Pharmacodynamic models

Pharmacodynamic models mathematically relate a drug s pharmacological effect to its concentration at the effect site. Examples of the types of pharmacodynamic models that have been employed include the fixed-effect model/ maximum-effect models (Emax and sigmoid Emax)/ and linear and log-linear models (11). Unlike pharmacokinetic modelS/ pharmacodynamic models are time independent. However these models can be linked to pharmacokinetic modelS/ as discussed in Chapter 19. 

The concept of a direct and rapidly reversible pharmacological response implies that the intensity of response is directly associated with the drug concentration at the site of action. In this category, two models (pharmacodynamic and pharmacokinetic-pharmacodynamic) are discussed. 

Drug Experimental model Pharmacodynamic response Direction of stereoselectivity (eudismic ratio) Ref. 

Pharmacokinetics. Figure 2 Sigmoid Emax model of pharmacodynamics with Hill coefficient (H), concentration producing half-maximum effect (CE50), threshold concentration (CE05), and ceiling concentration (CE95). 

In-vitro models can provide preliminary insights into some pharmacodynamic aspects. For example, cultured Caco 2 cell lines (derived from a human colorectal carcinoma) may be used to simulate intestinal absorption behaviour, while cultured hepatic cell lines are available for metabolic studies. However, a comprehensive understanding of the pharmacokinetic effects vfill require the use of in-vivo animal studies, where the drug levels in various tissues can be measured after different dosages and time intervals. Radioactively labelled drugs (carbon-14) may be used to facilitate detection. Animal model studies of human biopharmaceutical products may be compromised by immune responses that would not be expected when actually treating human subjects. 

Physiologically Based Pharmacokinetic (PBPK)/Pharmacodynamic (PD) Models... 

Physiologically Based Pharmacodynamic (PBPD) Model—A type of physiologically-based dose-response model which quantitatively describes the relationship between target tissue dose and toxic end points. These models advance the importance of physiologically based models in that they clearly describe the biological effect (response) produced by the system following exposure to an exogenous substance. 

Hurwitz SJ, Schinazi RF (2002) Development of a pharmacodynamic model for HIV treatment with nucleoside reverse transcriptase and protease inhibitors. Antiviral Res 56 115-127 Hurwitz SJ, Tennant BC, Korba BE, Gerin JL, Schinazi RF (1998) Pharmacodynamics of (—)-beta-2, 3 -dideoxy-3 -thiacytidine in chronically virus-infected woodchucks compared to its pharmacodynamics in humans, Antimicrob Agents Chemother 42 2804-2809 Hurwitz SJ, Otto MJ, Schinazi RF (2005) Comparative pharmacokinetics of Racivir, (+/-)-beta-2, 3 -dideoxy-5-fluoro-3 -thiacytidine in rats, rabbits, dogs, monkeys and HIV-infected humans, Antivir Chem Chemother 16 117-127... 

Jen J, Laughlin M, Chung C, Heft S, Affrime MB, Gupta SK, Glue P, Hajian G (2002) Ribavirin dosing in chronic hepatitis C application of population pharmacokinetic-pharmacodynamic models, Clin Pharmacol Ther 72 349-361... 

Sheiner LB, Steimer JL. Pharmacokinetic/pharmacodynamic modeling in drug development. Annu Rev Pharmacol Toxicol 2000 40 67-95. 

Gieschke R, Reigner BG, Steimer JL. Exploring clinical study design by computer simulation based on pharmacokinetic/pharmacodynamic modelling. Int J Clin Pharmacol Ther 1997 35 469-74. 

What are called physiologically based pharmacokinetic (PBPK) and pharmacodynamic (PBPD) models are more mechanistically complex and often include more compartments, more parameters, and more detailed expressions of rates and fluxes and contain more mechanistic representation. This type of model is reviewed in more detail in Section 22.5. Here, we merely classify such models and note several characteristics. PBPK models have more parameters, are more mechanistic, can exploit a wider range of data, often represent the whole body, and can be used both to describe and interpolate as well as to predict and extrapolate. Complexity of such models ranges from moderate to high. They typically contain 10 or more compartments, and can range to hundreds. The increase in the number of flux relationships between compartments and the related parameters is often more than proportional to compartment count. 

Schaddelee MP, Collins SD, DeJongh J, de Boer AG, Ijzerman AP, Danhof M. Pharmacokinetic/pharmacodynamic modelling of the anti-hyperalgesic and antinociceptive effect of adenosine A1 receptor partial agonists in neuropathic pain. Eur J Pharmacol 2005 May 9 514(2-3) 131-40. 

Duffal SB, Kimko HC (eds). Simulation for designing clinical trials a pharmacokinetic-pharmacodynamic modeling perspective (Drugs and the pharmaceutical sciences, Vol 127). New York Marcel Dekker, 2003... 

Mandema JW, Stanski DR. Population pharmacodynamic model for ketorolac analgesia. Clin Pharmacol Ther 1996 Dec 60(6) 619-35. 

The consequence of moving consciously toward this model will be the provision of a robust and scalable IT infrastructure and systems able to cope with exponentially growing data mountains that will need to be integrated and shared, accessed and mined in the most effective way. It will also require formidable computing power and sophisticated algorithms to be able to simulate both organs and whole body systems to reduce expensive failures in the clinic and predict much earlier the pharmacokinetic and pharmacodynamic properties and toxicological and efficacy profiles of molecules in pharmaceu-... 

Pharmacokinetics is closely related to pharmacodynamics, which is a recent development of great importance to the design of medicines. The former attempts to model and predict the amount of substance that can be expected at the target site at a certain time after administration. The latter studies the relationship between the amount delivered and the observable effect that follows. In some cases the observable effect can be related directly to the amount of drug delivered at the target site [2]. In many cases, however, this relationship is highly complex and requires extensive modeling and calculation. In this text we will mainly focus on the subject of pharmacokinetics which can be approached from two sides. The first approach is the classical one and is based on so-called compartmental models. It requires certain assumptions which will be explained later on. The second one is non-compartmental and avoids the assumptions of compartmental analysis. 

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