Bench to Bedside Flashcards

(133 cards)

1
Q

What are biomolecular (biologic) drugs?

A

Large biological molecules that have some therapeutic effect (mw>2KD)

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2
Q

What are the advantages of using biologics?

A

Large SA good for binding
Exquisite specifity- stronger/specific binding then small molecule techniques

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3
Q

What are the disadvantages of using biologics?

A

Not accessible by chemical synthesis
Not membrane permeable
Antigenic

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4
Q

Give 3 examples of biologics:

A

Insulin
mAbs
Erthroporetin

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5
Q

How are mAbs manufactured and what are the disadvantages of this?

A

In a unique living cell line, similar but not identical copies can be made
Difficult to fully characterise
Higher potential for immunogenicity

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6
Q

Describe recombinant production of therapeutic protein and give another name for it:

A

Heterologous expression of recombinant proteins
Introduction of a gene or cDNA coding for a protein of interest into a suitable producer organism
Heterologous because the protein of interest doesn’t occur naturally in the cell

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7
Q

What are the main steps in protein production by recombinant DNA technology?

A

Identification- amplification and isolation of the target gene
Introduction- of the vector into a host cell
Growth of the cell in vitro
Identification of cells containing the target protein
Isolation of purification of the target protein

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8
Q

What is the advantages of protein production by recombinant DNA technology?

A

Cleaner and efficient

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9
Q

Give examples of some suitable host organisms:

A

Microorganisms (Ecoli)
Yeast (S Cerevisiae)
Animal cell lines

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10
Q

What are the advantages of Ecoli being a host?

A

Molecular biology well characterised (well understood)
High expression levels of heterologous proteins are possible
Quick and cheap
Possible to scale up to large fermentation culture

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11
Q

What are the disatvantages of Ecoli being a host?

A

Heterologous proteins are intracellular (need to lyse cell and purify)
Inability to undertake post translational modifications (PTM)
Presence of LPS on E coli surface (pyrogenic)
Formation of inclusion bodies (insoluble aggregates of partially soluble heterologous proteins)

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12
Q

What is post translational modification (PTM) and give a major example?

A

Any covalent modification of peptide sequence that occurs after the peptide chain has been synthesised
Glycosylation

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13
Q

Describe what glycosylation is important for and its effects?

A

Is an important part of eukaryotic protein production, especially extracellular and cell surface proteins (glycocalyx)
Some proteins are unaffected by removal of glycosylated groups
IgG has one glycosylation site that strongly affects biological activity

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14
Q

What affect can glycosylation have for some proteins?

A

Increase solubility
Alter biological half life and activity

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15
Q

What are the 2 types of glycosolation?

A

N- linked glycosylation (most common)
O-linked glycosylation

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16
Q

Describe the steps in N-linked glycosylation:

A

Starts with a transfer of 14-merogliosaccharide donor to protein as it emerges from rough ER
Ogliosaccharide is anchored in ER membrane by dolichol by high energy phosphate bond
Transfer reaction is catalysed by oligosaccharyl transferase

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17
Q

Which sites can transfer occur in N-linked glycosylation?

A

Asn (N)-xxx-Ser/Thr (T/S) OR
Asn-xxx-Ser
Where xxx is any a.a except Pro

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18
Q

What occurs in N- linked glycosylation once the glycosyl chain has been added to peptide?

A

Other enzymes can trim bind off in different patterns, common trimming:
-3 glucose and 1 mannose are later removed in the ER by glucosidases
-Leaves (Man)3(GIcNAc)2 protein
Further saccharides are added and removed according but a core motif is always retained
This is thought to aid protein folding and transport through the cell

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19
Q

Describe O-linked glycosylation:

A

Occurs post-translationally in ER/Golgi (common in mucins)
Ser/Thr residues
Up to 8 different core structures (more differences)

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20
Q

Describe the assembly of ogliosaccharide chains:

A

Glycosylation requires a sugar donor (sugar-nucleotide e.g UDP-glucose) and an acceptor e.g nascent protein or ogliosaccharide
Glycosylation is not template driven
Proceeds according to donor/ enzyme availability

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21
Q

What are glycoforms?

A

Variations in glycosylation patterns

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22
Q

What can different glycoforms of one protein causes differences?

A

Stability
Solubility
Serum half life
Biological activity
Immunogenicity

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23
Q

When wouldn’t it be ideal to use recombinant protein production (using Ecoli)?

A

Prokaryotes do not have the necessary glycosylation machinery
Need to produce proteins for eukaryotes
Need to control production process- maintain consistent glycosylation

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24
Q

What alternative host can be used instead of Ecoli and why?

A

Chinese Hamster Ovary cells (CHO)
They have all the enzymes necessary

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25
Describe the process of hybridoma technology to produce mAbs:
Immunise mouse with specific antigen IS of mouse produces Abs which produce plasma B cells (isolation of these) Plasma cells mixed with immortal myeloma and fused with PEG Cells grown in HAT medium, which only allows fused cells to grow Cells are diluted to one cell per well Fused cells showing high Ab production are expanded and grown in large number for Ab production
26
What are the problems and therefore solution with using hybridoma technologies?
Human anti-mouse antibody (HAMA) response Solution is to use humanised and full human antibodies
27
Describe the large scale process of production of recombinant proteins:
Innoculate a liquid bacterial culture broth (thousands of litres) with bacteria harbouring recombinant gene of interest Grow eukaryotic cells (1000L+) that carry a plasmid coding for the protein of interest
28
Describe the isolation process:
Treatment with chemicals (e.g detergent) or alkaline conditions Sonication/ homogenisation Agitation in the presence of abrasives
29
Describe the types of chromatographic purifaciton:
Affinity chromatography Ion exchange chromatography Gel filtration chromatography
30
How long is a patent for a biologic?
Around 20 years
31
Why can't a biosimilar be generic?
As the new protein has the same sequence but may have different properties e.g different folding
32
What are liposomes?
Composition of primarily phospholipids
33
Describe the method of preparation of liposomes:
Lipid components are added to an organic solvent and freeze dried- forms a lipid cake To make water soluble, lipid cake is added to aq solution Then hydrated and mixed (agitation) with extra water to form large MLV (have multiple lipid bilayers within structure) To get down to individual lipids with single layer, need sonication, extrusion, homogenisation= unilamella
34
Name the different classes of liposomes:
SUV- small unilamella vesicles LUV- large unilamella vesicles MLM- multilamella vesicles
35
Describe SUVs:
Single lipid bilayer enclosing aqueous component 25-100nm diameter
36
Describe LUVs:
100nm-1µm diameter
37
Describe MLMs:
More than 1µm diameter
38
What does it mean that phospholipids are amphiphatic?
They have a polar head and non polar tail
39
What is and describe the packing shape of a phospholipid?
Compare the size of head group to tail group Cone (spherical molecule)= Less than 1/3 Cylinder (planar bilayer)= 1 Truncated cone (vesicles/liposomes)= 1/3-1
40
What is the function of cholesterol addition to phospholipids?
Extended planar group-hydrophobic Occupies tail part of bilayer so decrease permeability (stiffen and rigidify) so increase drug retention inside liposome
41
What is the function of PEGulation of liposomes?
Polyethylene glycol Disguise the liposome- as recognises PEG, stops liposome from coagulating Stops repulsions
42
Describe which drugs can be placed where in a liposome:
Drug characteristics also determine which are suitable for liposomal formulation Drugs with log P less than 1.7 (hydrophilic) can be incorporated into the aq compartment of liposome Drugs with lop P more than 5 will be retained in the lipid bilayer Drugs with intermediate log P ( between 1.7-5) can be difficult to incorporate as they partition between bilayer and compartment can be lost
43
What can be the resolution for drugs that have an intermediate log P that need to go into the liposome?
Use remote drug loading, rather than the older method of mixing drug and lipids
44
Describe active remote drug loading:
Make liposome without drug but include one or both in aq compartment something that gives a gradient-> perforin liposome, with pH, ionic strength, gel within the aq compartment (ammonium sulfate, citrate salts) Drug travels up gradient, and/or forms complex with components of compartments Capture drug and retains in liposome
45
What are the reasons for encapsulation of drugs within liposomes:
ADMET- more than 50% of drug failures For altering the pharmacokinetics and bio-distribution of the drug To function as a drug reservoir (sustained release) For protecting new drugs from attack e.g peptide, nucleotide drugs
46
What are the problems with encapsulation?
Poor solubility- in lipid- comes out near target size Tissue damage on extravasion Rapid breakdown of drug in vivo Unfavourable pharmacokinetics (rapidly cleared)- increase circulation time Poor distribution-only have to deal with pharmacokinetic properties of liposome Lack of selectivity of target tissue
47
How are liposomes used in cancer treatment?
IV- injected liposomes interact with blood opsonins Opsonised liposomes enter the mononuclear phagocytic system (MPS) This results in a build up of drug containing liposomes at these sites, creates an MPS depot, for slow release of drug into circulation, mimicking slow transfusion
48
What is the alternative option when MPS deposition is not beneficial:
Surface modification (e.g PEGylation) creates hydrophilic surfaces that repel opsonins and maintain liposomes in circulation (stealth coating) This enhances opportunities for liposomes to accumulate at pathogenic sites by Enhanced Permeability and Retention (EPR) Remains longer in the blood stream
49
What does the opsonin mediated removal of liposomes depend on?
Opsonin-mediated removal of liposomes depends on liposome size (larger more cell like), lipid composition and surface charge
50
Why would MPS deposition not be beneficial?
Stability, clearance rates and tissue distribution of liposome is now important
51
Describe Myocet as a treatment for cancer:
Doxorubicin (antrhacycline antibiotic, intercalates into DNA strands and block) in egg phosphatidylcholine/ cholesterol liposomes 1st line treatment for metastatic breast cancer
52
Describe the structure and route into the body of Myocet:
LUV liposomes, around 180nm diameter They will be recognised by opsonins- large liposomes without PEG to disguise them, will form MPS depots and slowly release drug into circulation
53
Describe Caelyx (aka Doxil) as a treatment for cancer:
Doxorubicin in liposomes containing PEG2000- distearoyphosphatidy ethanolamine (DSPE) Treatment for advanced ovarian and breast cancer, Kaposi's sarcoma
54
Describe the structure and route into the body of Caelyx:
SUV liposomes, less than 100nm diameter Small PEGylated liposomes can avoid opsonisation and so persist in blood circulation Accumulate in tumours via EPR effect
55
Describe Abraxane as a treatment for cancer:
Albumin bound paclitaxel Used in the treatment of breast cancer and non-small cell lung cancer
56
Describe the structure and route into the body of Abraxane:
Human serum albumin is an endogenous component of the blood (35-50g/L in blood)-non antigenic So using it as a carrier for drug delivery circumvents many issues associated with liposomes No need for PEGylation
57
Describe albumin as a drug carrier:
Capsulates hydrophobic drug- hydrophilic outside, like micelles Can be taken up by GP60 glycoprotein- using body's natural response
58
Describe solid lipid nanoparticles (SLN):
Lipid core matrix comprises exipients such as mono-di and triglycerides, fatty acids and waxes SLN can be produced by different formulation techniques providing reasonably high drug encapsulation Self (nano) emulsifying drug delivery systems
59
Describe the Pfizer/biotech covid vaccination:
Lipid nanoparticle mRNA 70-100nm Ultralow temp as unstable PEGylated lipid, cholesterol
60
Describe the AstraZenca covid vaccination:
Adenoviral vector 80-120nm- exploiting naturally occurring adenovirus Easier to store- longer at a lower temp
61
What are the safety precautions with nanoparticles?
Nanometer dimensions- how it can accumulate Toxicity- composition, surface coating, conc, exposure time Biodegradability Metabolism and excretion
62
Where are renal and hepatic products excreted in?
Renal-> urine Hepatic-> bile (faeces) clearance
63
What is clearance?
Volume of blood plasma which is completely cleared of substance (drug) per unit time
64
What determines whether a substance is cleared renally or hepaticly?
Glomerular filtration-molecules/particles below 6-8nm are efficiently filtered by glomerulus, larger molecules remain in blood MPS takes up larger particles- can retain months/years Surface coatings (PEG/Dextrans) can help avoid opsonisation and MPS uptake If too large for renal clearance and avoiding MPS, hepatic clearance will follow
65
What is passive targeting in a simple liposome?
Not manipulating the body, just allowing it to react A process in which deposition of nano sized systems (1-100nm) within the tumour microenvironment is enhanced due to distinctive characteristics inherent to the tumour mildew, not normally present in healthy tissues
66
What is the goal (benefits) of nano medicine?
Small molecule drugs are poorly targeted and rapidly cleared in urine Few of them reach their target and the rest can accumulate in other tissue, causing SEs (like chemo as doesn't target specific cells) Nanomedicines are larger (not excreted in urine), so are cleared from the body more slowly They can also accumulate at the therapeutic site through targeting methods Less drug is released in other tissues so fewer SEs
67
What is the EPR effect in nanomedicine?
Enhanced Permeation and Retention Taking advantage of blood vessel damage for the drug to get into the cells
68
Describe the EPR effect in normal BVs:
Healthy endothelial cells, barrier to BV so stops blood into tissue Lymphatic system drains waste material from cells Nanoparticles just flow through in blood stream as a strong barrier
69
Describe the EPR effect in tumour BVs:
BV distorted/ degraded- angiogenic endothelial cells is erratic, leaky vasculature Bvs break down and blood goes into tumour tissue So nanoparticles can also enter tumour tissue Enhanced retention in tumour, lymphatic system breaks down so material isn't being drained away and will accumulate their (nanoparticles)
70
Describe the lymphatic system:
One way stream from peripheral tissues to blood Doesn't carry O2 or essential nutrients It absorbs extraverted protein rich fluids, lipids, macromolecules and immunocompetent cells from the interstitial spaces within tissues After resorption from lymphatic capillaries, lymph is transported to larger vessels and flows back into blood stream via the left lymphatic duct (thoracic duct)
71
What is the normal function of the lymphatic vessels?
Maintain plasma volume Prevent increase tissue pressure Permit passage of leukocytes, so proper functioning of IS
72
How specific is EPR?
Provide relatively modest specificity offering 20-30% increase in delivery compared with critical normal organs e.g estimated only 0.7% of injected dose accumulated EPR is highly heterogeneous, changing over time during tumour development and possibly being transient
73
What are clinical barriers of oral drug delivery?
Fed and fasted state variability in drug absorption Inter and intra individual differences in oral bioavailability Differences in gastric emptying time and GI transit time Disease state
74
What are physiochemical (drug related) barriers of oral DD?
Poor aq solubility pH dependent solubility Extensive ionisation at GI pH range Extreme lipophilicity High MW Susceptibility to pH mediated degradation
75
What are the physiological barriers of oral DD?
Mucus barrier Diverse pH range of GIT Rapid gastric emptying Gastric and intestinal motility First pass metabolism Presence of digestive enzymes GI microflora and their secretion
76
What are the biopharmaceutical barriers of oral DD?
Poor drug permeability Pre systemic metabolism in GIT Presence of drug efflux transporters pH and mucosal layer thickness variations in GIT depending on location
77
Describe the role of mucus:
A ubiquitous protective barrier Any wet surface on body has mucus layer Role is to: Protect epithelium against particulate damage and pathogenic attack Lubricates to allow passage of food through GIT etc Hosts commensal bacteria Selectively allows nutrients passage to the epithelium during digestion Poses a barrier to the oral and nasal delivery of drugs
78
What occurs in the absence or excess of mucus?
Absence leads to colitis in GIT, dry eye syndrome in tear film Modification of respiratory mucus in CF leads to inflammation and infection- thickened and over production of mucus
79
What is mucus made from?
Mucins from the mucus layer Water, salts, bile acids, lipids and proteins
80
Describe the structure of mucins:
Are glycoproteins Protein backbone, glycosylated with sugar side chains, O-glycosylation, connected with serine/ threonine Stiff extended polymer structure
81
Where can mucins be excreted?
Can be excreted into mucous (individual long chain polymers) or membrane bound at epithelial surface
82
Where are mucins made?
Made in the ER to Golgi where glycosylated to vesicles to mucus
83
What proteins are in the mucus of the GI?
SI=MUC2 LI=MUC2 +small amounts of 5AC and 6
84
Describe the layer of mucus in the SI:
1 layer of mucus in lumen Bacteria can pass fairly freely Small molecules can pass through mucus layer to the epithelium
85
Describe the layer of mucus in the LI:
Thick mucus layers in lumen, stops bacteria passing through In the LI, no bacteria in inner mucus layer as so dense, protects against diseases
86
Can nanoparticles move through mucus and why/ why not?
Yes, they can move quite freely through mucus Particle diameter below 200nm so can move quite freely
87
Describe the different types of drug permeability across the intestinal mucosa and explain the outcomes:
Need to generate a steep conc (of drug) gradient just outside the point of absorption Need very careful control of release of drug -too fast=drug doesn't reach epithelium -too slow=conc gradient too shallow so drug doesn't cross epithelium
88
What is the estimated ideal time of drug release time across the SI?
Around 2-3 hours Drug needs to cross the mucus barrier
89
Name 2 approaches of drug delivery in terms of moving a drug with mucus and why?
Mucus moves down the GIT so drug has to go with flow -mucoadhesive -mucopenetrant
90
Describe the mucoadhesive drug delivery system:
Drug/carrier adheres to mucus, is carried along GIT, drug released along the way, drug retained for lifetime of mucus transit, but still has to pass through mucus going 'against the flow'
91
Describe the mucopenetrant drug delivery system:
Drug/carrier penetrates through mucous to get to epithelium (against flow), difficult to avoid mucoadhesion Need nano-sized vehicles with 'stealth' coating e.g PEG
92
Name the 5 routes of drug absorption across the mucosa:
1. Transcellular route: passive diffusion 2. Paracellular route: passive diffusion 3. Transcellular route: active transporter utilisation 4. Lipid absorption via micelles/bile salts 5. Particulate absorption via GALT (gut associated lymphatic tissue)
93
Describe the mechanism for the passive trans cellular route:
Entering and leaving cell on basolateral side Passive diffusion (Fick's Law): -high conc on apical side of cell (on epithelium) -low conc inside the cell -molecule diffused into cell and out the other side into blood
94
Describe the type of drugs used in passive the trans cellular route:
Most drug molecules Neutral molecules- unionised LogP-needs to partition into membrane so has to have some degree of lipophilicity
95
What does a parabolic relationship mean?
At some point, LogP (0), the absorption (and biological activity) reaches a max
96
What occurs with a drug if you increase its Log P?
Decrease aq solubility Decreases plasma protein binding Increases binding to non-target sites
97
Describe the relationship between drug size and absorption:
Larger molecules cross cell membranes more slowly than smaller Tight junctions restrict the diffusion of polar molecules Diffusion Coefficients decrease (Stokes-Einstein) Active transporters responsible for fast transport of some polar molecules
98
What are tight junctions?
Two cells next to each other, interacting plasma membranes Essential for structural integrity of GIT epithelium Used for passive paracellular route
99
Describe the mechanism for the passive paracellular route:
Absorption through the tight junctions
100
What pore size are in the different parts of the GIT and what size drugs can be transported through the passive paracellular route?
Calculated as 0.8nm in the jejunum and 0.3nm in the ileum and colon These are calculated at the average size over time so drugs the diameter of less than 1.15nm, can be larger than pore size due to fluctuations
101
Name and describe the drugs used in passive paracellular route:
Small hydrophobic molecules with a diameter of less than 1.15nm E.g Mannitol (0.67nm) PEG (0.53nm) Lactulose (0.95nm)
102
Describe the mechanism of active transport trans cellular route:
Molecule 'piggybacks' into the cell using the cells natural system seasoned for natural substrates such as a.as and vitamins- against the conc gradient
103
Name and describe the substrates used in active transport trans cellular route:
L-dopa and D-cycloserine utilise the a.a transporter ACE inhibitors utilise the oligo (2to3) peptide transporter (PEPT)
104
Where are active transporters located?
Present on apical brush border membrane of intestinal epithelium Generally restricted to specific segments of intestinal mucosa e.g folate transporter, PEPT transporter etc
105
Name drugs that go via the passive transcellular route and their Log P:
Propranolol- 2.6 Testosterone- 3.0 Naproxen-3.3
106
Name drugs that go through the paracellular route and their log P:
Cimetidine- 0.4 Atenolol- 0.2 Both long and thin
107
Name drugs that go through the carrier mediated route and their log P:
Cefalexin- 0.7 Levodopa- -2.4 Captopril- 0.3
108
What does a low and high log P mean?
High log P- above 3= lipophilic Low log P- below 3= hydrophilic
109
Describe the mechanism of lipid absorption via micelles/bile salts:
Bile salts secreted into small intestine to emulsify lipid molecules Lipids then hydrolysed by lipase to give MGs and FAs Formation of mixed micelles of MG, FA and bile salts Lipid molecules absorbed either directly ion micelle or by partition from micelle into the cell
110
Describe the substrates used in lipid absorption via micelles/ bile salts:
Poor water soluble drugs (fat soluble) so lipophilic drugs
111
Describe the mechanism of particulate absorption via GALT:
Endocytosis via M (membranous) cells (which sample contents of intestinal lumen) in the Peyer's Patches of GALT in the SI Subsequent absorption into the lymphatic system Eventual distribution to liver and spleen
112
Describe the substrates used for the particulate absorption via GALT:
Macromolecules Microparticles (<10µm)
113
What are 2 factors in the body which can mitigate against the absorption from the GIT lumen?
P glycoprotein Cyp3A4 (CYP450)
114
How does Cyp3A4 act to stop absorption?
Acts to decrease the amount of drug absorbed through the gut (metabolise to non active form) Stop from passing to basal layer into systemic circulation
115
How does P-gp act to stop absorption?
Efflux transporter protein Acts to remove drug back into the intestinal lumen May also remove drug metabolites from the cell Stop from passing to basal layer into systemic circulation
116
Describe the Cyp450 family:
Family of enzymes Responsible for much of the metabolism of administered drugs There are several Cyp sub families The major one is the Cyp3A subfamily- predominant forms for human drug metabolism is the Cyp3A4
117
Where are the CYP enzymes located?
Liver, SI (brush border) Levels decrease from stomach to colon Levels in SI are approx 10-50% of those in the liver Liver and SI expression is not co-ordinated
118
Where are the P-gps located?
Apical membrane (bound) Levels increase from stomach to colon, also found in tumour cells, BBB, kidney etc Encoded by ABCB1 gene
119
Describe the P glycoproteins:
ATP-dependent Saturable kinetics
120
How can P-gps undergo resistance?
Restance on some tumult cells to several anti-cancer drugs after initial treatment- the drug is pumped back out so can't exert its therapeutic effect Maintains its role in normal physiological functions-recognises drug as toxic
121
What is the function of P-gps?
Efflux transporter protein (one of several) Removal or toxic materials from the cell
122
What are the substrates like in CYPs?
Many current therapeutic drugs Structurally diverse e.g midazolam, saqunavir, simvastatin, ciclosporin
123
What are the substrates like in P-gps?
Structurally diverse e.g doxorubicin, ciclosporin, tacrolimus, saqunavir Large and amphiphatic (has charge)
124
Name inhibitors of CYPs and what is the consequence of this?
Enhance absorption of drugs Ketoconazole Grapefruit juice (intestine only)
125
Name inhibitors of Pgp and why?
Drugs: verapamil, ketoconazole Competition for Pgp in many drug cocktails- reach saturation limit Excipients: PEG, TWEEN
126
Name inducers of CYP and Pgp:
Rifampicin, phenytoin, dexamethasone, phenobarbital
127
What are key questions to consider when assessing biopharmaceuticals?
Is drug released from the dosage form? Is the drug stable in physiological fluids? Is the tissue permeable to the drug? Is the drug metabolised before it reaches systemic circulation?
128
What factors can affect bioavailability?
Dissolution and solubility Dosage form and particle size Drug form Absorption processes-dissociation into ionised and unionised forms affecting partition into plasma or lipid solubility Active processes can change absorption-efflux transports, metabolism
129
Describe how liphophilicty of a drug is critical to its absorption and bioavailability:
Large poorly lipid soluble drugs (P<0) are poorly absorbed after oral admin so given IV e.g heparin Small poorly lipid soluble drugs can be absorbed by the paracellular route (tight junctions) Lipid soluble drugs (P 0-3) are readily absorbed across the mucosal epithelium and so are suited to oral administration Very lipid soluble drugs are also readily absorbed but are more susceptible to metabolism and biliary clearance (incorporation into bile acid micelles)
130
How would you calculate if the tissue is permeable for the drug?
Many methods: -computational (stimulate variants of logP/D) -In vitro cell culture ^both used early on as cheap, allows for molecule optimisation -Tissue studies (ex vivo) -Human studies ^these 2 more expensive
131
What is LogP?
Drug conc in octane and water phases
132
How would you study the in vitro epithelial permeability?
Intestinal epithelial cells are grown on membrane filter Add drug to lower compartment and sample from higher compartment over time
133
How would you calculate if the drug is metabolised before it reaches systemic circulation?
Add drug to homogenised gut tissue/ brush border homogenate Measure the extent of metabolite by HPLC/mass spec Mass spec allows the identification of metabolite structure