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Presented by Dr. Sannithi Nagarjuna

Coordinator for RIPER-GPAT Cell, Hyderabad Academy & Online GPAT Academy 7899107907

9885784793 [email protected] It is a branch of deals with the study of , pharmacological actions and uses of .

(What the does to the body)

(OR)

It is defined as the response of the body to the drug. It refers to the relationship between drug concentration at the site of action and resulting effect.

(OR)

It is the study of biochemical, physiological and molecular effects of drugs on the body. Most of the drugs produce their mechanism of action by binding to the receptors. DEFINITIONS

1. RECEPTORS → defined as specific binding sites for drug

molecules/ ligands and chemically they are protein in nature.

All receptors are proteins but all proteins are not receptors.

2. → defined as a substance that selectively attaches to

the receptors, activates the receptors and produces maximum

pharmacological action.

Both receptors and ligand are highly specific. Receptors Ligand

Muscarinic and Nicotinic Acetylcholine receptors ()

Adrenergic receptors Noradrenaline

Histamine receptors Histamine

Dopamine receptors Dopamine

5-HT receptors 5-HT (Serotonin)

GABA receptors GABA 3. AFFINITY → ability of an agent to bind with the receptors

4. ( )→ ability of an agent to activate the receptors and produces pharmacological action 5. : Affinity + Maximum Intrinsic activity (IA= + 1)

Agonist and ligand both are same, the only difference is agonist is exogenous and ligand is endogenous. Agonist produces actions similar to ligand or Agonist increases the actions of ligand

6. ANTAGONIST: Affinity + No Intrinsic activity (IA= 0)

Antagonist blocks or stops the actions of ligand hence it is otherwise called as blocker. Source : Google Source : Google Ligand Agonist Antagonist

Acetylcholine Carbachol,

Bethanechol

Noradrenaline Dobutamine

Histamine 2-methyl histamine TYPES OF RECEPTORS

❖ Receptors will not exist as alone and they are always present in attached manner

(Coupled manner)

❖ Based upon the coupled substance receptors are classified into 4 types 1. G-Protein Coupled Receptors ( Receptors coupled to G-Protein )

2. Ionotropic receptors ( Receptors coupled to Ion channels )

3. linked receptors ( Receptors coupled to )

4. Nuclear receptors ( Receptors coupled to nucleus) G-Protein Coupled Receptors ( Receptors coupled to G-Protein )

❖ Receptors located across/on/within the cell

membrane

❖ Hence called as transcellular receptors

❖ Here there are two parts one is G-protein and

another one is Receptor consist of

7 transcellular helical structures

3 loops

-NH2 group present on extracellular side

-COOH group present on intracellular side

G-protein is trimeric in nature consist of 3 subunits called as α, β, and γ and these three subunits attached to GDP. binding of ligand with the receptors

GDP replaces with GTP

G-Protein dissociated into 2 complexes

GTP α β γ

Interacts with the pathways

Release of substances called as secondary messengers

Produces pharmacological actions Source : Google Source : Google PATHWAYS

1. ADENYL CYCLASE PATHWAY

ATP ------→ cAMP ------→ Inactive

❖ cAMP acts as a second messenger

❖ Enzyme Phosphodiesterase involved in the inactivation of cAMP Source : Google ACTIONS OF CAMP In cardiac muscle/Heart -- Increases force of contraction, Increases cardiac output, Increases blood pressure, Increases heart rate.

In smooth muscles (GIT, Bronchi, Uterus) – Smooth muscle relaxation

In Liver – Glycogenolysis

In adipose tissue Lipolysis

In Platelets Decreases platelet aggregation 2. PHOSPHOLIPASE PATHWAY

Stimulation of this pathway results in the breakdown of phospholipids.

Cell membrane phospholipids upon breakdown will release Inositol-1,4,5- triphosphate (IP3)and Diacylglycerol (DAG) which act as second messengers.

IP3 & DAG always produce stimulation. ACTIONS OF IP3 AND DAG

Location Action

Cardiac muscles Contraction

Smooth muscles Contraction

Skeletal muscles Contraction

Glands Increase in secretions

CNS CNS Stimulation GS → Increased levels of cAMP

Gi → Decreased levels of cAMP

Gq → Increased levels of IP3 and DAG EXAMPLES: 1.Muscarinic receptors (M1- M5)

2. receptors (α1- α2 & β1- β3)

3.Histamine receptors (H1-H3)

4.Dopamine receptors (D1-D5)

5.5-HT receptors (5-HT1 to 5-HT 7 except 5-HT 3)

6.Opiod receptors

7.GABAB receptors MUSCARINIC RECEPTORS(M1 - M5)

Gq Gi

M1 M2

M3 M4

M5 Type of Second Location Pharmacological actions receptor Messenger

M1 Gq ❖ Gastric Parietal Cells

❖ Ciliary Muscles of Iris

M3 Gq ❖ Smooth muscles like Bronchi, Uterus, GIT

❖ Glands like sweat glands, salivary glands & lacrimal glands

M5 Gq CNS Type of Second Location Pharmacological actions receptor Messenger

M1 Gq ❖ Gastric Parietal Cells ❖ Increase in acid secretion

❖ Ciliary Muscles of Iris ❖ Contraction of Ciliary Muscles of Iris (Miosis)

M3 Gq ❖ Smooth muscles like ❖ Smooth muscle contraction like Bronchi, Uterus, GIT Bronchoconstriction, Uterus constriction, Contraction of GIT, Increase in motility of GIT

❖ Glands like sweat ❖ Increase in secretions glands, salivary glands like sweating, salivation and & lacrimal glands lacrimation

M5 Gq CNS ❖ CNS stimulation Type of Second Location Pharmacological receptor Messenger actions

M2 Gi Heart

M4 Gi CNS Type of receptor Second Location Pharmacological Messenger actions

Decrease in M2 Gi Heart force of contraction, Decrease in cardiac output, Decrease in blood pressure, Decrease in heart rate

No action M4 Gi CNS Source: Google PHARMACOLOGICAL ACTIONS OF ACETYLCHOLINE

Location Pharmacological actions Heart Decrease in force of contraction, Decrease in cardiac output, Decrease in blood pressure, Decrease in heart rate Smooth muscles like Smooth muscle contraction like Bronchoconstriction, Bronchi, Uterus, GIT Uterus constriction, Contraction of GIT, Increase in motility of GIT Gastric Parietal Cells Increase in acid secretion

Ciliary Muscles of Iris Contraction of Ciliary Muscles of Iris (Miosis)

Glands like sweat glands, salivary Increase in secretions like sweating, glands & lacrimal glands salivation and lacrimation

CNS CNS stimulation ADRENERGIC RECEPTORS {α1 – α2 & β1- β3}

Gq Gi GS

α1 α2 β1

β2

β3 Type of Second Location Pharmacological actions receptor Messenger

α1 Gq ❖ Blood vessels

α2 Gi ❖ CNS Type of Second Location Pharmacological actions receptor Messenger

Vasoconstriction, α1 Gq ❖ Blood vessels increase in blood pressure

No Action α2 Gi ❖ CNS Type of Second Location Pharmacological actions receptor Messenger

β1 GS ❖ Heart

β2 GS ❖ Smooth muscles ❖ Bronchi ❖ Liver

β3 GS ❖ Adipose tissue Type of Second Location Pharmacological actions receptor Messenger

Increase in force of β1 GS ❖ Heart contraction, Increase in cardiac output, Increase in blood pressure, Increase in heart rate

❖ Smooth muscle β2 GS ❖ Smooth muscles relaxation ❖ Bronchi ❖ Bronchodilation ❖ Liver ❖ Glycogenolysis

β3 GS ❖ Adipose tissue ❖ Lipolysis PHARMACOLOGICAL ACTIONS OF NORADRENALINE

Location Pharmacological actions Heart Increase in force of contraction, Increase in cardiac output, Increase in blood pressure, Increase in heart rate

Smooth muscles Smooth muscle relaxation

Bronchi Bronchodilation

Blood vessels Vasoconstriction, increase in blood pressure

Metabolic effects Glycogenolysis & Lipolysis IONOTROPIC RECEPTORS (RECEPTORS COUPLED TO ION CHANNELS )

❖ Receptors coupled to ion channels

❖ Receptors located across/on/within the cell membrane

❖ These are also transcellular receptors

❖ Also called as ligand gated ion channels Ligand binds to the receptors

Opening of ion channelsO will take place p

Result in either influx or efflux of ions depending upon concentration gradient

Result in pharmacological actions which may be stimulation or inhibition Source : Google Sodium, Calcium & Chloride ions present extracellularly so when these ion channels get opened that result in influx of ions.

Potassium ions present intracellularly so when these ion channels get opened that result in efflux of ions. Ligand binds to the receptors → Sodium channels → Influx of sodium ions→

Ligand binds to the receptors → Calcium channels → Influx of Calcium ions→

Ligand binds to the receptors → Chloride channels → Influx of chloride ions→

Ligand binds to the receptors → Potassium channels → Efflux of potassium ions → Ligand binds to the receptors →Sodium channels → Influx of sodium ions→ Stimulation

Ligand binds to the receptors → Calcium channels → Influx of Calcium ions→ Stimulation

Ligand binds to the receptors → Chloride channels → Influx of chloride ions→ Inhibition

Ligand binds to the receptors → Potassium channels → Efflux of potassium ions →Inhibition Location Stimulation Inhibition Contraction, Relaxation, Cardiac Increase in force of Decrease in force of contraction, contraction, muscle/Heart Increase in cardiac Decrease in cardiac output, output, Increase in blood Decrease in blood pressure, pressure, Increase in heart rate Decrease in heart rate

Smooth muscles Contraction Relaxation

Skeletal muscles Contraction Relaxation

Glands Increase in secretions Decrease in secretions

CNS CNS Stimulation CNS depression EXAMPLES:

1. Nicotinic receptors (NM & NN receptors)

2. 5-HT3 receptors

3. GABAA receptors

4. NMDA receptors Type of Type of ion Location Pharmacological actions receptor channel attached

NM Sodium ❖ Skeletal muscles

NN Sodium ❖ Autonomic ganglia

5-HT3 Sodium ❖ CTZ

GABAA Chloride ❖ CNS

NMDA Calcium ❖ CNS Type of Type of ion Location Pharmacological actions receptor channel attached Skeletal muscle contraction NM Sodium ❖ Skeletal muscles

Ganglionic stimulation NN Sodium ❖ Autonomic ganglia

Nausea and vomiting 5-HT3 Sodium ❖ CTZ

CNS depression GABAA Chloride ❖ CNS

NMDA Calcium ❖ CNS CNS stimulation Type of Pharmacological Category Therapeutic receptor actions Uses

NM Skeletal muscle Skeletal NM receptor contraction Muscle blockers relaxants

NN Ganglionic stimulation Ganglionic NN receptor blockers blockers

5-HT3 Nausea and vomiting Antiemetics 5-HT3 antagonists

GABAA CNS depression CNS GABAA depressants receptor

NMDA CNS stimulation CNS NMDA depressants receptor blockers ENZYME LINKED RECEPTORS

(RECEPTORS COUPLED TO ENZYMES)

❖ Receptors coupled to enzymes

❖ Receptors located across/on/within the cell

membrane

❖ These are also transcellular receptors Ligand binds to the receptors

Enzymes automatically undergo phosphorylation (Autophosphorylation)

Responsible for mediating the pharmacological actions Most of the enzymatic receptors are coupled to the enzyme

Tyrosine Kinase EXAMPLES:

1. Insulin receptors (Tyrosine Kinase)

2. Epidermal growth factor receptors (Tyrosine Kinase)

3. Natriuretic peptide receptors (Guanyl cyclase) NUCLEAR RECEPTORS ( RECEPTORS COUPLED TO NUCLEUS)

❖ Receptors coupled directly to nucleus

❖ Receptors located inside the cell

❖ These are also called as intracellular receptors

❖ Otherwise called as steroidal receptors Ligand binds to the receptors

Direct change in gene expression

Synthesis of specific mRNA

Synthesis of specific proteins

Responsible for mediating pharmacological actions Source: Google EXAMPLES:

1. receptors

2. Mineralocorticoid receptors (Aldosterone receptors)

3. Estrogen receptors

4. Progesterone receptors

5. Androgen receptors (Testosterone receptors)

6. Vitamin A & Vitamin D receptors

7. Thyroid receptors Source: Google Source : Google SIGNAL TRANSDUCTION

Ligand after binding to the receptors a sequence of events/steps taking place in order to produce pharmacological actions. Fastest acting receptors

Most intensifying action observed in case of Fastest acting receptors Ionotropic receptors

Most intensifying action Nuclear receptors observed in case of Transcellular Intracellular receptors receptors

Ligand binding site

Reactions

Examples Transcellular Intracellular receptors receptors

Ligand binding site Extracellular Intracellular

Reactions Intracellular Intracellular

Examples GPCR, Ionotropic Nuclear receptors receptors, Enzyme linked receptors Presented by Dr. Sannithi Nagarjuna

Coordinator for RIPER-GPAT Cell, Hyderabad Academy & Online GPAT Academy 7899107907

9885784793 [email protected]