Pharmacokinetics
the relationship between drug input (dose, dosage, frequency) and how the concentration of drug changes with time
Pharmacodynamics
the relationship between concentration at an active site & effects with time on the body
Systemic Absorption
the process by which unchanged drug proceeds from the site of administration to site of measurement
Distribution
Process of reversible transfer of the drug to and from the site of measurement and the peripheral tissues.
Disposition
sum of all kinetic processes that occur to a drug after systemic absorption
•elimination and distribution
ADME
Absorption Distribution Metabolism Excretion
Therapeutic Window
• Exposure high enough to get desired response from drug but not too high to cause adverse effects
Transcellular vs Paracellular Transport
Trans: transport through a cell membrane
Para: Transport between cells
Intravascular Dosing
Drug is placed directly in the blood. Ex; intra venous
1)Distribution from blood to tissue across capillary membrane
2)Hepatic Elimination (metabolism) - transfer from blood to intracellular compartment of hepatocytes
Renal elimination (excretion)
Extravascular Dosing
same steps as intra w addition of absorption step from admin site to blood
Systemic pathways for Extravascular dosing
oral, intramuscular, subcutaneous, sublingual, buccal, dermal, pulomnary, rectal
Regional pathways for Extravascular dosing
ventricular delivery to brain, pleural delivery to the lungs, peritoneal delivery to abdomen
Passive Diffusion
(most drugs)
molecules transfer from regions of high to low concentrations
Passive Facilitated Diffusion
Movement across the membrane facilitated by a transporter
Active transport
Can move drugs against an opposing gradient, The direction of movement can be either influx (into the cell) or efflux (out of the cell)
Which types of diffusion follow the concentration gradient
Passive & Facilitated
Which types of diffusion are structure specific
Facilitated & Active because of the transporters
Which types of diffusion have saturable transport
Facilitated & Active because of the transporters
Which types of diffusion can be inhibited by structurally related compounds
Facilitated & Active because of the transporters
Which types of diffusion require energy
Active transport
Which types of diffusion can be inhibited by metabolic poisons
Active transport
Because active transport mechanisms depend on cellular metabolism for energy, they are sensitive to many metabolic poisons that interfere with the supply of ATP
What types of diffusion can go from lower to higher concentrations
Active transport
What does the transport maximum look like graphically
What factors affect drug transport across a membrane barrier
Molecular Size
Lipophilicity
Degree of protein binding
Charge (degree of ionization)
Ficks First Law
Rate= [ (D K SA)/ h] (Cside1-Cside2)
amount/time
D= diffusion coef
K= lipid/water partition coef
SA= Surface area (cm^2)
h= membrane thickness
c= drug concern on each side
Describes the passage of drugs through membranes by Diffusion
Permeability
(D * K)/ h = P in distance/time
expression of ease of membrane penetration
Diffusion Coefficient D (Stokes Einstein)
D= ( R * T) / (6 * N * pi * r *n)
R= gas constant
N= avogadro number
r= radius
n= viscosity
As the membrane SA increases the rate of absorption….
increases
As the functional membrane height increases the rate of absorption….
decreases
As the lipid water partition coefficient increases the rate of absorption…
increases
As molecular size increases, the rate of absorption…
decreases
As concentration on side 1 increases, the rate of absorption…
increases
As viscosity increases, the rate of absorption …
decreases
Cite active transport example of particularly p-glycoprotein
Active transporters play major roles in removing drug metabolites and foreign substances from cells and tissues
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EX: Tumor resistance to specific anticancer drugs
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•MDR1 was found to efflux many drugs that had entrees cancer cells, P-glycoprotein was found to be responsible, it is located in many organs and tissues and plays a big role in the hepatic secretion of many drugs into bile
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•P-gp recognizes hundreds of compounds, it works as a hydrophobic vacuum cleaner, pulls substances from the lipid bilayer, expelling them to promote multi drug resistance
Protein binding- lipophilic drugs
•Only unbound, nonpolar drugs are able to cross lipid membranes
•Unbound concentration provides the driving force for drug transport
•At distribution equilibrium, Unbound drug concentration will be equal on both sides of the membrane
Degree of Ionization
•pH partition hypothesis: only un ionized nonpolar drugs are able to cross lipid membranes
•pH partition hypothesis applies @ equilibrium- used to predict the influence of pH on the rates of absorption and distribution
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For 2 drugs with equal lipophilicity/molecular size/ protein binding that are not subject to carrier-mediated transport, the drug which is more unionized at a given pH will nearly always exhibit a faster rate of penetration across the membrane
Henderson Hasselbalch equation
pH= pka + log [unpronotated / protonated]