Basic Pharmacokinetics Flashcards

1
Q

What is Pharmacokinetics ?

A

Pharmacokinetics is what the body does to a drug

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2
Q

What is volume of distribution ( V )

A

Volume of fluid in which total amount of drug in body would need to be distributed to give a concentration equal to the concentration measured in plasma

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3
Q

What does the one compartment model show ?

A

The one-compartment open model is the simplest way to describe the process of drug distribution and elimination in the body. This model assumes that the drug can enter or leave the body (ie, the model is “open”), and the entire body acts like a single, uniform compartment. The simplest route of drug administration from a modelling perspective is a rapid intravenous injection (IV bolus). The simplest pharmacokinetic model that describes drug disposition in the body is the IV bolus model where the drug is injected all at once into a box (the human body) or compartment, and the drug distributes/equilibrates instantaneously and rapidly throughout the compartment. Drug elimination from the compartment also begins to occur immediately after the IV bolus injection.

Refer to BASIC PK 1 PPT

Volume of compartment = Dose / concentration of drug

V = D/C

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4
Q

Magnitude of V

A

The magnitude of v depends on the drug in plasma vs the drug in tissue .

A small V - more drug in plasma - shows that its more water soluble - plasma protein binding - larger Relative molecular mass meaning its harder for it to pass through the capillaries

A larger V = drug is held more in the tissue - binding to tissue proteins - smaller RMM which shows that it is easier for a drug to pass through the capillaries

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5
Q

What does V tell us ?

A

Where the drug is distributed in the body

the physiochemical properties of the drug

The amount of drug in the body at a particular time, if the conc of the drug is sampled

Calculation of loading dose of a drug

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6
Q

Patient factors which can be affecting V

A

Liver, renal or cardiac impairment

Reduced blood perfusion to tissues

Changes in plasma protein binding

Old age

Pregnancy

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7
Q

What is Loading Dose ?

A

Loading dose is when a higher dose of a drug is given so that therapeutic effects are achieved faster.

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8
Q

When might a LD be given ?

A

If the drug has a long elimination half life

in acute conditions

in life threatening arrythmias

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9
Q

Calculating Loading Dose

A

LD = DESIRED C X V
/ S X F

If the patient already received the drug

Incremental LD =
(DESIRED C - MEASURED C ) X V
/ S X F

S = SALT FACTOR OF THE DRUG
F = BIOAVAILABILITY

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10
Q

What is the elimination rate constant K ?

A

Ct = Co - Kt (Refer to BK2 ppt )

K is fraction of drug dose eliminated from compartment per unit time

Amount of drug eliminated decreases as plasma concentration decreases

But fraction of drug eliminated is constant

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11
Q

What is the clinical importance of K ?

A

Larger K means faster rate of drug elimination from body

Drugs with rapid elimination have a short duration of effect after a single dose

Drugs eliminated more rapidly would need to be given more frequently

Drugs eliminated more slowly should be given less frequently

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12
Q

What is half life (T 1/2 )

A

Half life is the time taken for plasma drug conc to fall by half of what it was at beginning of measurement period.

It is another index rate of drug elim along with K

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13
Q

Calculation of half life

A

A drugs half life is determined by its clearance and volume of distribution

CL=KV

REFER TO BK 2 PPT

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14
Q

What is the steady state ?

A

Rate or drug going in = rate of drug going out

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15
Q

Time to steady state

A

time to steady state varies from drug to drug

High K - short half life - steady state reached quicker than lower K and longer half life

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16
Q

Factors affecting half life ?

A

Volume of distribution
Large v = little drug in plasma = longer half life

Small V - most of drug in plasma = shorter half life

Clearance
High clearance = shorter half life
Lower clearance = Longer half life

Disease can decrease both v and cl

Hepatic or renal failure reduces drug clearance

17
Q

PPI’S

A

Have a short elimination half life about 1 hr which indicates they are fast acting. effects of PPI last about 24 hrs

PPIS take 2-3 days to achieve steady state inhibition of acid secretion

increasing dose doesn’t have much further effect once optimal is reached

increasing fq of administration increases effect to 80% inhibition as opposed to 66% of maximal acid output.

18
Q

What does the area under the curve represent ?

A

measures how much and for how long a drug stays in the body

can be used to determine pharmacokinetic parameters such as clearance

19
Q

How do you calculate AUC ?

A

AUC = Co / K

Refer to BK 3 PPT

20
Q

What is bioavailability ?

A

Bioavailability is the fraction of dose reaching the systemic circulation in a chemically unaltered form.

21
Q

What is clearance ?

A

Removal of drug from a volume of plasma in a given unit of time

22
Q

Calculations for rate of elimination.

A

ROE = CL X C
ROE = K X A
AND C = A / V

THEREFORE CL = K X V

23
Q

Clinical importance of CL

A

Decrease in drug clearance means slower rate of elimination

Dosage adjustment may be required in eliminating organ dysfunction

24
Q

How to calculate Creatinine clearance

A

Refer to BK 4 PPT

25
Q

Creatinine clearance bandings

A

50-20 ml/min = mild

20-10 ml/min = moderate

Less than 10ml / min = severe

Decrease in kidney function results in lower creatinine clearance

26
Q

Dosage adjustments in renal impairment

A

Loading dose

Maintenance dose

If half life is prolonged then time to steady state will also be increased

27
Q

What is hepatic clearance ?

A

Fraction of drug removed from blood during one pass through the liver

28
Q

Calculation of hepatic extraction rate

A

refer to bk 4 ppt

29
Q

How can liver impairment be assessed ?

A

Liver function tests
ALT and AST levels
Alkaline phosphatase
clotting studies
dosage adjustment

30
Q

Calculations of multiple dosing and constant I.V infusions

A

Refer to BK 4 ppt