How does Congestive Heart Failure Alter Response to Drugs?

Abstract

The process whereby administration of a drug results in pharmacologic effect depends on two major sets of variables: pharmacokinetic and pharmacodynamic factors. Pharmacokinetics refers to the relationship between dose of a drug and resultant drug concentrations (parent or metabolite; plasma or tissue). Methods to study the impact of variables such as age, disease state, or concomitant drug administration on plasma pharmacokinetics of drugs and metabolites have been fairly well worked out. It is convenient to think of pharmacodynamics as the relationship between drug concentration and effect. Although it is widely recognized that drug effects may vary among patients despite equivalent drug concentrations, methods for quantifying these pharmacodynamic differences are generally unavailable, so quantification of interindividual variability in drug “sensitivity” remains largely descriptive.