The importance of physical health assessment
David B Cooper in Introduction to Mental Health–Substance Use, 2017
Prescribed drugs have side-effects, cautions, contraindications and potential interactions with other substances (prescribed and non-prescribed). The decision to prescribe medication requires an understanding of the biological and physiological effect of a drug on the body (pharmacodynamics). In addition, knowledge of the way in which the body metabolises and excretes the drug (pharmacokinetics) is essential. Pharmacodynamics and pharmacokinetics are greatly influenced by: ➤ the physical health of the individual receiving the drug➤ other medication prescribed.
Dose-Finding Designs Based on the Continual Reassessment Method
John Crowley, Antje Hoering in Handbook of Statisticsin Clinical Oncology, 2012
Statistical modeling of Phase I dose finding studies, such as the modeling that takes place with the CRM, has been introduced in the last two decades. Much more fully studied in the Phase I context are pharmacokinetics and pharmacodynamics (see Chapter 3). Roughly speaking, pharmacokinetics deals with the study of concentration and elimination characteristics of given compounds in specified organ systems, most often blood plasma, whereas pharmacodynamics focuses on how the compounds affect the body. This is a vast subject referred to as PK/PD modeling. Clearly such information will have a bearing on whether or not a given patient is likely to encounter DLT or, in retrospect, why some patients and not others were able to tolerate some given dose. There are many parameters of interest to the pharmacologist, for example, the area under the concentration time curve, the rate of clearance of the drug, and the peak concentration.
General Discussion about Human CYP2D6
Shufeng Zhou in Cytochrome P450 2D6, 2018
Concomitant use of a drug that affects the activity of the same CYP responsible for biotransformation of another drug can lead to significant increases in plasma concentrations and potentially important drug–drug interactions (Ito et al. 1998). Such interactions may be associated with poor tolerability or increased risk for toxicity. On the other hand, for drugs/prodrugs requiring biotransformation via CYP enzymes from an inactive/less active parent compound to a pharmacologically active metabolite, drug interactions may manifest as a reduction in efficacy. Cases of fatal drug interactions have been reported and several prominent drugs (e.g., cerivastatin, mibefradil, sorivudine, and terfenadine) have been withdrawn from the market because of severe adverse reactions related to drug interactions (Li 2001). Both pharmacokinetic and pharmacodynamic components may be involved in these toxic drug interactions. Because of the clinical significance of drug interactions, it is important to identify drugs and compounds in development that may interact with other drugs, and timely identification of such drugs using proper in vitro and in vivo approaches has important implications for drug development (Zhou et al. 2007).
Ocular nonsteroidal inflammatory drugs: where do we stand today?
Published in Cutaneous and Ocular Toxicology, 2020
S. A. Kandarakis, P. Petrou, E. Papakonstantinou, D. Spiropoulos, A. Rapanou, I. Georgalas
On the other hand, pharmacodynamics is the study of the biochemical and physiologic effects of drugs (especially pharmaceutical drugs) in the body of a living organism21. Regarding NSAIDs, their main physiologic action focuses on the COX inhibition, via which PGs biosynthesis is downregulated, limiting their biologic effects. When an ophthalmic NSAID is topically administered in the eye, the subsequent reduction in PGs concentrations in the eye results in several effects, including inhibition of miosis, decreased permeability of the blood-ocular barriers, decreased leukocyte migration, changes in intraocular pressure and restriction of conjunctival hyperaemia. Via all the above mechanisms, NSAIDs can be useful in the management of various ophthalmic conditions16.
Individualized precision dosing approaches to optimize antimicrobial therapy in pediatric populations
Published in Expert Review of Clinical Pharmacology, 2021
Quyen Tu, Menino Cotta, Sainath Raman, Nicolette Graham, Luregn Schlapbach, Jason A Roberts
Pharmacodynamics is the study of the relationship between a drug concentration and its pharmacological or toxicological response. It is often referred to as ‘what the drug does to the body’ [16]. Less is known about human ontogenesis on antimicrobial PD. Age-specific drug-receptor, drug-disease, and drug-physiology response may account for some differences that have been observed between children and adults [27]. A well-described example is the effect of the tetracycline antimicrobial class on young children. Following up infants who were given tetracycline during the period of tooth formation has revealed the majority of these infants developed yellow and brown discoloration of teeth later in life [101]. This was confirmed to be permanent staining that occurred at any dose and any duration up to 8 years of age [101]. This PD interaction between tetracyclines and children is attributable to the tetracycline-calcium complex chelation during development of tooth formation in children [101]. In another example, Klugman has observed that children with acute meningitis had acceptable vancomycin concentrations in their cerebrospinal fluid (CSF), as opposed to inadequate concentrations in adults [102]. This phenomenon has been justified by the enhanced permeability to small lipid-insoluble molecules in the developing rather than fully mature brain [103].
Bepotastine besilate for the treatment of perennial allergic rhinitis
Published in Expert Opinion on Pharmacotherapy, 2018
Ismael Carrillo-Martin, Alexei Gonzalez-Estrada, Ves Dimov
Bepotastine besilate (BB) is available in two forms, including an oral and an ocular preparation (Box 1). BB is a second-generation antihistamine that is highly selective for H1-receptors [10]. It has very low affinity to other cell receptors such as histamine H3, α1-, α2 – and β-adrenergic, serotonin, muscarinic, and benzodiazepine receptors, which causes adverse effects to be few and uncommon [11]. H1-receptor blocking is not the only anti-allergic activity of BB, it has inhibitory effects on eosinophilic inflammation in the respiratory tract and peripheral blood [12,13]. Furthermore, BB can stabilize mast cell function, inhibit IL-5 (Interleukin-5) production, and inhibit the activity of leukotrienes B4 and D4 [11]. The chemical formula for BB active compound is (+) −4-[[(S)-p-chloro-alpha-2-pyridylbenzyl]oxy]-1-piperidine butyric acid monobenzenesulfonate, and the chemical structure is shown in the manuscript’s drug summary box [14,15]. Pharmacodynamics and Pharmacokinetics
Related Knowledge Centers
- Adverse Effect
- Animal
- Biochemistry
- Physiology
- Pharmacokinetics
- Drug
- Medication
- Infection
- Pharmacology
- Dosing