Lecture 4: pharmacokinetics Flashcards

1
Q

whats is the acronyms for pharmacokinetics

A
“ADME”
absorption
distribution
metabolism 
excretion
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2
Q

Factors Affecting Drug Absorption

A
  • rate of dissolution (e.g., of tablet)
  • surface area
  • blood flow
  • lipid solubility
  • pH partitioning
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3
Q

what kind of transport do most drugs use?

A

simple diffusion- non protein mediated transport

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4
Q

what is a major transporter of drugs OUT of cells?

A

P-glycoprotein (active transport)

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5
Q

why is aspirin better absorbed in the stomach?

A

is a weak acid

becomes trapped in basic compartments (looses H+ and becomes charged)

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6
Q

why is amphetamine no absorbed in the stomach?

A

weak base

becomes trapped in acidic compartments because can’t lose extra H+

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7
Q

what factors effect drug distribution?

A
• ability of drugs to enter the cells
(= same considerations as for absorption above)
• blood flow to tissues
• ability of drugs to exit the vascular
system (next)
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8
Q

what kind bind drugs in vasculature?

A

protein (albumin)

-drug is not bioactive

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9
Q

what type of drugs does the blood brain barrier let through?

A

lipid soluble

ionized or polar ONLY IF HAVE TRANSPORTER

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10
Q

what are sites of peripheral drug concentration?

A

1) Fat
2) tissue (muscle, liver)
3) bone (tetracyline)
4) transcellular reservoirs (GI tract)

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11
Q

what is the primary site of biotransformation or metabolism?

A

liver

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12
Q

what does the liver do with drugs?

A

1) may activate a prodrug

2) crucial for renal elimination of lipophilic drugs (makes them more polar so trapped)

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13
Q

what are secondary areas of drug metabolism?

A
– kidney proximal tubules
– lungs (type II cells)
– intestines
– testes (Sertoli cells)
– skin epithelial cells
– brain
– plasma
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14
Q

what are the two phases of drug metabolism (biotransformation)?

A

phase 1: oxidation, reduction, hydrolysis

phase 2: conjugation

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15
Q

what enzymes do oxidative process use?

A

those found on smoother ER (cytochrome P 450)

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16
Q

phase II biotransformation: conjugation

A

makes drugs more water soluble and more excretable (molecule added= very polar)

17
Q

Glucuronidation

A

–major route of metabolism for drugs and
endogenous compounds (steroids, bilirubin)
–occurs in the endoplasmic reticulum
–inducible

18
Q

sulfation

A

–another major route of drug metabolsim

–occurs in the cytoplasm

19
Q

– acetylation and methylation

A

• typically makes drugs less water soluble
• addition of these groups by transferases tends to reduce drug activity;
i.e., inactivates drug

20
Q

what decreases bioavailability of orally administered drugs?

A

first pass metabolism

-goes into portal vein to liver and doesn’t get into bloodstream

21
Q

what is the major route of drug excretion?

22
Q

what are nonrenal routes of drug excretion?

A
  • bile
  • sweat
  • breath
  • breast milk
23
Q

what are the steps in renal drug excretion

A

1) glomerular filtration
- small molecules filter
- proteins dont
2) passive tubular reabsorption
- lipid soluble drugs
- unionized weak acids and bases
3) active tubular secretion
- protein bound drugs

24
Q

Factors that Modify

Renal Drug Excretion

A
• pH-dependent ionization
(shown above under absorption)
• competition for active tubular
transport
• age... GFR falls in all as we age
25
Excretion rate:
the mass eliminated per unit time 3⁄4 with first order kinetics, this increases as the plasma concentration increases
26
Clearance:
the plasma volume from which all of the solute is removed per unit time (i.e., ml/min = a flow rate) 3⁄4 with first order kinetics, this remains constant as plasma concentrations change
27
Zero order kinetics
``` • constant amount eliminated per unit • the drug elimination process is saturated • consequently, the amount of drug eliminated is independent of the drug concentration ```
28
First order kinetics
constant fraction is eliminated per unit time drug elimination process is not saturated the mass of drug eliminated is directly related to the drug concentration
29
Capacity-Limited Reactions
• displays zero order kinetics initially • displays first order kinetics as the drug concentration falls
30
loading dose
initial large dose followed by maintenance dose for drugs with a long half life ex= digoxin
31
in the clinic after how many 1/2 lives does steady state need to be approached
4 is minimal acceptable time