in
previous videos i've mentioned about the mechanism of the drug in pharmacokinetics i've
mentioned about the absorption digestion it should be distribution i'm sorry absorption
digestion yes metabolism and excretion okay now let's discuss about the types of drug
receptors there are actually there are actually four types of your receptors we have your ligand
gated receptors okay your ligand-gated receptors we have also your enzyme link receptors your
g protein g protein and coupled receptors should i say and your intracellular receptor so there
are four types we have your ligand-gated receptor link receptor g-protein intracellular receptors
so a particular receptor has a specific site to bind to molecules or ligand this is called luck and
key model okay that is your luck and key mode let me discuss about your um ligand gated
receptor what about your ligand-gated receptor class in ligand receptor the cell membrane
requires your specific ligand gated channels for the movement of hydrophobic molecules to it
there so the you can see class you can see that the ligand there binds to the receptor and then
the receptor you see that receptor gates receptor gate opens an example of that is your
acetylcholine they binds to your nicotinic receptor so the sodium as you can see they enters
now the cell and then when they enter the cell electronic chemical gradient is now created and
then resulting in the the polarizations it gate the receptor gate opens sodium enters the cell
there will be no electrochemical gradient that is being created which results in the polarization
so that is what happening in ligand-gated how about sir in your what we call enzyme linguist in
enzyme link receptor class the trans membrane of the receptor are enzymes or closely related to
your enzymes an example there okay an example of which as you can see class is your tyrosine
receptor the binding of the ligand causes now the conformation which results in aggregation of
the receptors so once it is formed tyrosine is activated okay once the tyrosine is activated it will
now cause the atp atp to become adp which causes your phosphorylation of the receptors it
causes phosphorylation of your receptors once it's tyrosine picks up phosphate group different
inactive intracellular proteins come up and attach to the phosphate tyrosine they are the
conversion of your atp to your adp leading now to cascade of activation then they will produce
a cellular response and this was what is happening to enzyme receptor now in g protein okay ng
protein first you can see that class the ligand okay as you can see the ligand first bind to the
receptor this ligand class as you can see it will bind to the receptor if this ligand binds to the
receptor it will cause a structural changes it will cause struggle changes into the receptor there
excess extra structural changes into the receptor and then turns changes and shape of the g
protein which reduces class gtp to gdp okay leading to the separation of the alphas you can see
alpha sub unit from beta and gamma unit you see that class okay i'll repeat so first the ligand
will bind here to the receptor causing structural changes into the receptor and then turns
changes the shape of the g-protein which reduces your gtp to gdp leading now to the
separation of your alphas you can see the alpha separated okay alpha units separated from beta
and gamma unit and it turns which turns activates other enzymes and your g proteins okay
energy proteins now how about for the fourth type and the last type that is your intracellular
receptor this is very simple in intracellular receptor class okay this particular ligand ligand that
passed through the cell membrane enters okay to the cell and into the nucleus as you can see
crossing the nuclear membrane so after entering the after entering the nucleus the ligand now
will bind to the intracellular receptor there perfect okay if that particular ligand binds into the
instance intracellular receptor this now can alter the transcription of dna within the cell okay so
those are the four types of your receptor you

PHARMACODYNAMICS PART IV
okay let's discuss now in the part four of your pharmacal dynamics which is the mechanism of
action mechanism of drug action mechanism of your drug action so drugs again they act by
binding to receptors binding of the drug may activate the receptor they produce a response or
it may inactivate a receptor so they are blocking the response we have the concept of your
agonist and your antagonist so the different activity of many drugs is determined by the ability
the strength of the drug to bind the specific receptor so the better the drug fits the receptor site
so the more active the drug is so different mechanisms of your drug action includes we have
seven mechanisms actually number one we have your mechanism of your stimulation [Music]
okay number two we have your depression [Music] another mechanism that you should know of
is your irritation will go one by one and then number four we have your replacement we have
your replacement number five your cytotoxic okay your cytotoxic action at number six we have
your anti microbial okay antimicrobial action and lastly number seven your modification i will
just write it okay adjacent ear stimulation modification of your immune styles modification of
your immune status so there are seven there are seven mechanisms of your drug action it's
which includes your drug stimulation depression irritation replacement cytotoxic action
antimicrobial action and modification of your immune system let's go with first let's discuss your
stimulation so number one we have your stimulation okay what about surgery stimulation
actually obviously derived from the term stimulation stimuli so the drug that what that
stimulates obviously a drug okay that stimulates or enhances okay enhances a particular intrinsic
activity particular intrinsic activity so this drug selectively enhance the level of activity of a
specialized cells so this is the process of your stimulation of your cells let me give you an
example class stimulation we have your adrenaline or your epinephrine obviously your
adrenaline or epinephrine it stimulates what stimulates the heart that's your stimulation your
stimulates your salivary gland there's some stimulation that is an example good example
pillowcarbine stimulates what blend your salivary gland salivary as simple as that that's your
concept of your stimulation another concept is your depression [Music] okay your depression
stimulation the key word there is stimulates or enhances a particular activity while your
depression obviously this particular drug selectively selectively what selectively depress
decreases depress a particular activity an activity of a specialized cells press a particular or
specialized cells what would be a good example class a good example of your depression
obviously is your barbiturates barbiturates it causes us barbiturate is a cns down causes your cns
depression you will encounter those class okay when you reach your third year even your fourth
year so it's very important to know the basic concept how about sir your irritation how about
your irritation if you say irritation the drug creates drug creates selective drug create selective
noctus undesirable noxus effect on a specialized cells good example obviously irritation is your
astringent another mechanism is your number four your we have your replacement what about
your replacement replacement uses it is simply use of natural use of a natural metabolites use of
a natural metabolites hormones in deficiency states so it replaces essential body compounds
natural metabolites hormones so the action of this the mechanism of your replacement is simply
to replace essential body compounds a good example of your replacement is your insulin which
is obviously used for diabetes and needles your iron could be a good example it can be used to
surplus replacement to patients suffering from anemia your patients diagnosis of parkinson's
disease you can make use of the replacement of your level it replaces a an essential body
compounds and number five we have your cytotoxic action or mechanism of a drug so this
cytotoxic it's selectively kills okay kills invading kills invading parasites kills invading parasites
cytotoxic example of which is you have your chloroquine cyclophospham cyclophos chromide
chloroquine penicillin and software that's your cytotoxic kills invading parasites or cancers
invading parasites or cancers sorry i didn't write that one okay number six we have your anti-
microbial you have your antimicrobial drug so this mechanism prevent prevents it will inhibit or
kill invading for cytotoxic here it will kill infectious organism that is already present infectious
organisms infectious organs and then the last mechanism of drug action is your modification
modification of an immune status multiplication of an immune status this modification again
obviously it will modify it will enhance its either enhance modify or depress the immune system
depress the immune system a good example of the modification of your immune status is we
have your what you call this interference interference and your methyl peroxide so those are the
different mechanisms of your drug action which includes seven again we have your stimulation
depression irritation [Music] replacement cytotoxic action antimicrobial action and motivation of
your immune status so that is what we call your mechanism of your drug action now another
important concept of your pharmacodynamics aside from its aspects the mechanism of a drug
action the types of your drug receptor it's very important to take into consideration the different
therapeutic effect so this is five okay therapeutic action of drugs what are the different
therapeutic action of drugs meaning they are the therapeutic desirable actions of a particular
drug number one we have curative we have your curative obviously curative it will cure the
problem it will resolves resolves the problem a good example of your curative do we have you
your antibiotic antibiotic for infection it will cure it will resolve the problem number two is your
palliative you should know this basic concept class if your curative resolves or simply solve the
problem cure the problem or particular disease positive it will just only elevate it will lessen only
elevate the signs and symptoms of the disease it will only alleviate it will only lessen okay the
signs and symptoms a good example is a morphine morphine morphine barcelona morphine
number three therapeutic effects substitutive positive curative substitute what is a what is your
substitute as subs it will replace okay replaces the particular what hormone or the amazing
enzyme or the hormone curative it will resolve the problem your positivity will just lessen or
alleviate your substitute it will just replace the hormone that is actually missing or the enzyme
that is lacking to the patient a good example is obviously this may sound cliche but this is a
good example insulin for diabetes melatonin and another therapeutic action of the drug we
have your support you're supportive we say supportive it will obviously it will supports body
functions it will only support body function until the treatment until the treatment can take over
or the body can compensate first it will support the body function until the body compensates
or until the treatment they can take over or the body can compensate what is a good example
of a supportive therapeutic action of a drug a good example class is sorry good example is an
epinephrine your epinephrine by titrate epinephrine by titrate for low bp that is a supportive
okay therapeutic action of the drug it supports the body until the body compensated or until
the treatment can take over number five is we have your purity positive substitutive supportive
what is the other one restorative yes very good okay we have your resto key word for restorative
obviously it will restores the body it will restores the body back back to a back to health restores
the body back to health what is a good example supplements vitamins they are restorative in
nature vitamins they are restorative in nature so that is about the therapeutic action of drugs
which includes 30 palliative substitute supportive and restorative another concept of
pharmacodynamics that is very also important we have your pharmacodynamics interaction
pharmacodynamics pharmacodynamics interactions what about serious pharmacodynamic
interactions so those are they're those that result in additive synergistic or antagonistic drug
effect antagonistic drug effect now let me just illustrate this class this is very important what is
the difference between your additives and your synergistic if we say additive drug effect it is
actually um the sum additive it is the sum of the effects it is the sum of the effects of the two
drugs some is the totality of the administered drugs when two drugs are administered in
combination and the response is increase obviously that is beyond what either could produce
alone so this can be desirable or undesirable i repeat additive drug is when the two drugs are
administered in combination and the response is increase that is beyond what either could
produce alone so simply your additive drug effect two drugs of the same classification
remember that class there are additive two drugs of the same classification it will increase the
effect that is beyond what either could produce alone what is a good example of your additive a
good example of your additive is your aspirin and your content as per encoding there are
analgesics that work by a mechanism but they can be given together for increased pain relief
that's a good example of your additive drug effect mathematically speaking additive is simply
illustrated as what one plus one equals two that is additive two drugs of the same classification
are given producing increased effect response that is beyond what either could produce alone
that is an additive how about sir your synergistic okay your scene or just take a drug effect what
about your synergistic your synergistic that is the clinical effect of the two drugs given together
is substantially greater than that of either giraffe so meaning two or more drugs are given
together one drug can have a synergistic effect on another panda class your synergistic it is
simply the clinical it is simply the clinical effect of the two drugs of the two drugs given together
given together is substantially okay it is substantially greater greater than that of either dragalon
so what is the line of demarcation between additive and synergistic drug in additive an additive
drug effect class it is the sum of the effect of the two drugs okay when two drugs are
administered in combination and the response is increased that is beyond what either could
produce alone and synergistic that is the clinical effect of two drugs when given together when
combined together it's not just only increase it is actually greater than that of either drug alone
so when two or more drugs are given together one drug can have a synergistic effect on the
other it will it will add it will potentiate the therapeutic effect what is the difference between
additive and your synergistic additive versus inner justice the synergistic class your additive
again your additive to drugs of the same classification okay in your synergistic two drugs of
different classification two drugs of different classification now let me give you an example like
for example in your antibiotics you know that ampicillin amoxicillin can be given without their
inhibitors sometimes doctors would we will order and pestilent with sulbata amoxicillin with
clavu with clavulanate so your sulbactam is a bacterial enzyme inhibitor normally ampicillin can
be given without inhibitors but sometimes doctors would order amphicillin with sul bhakta why
if you gave that bacterial enzyme inhibitor if given it will inhibit bacterial enzyme activity so this
bacterial enzyme activity it enhances the effect it broadens the spectrum of activity of the
antibacterial agent mathematically speaking additive is one plus one equals two well synergistic
one plus one equals three it will enhance it will potentiate it will broaden the effect or the
activity of a particular trap that is what you call a synergistic effect of impact there is what we
call the synergistic effect of a trap another aside from your additive your synergistic literacy your
antagonistic obviously from the term alone antagonistic drug effect what about your
antagonistic drug effect that is actually illustrated as your drug drug interaction that is actually is
treated as your drug drug interactions so when drugs with antagonistic effects they are
administered together one drug reduces or blocks the effect of the other and one drug so one
drug with antagonistic effects so you gave a particular medication and this particular medical a
and b medication are given and drug a has an antagonistic effect they are administered
together drug a will now reduce or lessen one drug reduces or it will blocks the effect of the
other it will block the effect of the other it could be actually desirable or undesirable this is very
important class i'll give you an example i'll give you an example in morphine sulfate okay let's
pray uh like for instance your molten sulfate in a morphing sulfate overdose we are giving
naloxone we're giving a naloxone naloxone is given as an antagonist naloxone is given as an
antagonist in order to what in order to block narcotic effects of your morphine sulfur heat that is
what we call your antagonistic in morphine sulfate overdose what is the antidote we are giving
naloxone why do you why should you give a naloxone because naloxone is given as an
antagonist it blocks the narcotic effect of your morphine circle another example class another is
another example in cases of your heparin heparin overdose cases of your heparin overdose what
is the antidote of your heparin okay you will expect that deforestation will order a protamine
sulfate why do you give proton sulfate it is actually given in order to block to reduce the effect
of your hair parry so your role here as a nurse is very very important the role of a nurse is very
important okay what will you do class what will you do the patient is taking um over-the-
counter drug herbal medication they can interact with each other remember class it is a myth
that interactions occur only with prescription medications what if this particular particular
patient class is a diabetic patient and then this particular patient receiving insulin and then this
patient approach your nurse i wish to drink lean juice i want to drink non-juice so what will you
do as a nurse your patient approaches you i will drink no juice remember you have to remember
it is a myth class it is a myth in depot that interaction occur only with prescription medication
remember that prescription medication over the counter herbal medication they can interact
with each other so if a patient approaches you that he wishes to drink noni juice you have to
what what is your role yes you have to notify the physician notify the precision because this not
a juice or any medication might may uh whatever be the nature or kind of that medication
maybe herbal over the counter prescription they can interact with each other there is a myth
that interactions occur only with breast cancer medication so if this patient approaches you i
want to drink knowledge juice you have to report to the physician notify the physician because
this knowledge juice might interact with the medication that is being ordered by the physician
you are diagnosed with this kind of diseases and then you heard in me in a commercial about
the sun around saminda now okay so you're taking this particular supplemental so as andres
you have to notify the physician so that the physician can know if this particular supplements or
drugs can interact with each other to the prescription drug in order yeah because sometimes
those particular medications it can actually mask the signs and symptoms of so remember it is a
myth that interaction it is a myth that interactions occur only with prescription medication take
no prescription may be prescription over the counter urban they can interact with each other so
your role is very important what would be your role as a nurse you have to notify you have to
report to the decision you have to report to the position another important aside from the
antagonistic synergistic additive effect let's include class another important number four side
effects um okay your side effects of the drug their side effect of the drug is described as a
secondary secondary effect secondary effect of drug therapy okay secondary response okay
secondary effect of drug therapy because the primary response obviously is desirable or the
therapeutic effect so side effect is the secondary effect of a drug therapy secondary effect of a
drug therapy so all drugs have side effects obviously even with correct hypothalamine dosage
all drugs have side effects even with correct drug dosage side effects occur that can be
predictable and range from inconvenient to severe to life threatening so it is important to know
that the occurrence of side effect is one of the primary reasons why patients stop taking their
prescribed medications they will stop they will take that medication without even knowing
because they lack knowledge about the side effect that it's normally occurring if it is actually
occurring union collagen inside effective medication so it is very important class it is a very
important role of a nurse okay teaching about the side effects is very important encouraging
them to report side effect is very important so important role here is class teaching the patient
okay teaching patient about the side effects that's the side effect of that medication encourage
them to report obviously encouraging your role is very important here encouraging them to
report side effects i'll give you a good example so your patient you admitted um patient
admitted in the hospital with the diagnosis of your tuberculosis we all know that one of the drug
that is given to a tb patient is jeri found a scene and the side effect of your compassion it causes
so if this particular nurse does not even [Music] [Music] morning glory very important you have
to teach the patient you have to teach about the side effect that those are normal see that's very
important class another number five adverse effect or adverse drug reaction obviously your
adverse drug reaction they are unexpected they're actually unintentional okay reactions to a
drug reactions to a drug therapy that occur at normal drug dosages it can be mild to severe
which includes anaphylaxis or cardiovascular collapse remember that your adverse effects are
always undesirable though they are unintentional they are unexpected they are always
undesirable so what will you do is your role if the patient suffers anaphylactic that's undesirable
obviously so your role here is to report to the physician you have to report to the session and
you have to work document get the document why do you need to document the adversity
because they represent variance from your plant therapy there's actually a deviation from your
subplant therapy so you need to report to the physician and document office and number six
we have your drug toxicity we have your drug toxicity drug toxicity it occurs when drug levels it
occurs when drug levels exceeds and it exceeds the therapeutic exceeds the therapeutic range
so it may occur secondary to overdose may be intentional or intentional or drug accumulation
or drug toxicity so this is very important to determine the therapeutic level of a drug the toxic
level of a drug that's why we discuss about the therapeutic effect of a drug in the previous
videos and then the toxicity level the lethal level so the factors that to the fact drug toxicity is
your diseases that are that is obviously existing genetics the age of a person for example in
patients with [Music] liver cirrhosis there will be accumulation of your ammonia and we all know
that ammonia is a toxic that is a noxious that's an obnoxious substance or body so we need to
administer a particular drug in order to excrete those waste product okay so drug toxicity again
it occurs when drug levels exceeds the therapeutic range therapeutic range so that is about the
therapeutic effect of a drug and the side effects adverse effect and your drug toxicity