Pharmacokinetics Flashcards

1
Q

What are the 4 main parts of pharmacokinetics

A

Absorption – drug absorption permits entry either directly or indirectly into the plasma

Distribution – the drug may then reversibly leave the blood and distribute into the interstitial and intracellular fluids

Metabolism – the drug may be biotransformed by metabolism in the liver or other tissues

Excretion – the drug and its metabolites are excreted from the body in urine, bile or faeces

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2
Q

Factors affecting the rate of absorption

A

Route of administration

Dosage

Lipid solubility

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3
Q

Major routes of drug administration

A
  1. Topical - applied where needed e.g skin ointments, aerosols
  2. Parenteral - avoids the gut e.g injections
  3. Enteral - reaches target after absorption from gut e.g paracetamol
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4
Q

Drugs will tend to exist in the… state when exposed
to an environment with a pH opposite to their own stated

A

Ionic

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5
Q

• Stomach = pH 2
• Plasma = pH 7.4
• Urine = pH 8

What form will aspirin (pKa 3.5) be in these area

A

Stomach - neutral form

Plasma - ionised

Urine - ionised

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6
Q

What is ion trapping

A

When the drug ionises and gets trapped in an area as it can no longer cross the membrane

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7
Q

Distribution of drug throughout body

A
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8
Q

What effects rate of distribution

A

Membrane Permeability
• Drugs diffuse faster through the highly
permeable renal capillaries
• BBB

Blood Perfusion
• Drug reaches highly vascularised tissues
more rapidly e.g. lung/liver

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9
Q

What effects extent of distribution

A

Lipid Solubility
• Most drugs are small molecules that can
passively diffuse across membranes in their
uncharged (neutral) state.

Plasma Protein Binding
• Drugs exist either dissolved in the blood as
bioavailable (free drug) or bound to plasma
proteins (PPB)
• When drugs are PPB they are not bioavailable
• Drugs can interact and one drug may displace
another e.g. aspirin displaces diazepam from
albumin

Tissue Binding
• Drugs can bind to tissues either rich in fat (if
drugs are very lipid soluble) or specific cellular
components e.g. proteins, mineral, pigments
• A couple that are new and require more detail

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10
Q

Drugs that bind to plasma proteins such as albumin exhibit…

A

Slower acting and prolonged therapeutic effects - as it stays in body for longer period of time

Also slower elimination

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11
Q

Tissue can bind to drugs e.g tetracycline…

A

Accumulate slowly in bones and teeth as they have high affinity for calcium

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12
Q

Formula to calculate volume of distribution

A

Vd= dose administered/ initial apparent plasma concentration

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13
Q

What is bioavailability

A

The proportion of a drug that passes into the systemic circulation after administration.

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14
Q

Factors affecting bioavailability

A

Absorption
• Solubility of the drug
• Chemical instability in the GI tract
• Drug formulation

Metabolism
• Metabolism in the gut/liver
• ‘first pass metabolism’

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15
Q

High first pass metabolism leads to… bioavailability

A

Low

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16
Q

How to overcome high first pass metabolism

A
  1. Larger dose
  2. Different method of administration e.g IV

Morphine and propranolol show high rates of first pass metabolism so oral dose is increase compared to IV dose

17
Q

How does the body metabolise drugs

A
  1. Reducing lipid solubility
  2. Altering biological activity

The end result of metabolism is usually the abolition of biological activity.

18
Q

Enzymatic modification of a drug

A
19
Q

What do the CYP450 enzymes do

A

Oxidation
Hydroxylation
Dealkylation
Deamination
Hydrolysis

Are located in most cells but are primarily found in the liver and GI tract

Involved in metabolising approximately 75% of all drugs

20
Q

Aspirin is hydrolysed to…

A

Salicylic acid which is analgesic, antipyretic
and anti-inflammatory properties

21
Q

What does conjugation do

A

further decreases lipid solubility and almost always results in pharmacologically inactive metabolite
Conjugate excreted in urine or bile
Commonest conjugation reaction is glucuronidation

22
Q

What is enterohepatic circulation

A
  1. Drug is metabolised to conjugate in liver
  2. Conjugate is excreted in the bile from gall bladder into the gut
  3. Conjugate undergoes bacterial hydrolysis in gut back into drug and free glucuronide
  4. Drug is reabsorbed into hepatic portal vein and transported to
    liver
23
Q

Renal drug excretion steps

A
  1. glomerular filtration
  2. active tubular secretion
  3. passive diffusion across tubular epithelium
24
Q

Drug molecules that are transferred by tubular lumen by two carrier systems…

A

OATS (organic anion transport system) and OCTS (organic cation transport system)

  1. Plasma protein binding is not a barrier to carrier mediated
    transport as drugs have higher affinity to transporter than plasma protein
  2. Carrier systems can transport drugs against an electrochemical gradient (requires energy)
  3. Not affected by pH
  4. Many drugs share same transporter → can lead to competition
  5. Most effective mechanism for drug elimination
25
Q

80% of renal blood flow filtered through 1.
20% of renal blood flow filtered through 2.

A
  1. Proximal tubule
  2. Glomerulus
26
Q

Role of probenecid

A

Binds to organic anion transporter and outcompetes penicillin, effectively inhibiting tubular secretion and prolonging effects of penicillin