biochem week 7

Prevent Damage: Address factors that could harm health or the environment.
Therapeutic Drug Monitoring: Assessing how well a drug is performing and determining safe dosage levels.
Therapeutic Effects: Controlling disease and alleviating symptoms through medication.

Definition: Therapeutic drug monitoring involves checking drug levels in the bloodstream to ensure they are within a desired range for effectiveness without being toxic.
Key Questions:
- What is therapeutic?
- What is a drug?
- How do we monitor?
Characteristics of Therapeutic Drugs:
- Healing/Curative Effect: Operates at specific levels.
- Chemical Classification: Used to affect specific tissues/functions.
- Selective: Targeted action at the site of action.
- Reversible: Actions can be reversed.
- Productive: Results in beneficial effects.
- Monitoring Necessity: Essential for drugs that can be toxic at elevated levels.

Key Components of Pharmacokinetics and Pharmacodynamics:
- DOSE - The amount of drug given.
- CONC (Concentration) - The concentration of the drug in the bloodstream.
- PK (Pharmacokinetics) - Study of how the drug is absorbed, distributed, metabolized, and excreted.
- PD (Pharmacodynamics) - Study of the effects of the drug on the body.

Drug + Receptor Interaction:
- Therapeutic Effects: Desired effects.
- Toxic Effects: Unwanted effects.
- EFFECTS K: Refers to the potency of drug effects.

Minimum Effective Concentration (MEC):
- Definition: The lowest concentration of a drug that produces the desired therapeutic response.
Minimum Toxic Concentration (MTC):
- Definition: The lowest concentration of a drug that produces unwanted or adverse effects.
Therapeutic Range:
- Definition: The optimal range between MTC and MEC that varies between patients.
Steady State:
- Definition: When the drug concentration remains within the therapeutic range consistently.
Graphical Representation: A dose-response curve illustrating these concepts.

Drug Classes:
- Anti-Analgesics: Pain Relief
- Antiepileptics: Used for seizure control
- Antibiotics: Used to treat bacterial infections
- Psychotropics: Used to treat mental health conditions
- Antineoplastics: Used in cancer treatment
- Heavy Metals: Including drugs with toxic constituents.
Examples of Drugs by Class:
- Salicylates
- Phenobarbital, Methotrexate
- Digoxin (Cardiac Glycosides)
- Caffeine, Psychoactive Drugs (e.g., Lithium)

Categories of Toxins:
- Gases: e.g., Carbon Monoxide (CO), Cyanide (CN-).
- Heavy Metals: e.g., Lead (Pb).
- Volatile Substances: e.g., Alcohols.
- Pesticides and Non-Volatile Drugs of Abuse: e.g., Cannabinoids.

Carbon Monoxide:
- Description: Odorless, tasteless gas from combustion sources.
- Exposure Route: Primarily inhalation.
- Mechanism of Action: Hemoglobin has 200x affinity for CO over O2, leading to hypoxia.
- Clinical Significance: Hypoxia can lead to severe symptoms including bright cherry-red skin.
Cyanide:
- Description: Insecticides and rodenticides; lethal dose can inhibit cellular respiration.
- Mechanism of Action: Binds to cytochrome oxidase complex, causing ATP deficiency.

Ethanol:
- Common use: Alcoholic beverage, toxic at high levels.
- Metabolism: Converted to acetaldehyde and acetic acid by liver enzymes.
- Clinical Effect: Acute exposure can lead to coma/death, chronic exposure leads to liver disease.
Methanol:
- Usage: Topical disinfectant; potentially lethal when ingested.
- Mechanism of Action: Converted to formaldehyde and formic acid, which are highly toxic.

Lead:
- Source: Lead-based paints, inhalation from leaded gases.
- Mechanism of Action: Inhibits heme synthesis, causing neurobehavioral issues.
- Clinical Significance: Behavioral changes, systemic symptoms, chronic exposure may lead to CNS damage.

Definition: Substances used to eliminate pests.
Mechanism of Action: Inhibit acetylcholinesterase, affecting the neurotransmission process.
Clinical Measurement: Analysis of acetylcholinesterase levels to diagnose poisoning.

Stimulants: e.g., Amphetamines, Anabolic Steroids.
- Measurement Methods: Immunoassays, HPLC.
Cocaine:
- Mechanism & Effects: Euphoria and potential cardiotoxic effects.
Hallucinogens: Includes PCP and LSD, used medically and recreationally; can cause severe reactions.
- Analytical Methods: Immunoassay, GC-MS confirmation.

Salicylates and Acetaminophen:
- Testing Protocols: Specific methods for measuring toxicity in the clinical setting, detailing side effects and organ impact.

Overview: Used to detect, diagnose, and monitor tumors, including assessing prognosis and potential recurrence.
Characteristics of Ideal Tumor Markers:
1. Specificity: Only produced in malignancy.
2. Sensitivity: Capable of detecting smallest tumors.
3. Quantity Correlation: Directly related to tumor size/load.
4. Short Half-Life: Levels drop quickly upon treatment.

Enzymes, Hormones, Serum Proteins, Genetic Markers:
- Common Tumor Markers: CEA, PSA, AFP, CA 15-3.
- Utility in Cancer Detection and Monitoring: Essential for effective management and early detection of malignancies.

Stages of Clinical Research: Identifying problems, literature review, hypothesis creation, sample definition, data collection, data analysis, conclusion formulating.
Statistical Approaches: Descriptive vs. Inferential statistics and their applications in drawing conclusions from research data.

Reliability: Consistency in measures over time.
Validity: Accuracy of what is being measured.
Generalizability: Applicability of findings to a wider population beyond the study sample.

Descriptive Statistics and Experimental Approaches: Analyses that encompass observational, mechanistic, therapeutic, and large-scale trials to ascertain treatment effects and disease understanding.