Cardiovascular pharmacology: Difference between revisions
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==Pharmacokinetics== | ==Pharmacokinetics== | ||
*Potency vs Efficacy: Potency is meaningless, effect per mg. Efficacy is the clinical effectiveness of drug. | *Potency vs Efficacy: Potency is meaningless, effect of drug per mg. Efficacy is the clinical effectiveness of drug. | ||
*PK is effect of the body on the drug. | |||
*Drug distribution: muscle high in water content. Women have less muscle mass. Older patients have less muscle mass. Elderly women have less total body water. Water soluble drugs are associated with a higher drug effect (eaxample alcohool). Do not diffuse into brain. Very important in beta blockers, they are hydrophilic. | |||
*Lipophilic drugs:Cross into CNS. Lopressor, propranolol | |||
==Hydrophilic== | |||
*In intravascular space | |||
*Cleared by kidney | |||
*Dont cross blood brain barrier | |||
Atenolol, hadolol, sotalol | |||
==Metabolism== | |||
*Liver C34 in half patients | |||
*grapefruit juice affects intestinal system, but not liver. Intestinal cytochrome CYP3A4. (dihydropiridine CCBs, | |||
lova, simva, cyclosporine, tacrolimus, sildenafil can be affected. May increase drug levels | |||
==Pharmacodynamics== | ==Pharmacodynamics== | ||
==Pharmacogenomics== | ==Pharmacogenomics== |
Revision as of 15:56, 29 September 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Scope
- 5% of questions of the boards
Pharmacokinetics
- Potency vs Efficacy: Potency is meaningless, effect of drug per mg. Efficacy is the clinical effectiveness of drug.
- PK is effect of the body on the drug.
- Drug distribution: muscle high in water content. Women have less muscle mass. Older patients have less muscle mass. Elderly women have less total body water. Water soluble drugs are associated with a higher drug effect (eaxample alcohool). Do not diffuse into brain. Very important in beta blockers, they are hydrophilic.
- Lipophilic drugs:Cross into CNS. Lopressor, propranolol
Hydrophilic
- In intravascular space
- Cleared by kidney
- Dont cross blood brain barrier
Atenolol, hadolol, sotalol
Metabolism
- Liver C34 in half patients
- grapefruit juice affects intestinal system, but not liver. Intestinal cytochrome CYP3A4. (dihydropiridine CCBs,
lova, simva, cyclosporine, tacrolimus, sildenafil can be affected. May increase drug levels