Pharmacologic principles for combination therapy

Myron Lee Toews, David B. Bylund

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

This article discusses the pharmacologic basis for understanding the therapeutic actions of drugs, particularly for their use in combinations. The focus is on principles underlying combination therapy in general, including examples from diseases other than chronic obstructive pulmonary disease (COPD). Pharmacodynamic aspects of drug action are covered, with an emphasis on recent advances in the understanding of drug-receptor interactions and of drug agonism. Pharmacokinetics and drug-induced adaptive changes in receptors and cell signaling pathways are summarized, emphasizing their importance for potential combination therapies aimed at prolonging drug action. An organizational framework for three different approaches to combination therapy is then proposed; the molecular rationales for each approach are described together with classic examples from other diseases, and then their application to combination therapy in COPD is discussed. Finally, terminology for the independent and interactive effects of drug combinations is discussed, and approaches to the quantitative analysis and visual display of the effects of drug combinations are introduced. The basic principles reviewed here provide the pharmacologic foundation for subsequent articles in this issue that address the combinations in current use for COPD, and they point to novel strategies for potential future approaches to combination therapy in COPD.

Original languageEnglish (US)
Pages (from-to)282-289
Number of pages8
JournalProceedings of the American Thoracic Society
Volume2
Issue number4
DOIs
StatePublished - Nov 14 2005

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Chronic Obstructive Pulmonary Disease
Drug Agonism
Drug Combinations
Pharmaceutical Preparations
Therapeutics
Drug Receptors
Drug Interactions
Terminology
Pharmacokinetics

Keywords

  • Desensitization
  • Dose-response curves
  • Drug-receptor interactions
  • Pharmacodynamics
  • Pharmacokinetics
  • Synergism

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Pharmacologic principles for combination therapy. / Toews, Myron Lee; Bylund, David B.

In: Proceedings of the American Thoracic Society, Vol. 2, No. 4, 14.11.2005, p. 282-289.

Research output: Contribution to journalArticle

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