Science of Medicines Week 19/20 Flashcards
(96 cards)
define drug distribution
the reversible transfer of drug from one site to another within the body
What does the rate and extent of tissue distribution depend on?
the drug and the tissue
What factors determine the kinetics (how fast) drug distribution occurs?
whether distribution is rate-limited by permeability or perfusion rate
What factors determine the extent to which drug distribution occurs?
- tissue perfusion
- drug-tissue affinity
- binding to plasma proteins or tissue factors
- passive permeability
- transporters
What path do drug molecules take from the blood into tissues?
capillaries -> interstitial fluid -> cells
What are the 2 main potential steps for drug distribution?
- passage over the capillary membrane
- passage over the cell membrane
How does movement of drugs across membranes occur?
by transcellular and paracellular pathways
What is paracellular movement across a membrane influenced by?
the tightness of the intracellular junctions
Which 2 categories is transcellular movement across membranes divided into?
- those involving passage by simple diffusion
- those involving facilitated mechanisms like transporters
What are the 3 processes of drug distribution?
- passive diffusion
- transporters
- hydrostatic pressure (very minor effect)
What is passive diffusion defined by?
Fick’s 1st law
What is passive diffusion across membranes influenced by?
diffusivity, partitioning, ionisation, pH, thickness of membrane, EFFECT OF PLASMA BINDING
What are transporters important for?
some drugs with poor passive permeability
How does hydrostatic pressure influence distribution process?
arterial end pressure > tissue pressure
tissue pressure > venous pressure
By which process do drug molecules usually pass from blood to interstitial fluid?
paracellular movement through membranes of blood capillaries
What factors is drug transport through membranes of blood capillaries INdependent of?
lipophilicity, charge and molecular size
For larger molecules, which factor becomes important in determining its distribution over capillary membranes?
charge - for example, negatively charged molecules have lower permeability across the renal glomerulus
What does passage of a drug molecule across the cell membrane from the interstitial space depend on?
drug physicochemical properties AND/OR the drug being a substrate for influx/efflux transporters
What do drug physicochemical properties include?
size, charge, lipophilicity
For which membranes is drug transport highly dependent on lipophilicity, charge and MW?
- blood-brain barrier
- hepatocytes
- renal tubules
How does pH affect drug distribution?
- pH determines the degree of ionisation of drugs
- membrane transport is slower for charged drugs
Which equation links pH and degree of ionisation?
Henderson-Hasselbalch equation
What is the 1st assumption of the pH-partition hypothesis?
only unionised drugs penetrate membranes
What is the 2nd assumption of the pH-partition hypothesis?
at equilibrium:
1. the concentrations of the unionised species are equal on both sides
2. the concentrations of ionised species is larger on the side with the lower pH (for a weak base)
3. the total concentration (ionised + unionised) is larger at the side with the lower pH