Drug antagonism

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Overview of drug antagonism in pharmacology


Drug Antagonism[edit | edit source]

Hormone receptor binding

Drug antagonism refers to the interaction between two or more drugs that leads to a reduction in the effectiveness of one or more of the drugs. This phenomenon is an important consideration in pharmacology and medicine, as it can impact the therapeutic outcomes of drug treatments.

Types of Drug Antagonism[edit | edit source]

Drug antagonism can be classified into several types based on the mechanism by which the antagonism occurs:

Competitive Antagonism[edit | edit source]

In competitive antagonism, an antagonist competes with an agonist for binding to the same receptor site. This type of antagonism can be overcome by increasing the concentration of the agonist. A classic example is the competition between histamine and H1 antihistamines at the histamine H1 receptor.

Histamine structure
H1 antihistamine structure

Non-competitive Antagonism[edit | edit source]

Non-competitive antagonism occurs when an antagonist binds to a site other than the agonist's binding site, causing a change in the receptor that reduces the effect of the agonist. This type of antagonism cannot be overcome by simply increasing the concentration of the agonist.

Uncompetitive Antagonism[edit | edit source]

Uncompetitive antagonism involves the antagonist binding only to the receptor-agonist complex, preventing the complex from producing a response. This type of antagonism is rare in pharmacology.

Allosteric Antagonism[edit | edit source]

Allosteric inhibition

Allosteric antagonism occurs when an antagonist binds to a different site on the receptor than the agonist, causing a conformational change that reduces the receptor's activity. This can modulate the effect of the agonist without directly blocking the agonist's binding site.

Chemical Antagonism[edit | edit source]

Chemical antagonism involves a direct chemical interaction between the antagonist and the agonist, leading to the inactivation of the agonist. An example is the use of dimercaprol to chelate heavy metals, reducing their toxicity.

Dimercaprol chelation
Meso-2,3-dimercaptosuccinic acid

Physiological Antagonism[edit | edit source]

Physiological antagonism occurs when two drugs produce opposite effects on the same physiological function. For example, the effects of epinephrine and acetylcholine on heart rate are physiologically antagonistic.

Clinical Implications[edit | edit source]

Understanding drug antagonism is crucial in clinical settings to avoid adverse drug interactions and to optimize therapeutic regimens. Clinicians must consider potential antagonistic interactions when prescribing medications, especially in patients taking multiple drugs.

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Contributors: Prab R. Tumpati, MD