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Summary - Fundamentals of Pharmacology (4BBY1040)

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A comprehensive, highly detailed summary of the Kings College London Fundamentals of Pharmacology module (4BBY1040), one of the core modules taken in 'Common Year One' of courses such as Biomedical Science, Neuroscience and Biochemistry in the Faculty of Life Sciences and Medicine. The summary covers all the lectures in depth, as well as extra reading from core textbooks already incorporated into the notes, so no extra work is needed to obtain the highest marks. I memorised this document alone and placed first in the year with 97% in the exam! Topics covered include drug discovery, potency, dose response curves, neurotransmitters, receptors, toxicity, clinical trials and more. It would therefore also be relevant for anyone studying foundational life sciences from medical students to nursing trainees etc.

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pharmacology
Created @December 6, 2022 1:00 PM

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what is pharmacology

Explain the differences
between pharmacology, therapeutics, pharmacy and toxicology

pharmacology - science of drugs: mechanism, effects, discovery,
development, interaction of organism

therapeutics - use of drugs to treat disease symptoms

pharmacy - formulation and dispensing of drugs as medicine, laws
governing use as medicine

toxicology - harmful effects of chemicals/drugs

Define the term “drug” and explain how drugs are categorised and named,
giving examples

chemical substance of known structure (not nutrient) that has a biological
effect on a living organism

names = chemical (prop acid), common (ibuprofen), proprietary (nurofen)

grouped by use (analgesic) or mechanism (cyclooxygenase inhibitor)

Summarise the key mechanisms by which drugs might produce their effects

exogenous that mimic/block action of endogenous - drug won’t work
unless bound

ligand/drugs bind to target proteins (complementarity) eg. enzymes,
receptors, channels, carriers to alter activity

binding depends on: size, drug flexibility (steric factors), bond type
(irreversible covalent/reversible - h bonds/hydrophobic/van der waals etc)

computers allow in silico design




pharmacology 1

, selective = one action only (no side effects), needed for therapeutic use

specific = only binds to target, used to achieve selectivity, unrealistic

Explain what is meant by
the pharmacokinetic and pharmacodynamic properties of drugs

pharmacokinetics = what body does to drug (’body action = kin’), ADME

pharmacodynamics = what drug does to body (’d = drug action’)

both need to be considered for therapeutic effectiveness

Recognise the importance of absorption, distribution, metabolism and
excretion (ADME) of drugs in determining their therapeutic effectiveness

influenced by drug properties and patient

1. absorption = extent/speed of entry to blood

depends on chemical properties (size, lipid solubility (ionisation), pH
stability) + administration route (eg. intrathecal - into spinal cord
membrane)

2. distribution = route after absorption

usually circulate in plasma (assume conc equal throughout) then diffuse
into ECF at tissue

lipid solubility to cross membranes, water solubility to dissolve in
plasma/ECF

may be localised/systemic (eg. non sedating antihistamines don’t cross
BBB)

Vd = impact of ‘interference’ (clotting, partitioning (inactive) in fat, access,
trapped in blood stuck to albumin eg. if bound to plasma proteins can’t
cross BBB) = volume occupied if dose in solution at plasma conc, high Vd
= more distribution so more drug needed for effect

3. metabolism = determines effect duration

broken down in liver (affected by liver function?), metabolites might be
active/toxic

4. excretion



pharmacology 2

, liver metabolites excreted by kidneys, in urine
(most)/faeces/sweat/bile/breath

half life = time for plasma conc to half

clearance = plasma volume cleared of drug/time eg. ml/min

sources of drugs and nature

List some key points in the history of the pharmaceutical industry

4000BC poppy seeds opium, 1500s paracelcus ‘all remedies are poisons’
(dose dependency)

1900s drug receptor interactions, pharm industry (intersection of synthetic
organic chem + therapeutics + pharmacology)

1930s antibacterials, 1960s rational drug design, 1990s techniques eg. high
throughput/combinatorial, 2002 genome, 2000s biologicals eg. insulin

List the main sources of drugs, giving examples from each source

natural eg. morphine/opium from poppies

compound libraries

combinatorial chemistry = molecular skeletons with attachment points
reacted with substituents = lots of unknown compounds
(=substituents^attachments)

Describe the key stages in the drug discovery process

1. basic research - understanding of disease mechanism etc

2. identification of potential drug targets - protein with role in disease

3. hypothesis - drug acting on certain target to treat

4. assay - effects of potential drugs, optimised and cycled

high throughput screening - rapid/automated, more specific assays
identifying compounds with desired action - only tells you whether drug
binds to target protein

5. animal models - check toxicity (2 mammals including >1 non rodent),
pharmacokinetics = candidate




pharmacology 3

, considerations = safety (patient and environment), ethics, intellectual
property, cost

Explain what is meant by the term “structure-activity relationship” and why it is
important in drug development

links chemical structure to action on target

used to optimise properties of potential drugs

knowing amino acid (AA) sequence of receptor (cloning) helps: know
structure, which areas bind to ligand, identify if ion channel or GPCR, allow
transfer to other species, discover similar receptors

List the four phases of clinical trials and explain the main purpose of each
phase

pre clinical (above) = finds 1/2 potential drugs, 5-10yrs, patent early lasting
for 20yrs then generics can be produced, testing safety

1. phase 1 = exploratory, ~50 healthy humans (maybe a certain group), ~1yr,
check safety and tolerability, placebo random double blind, increased
doses

2. 2 = clinical efficacy/safety, proof of concept, random double blind

a (exploratory - 50-200 ill, 1yr, checkpoint)

b (confirmatory - 200-500, 2yrs, comparison to current drug/placebo)

3. 3 = confirms efficacy and safety vs standard treatment/placebo, ~2000-
10000 range of pts, several yrs, application to regulatory bodies eg. FDA,
MHRA, EMA

4. 4 = ongoing post market surveillance/pharmacovigilance of rare/long term
side effects/interactions, rare patients, expiry of patent and generics
produced

overall £250-500mil

concentration response

draw typical “concentration vs response” and “log concentration vs response”
curves with appropriately labelled axes




pharmacology 4
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