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Drugs
Stimulate
Drug PRODUCTION
Y
OF IgE
IgE settles at
mast cell surface
Drug Allergy
2nd exposure
O Y
Drug
Ag + Ab
Antigen O
reaction
Release of
Degranulation of substances of
mast cell
anaphylaxis
Drug
Acts as
antigen
B. Disease process or pathological
condition that influence response
A. liver disease
B. renal disease
C. Presence of other Drugs
1.Summation
C.I.a. – Additive effect-when two(2)
drugs are given and half of each dose
used simultanously elicits the same
effect as the full dose of either drug use
alone.
Example:
A. Additive Effect = ½ + ½ = 1
Narcotic Analesic =
Codiene = 60 mgs
Combine
Aspirin + Codiene
Paralgin or codalgine
=
Stronger analgesic
Lesser GIT Lesser resp. with anti-
irritation depression inflammatory effect
C.I.b. Synergism – If the response is greater
than that of the full dose of either drug
Synergism = 1 + 1 = 3
Trimethoprim = Cotrimoxazole
Sulfamethoxazole +
N I ST AG
AGO ON
IS
T
ANTAGONIST
AGONIST
1 2
Naloxone
Heroin Addiction Antagonist
Agonist Resp.
depression
Opiate
receptor
Example:
D. Antagonism = 1 + 1 = 0
Competitive Antagonism
OUT
Antagonist
Naloxone displaces
Heroin Heroin from receptor
Reversal
Agonist
of effects
esp. resp.
depression
IV. Pharmacokinetic antagonism – drugs may affect
efficacy of other drugs by:
Altered dose
– response due to special features of drug
metabolism.
a. Tolerance
b. Tachyphylaxis
c. Cumulative effect
TOLERANCE- when there is a diminishing response
to an ordinary dose of a drug that is administer
over a period of time
Causes :
3. Drug inactivation by the liver microsomal
enzyme- this called pharmacokinetic tolerance or
drug disposition tolerance.
2. When there are less receptor sites available
receptor downregulation.
Cross –tolerance=when an individual develops tolerance
to a group of drugs which are pharmacogically related.
Example: If a patient develop tolerance to diazepam
(valium); which belongs to a class called
benzodiazepines he may also develop to another
benzodiazepine drug.