06 - Drug distribution & elimination Flashcards
Enterohepatic recirculation can extend the…
Half-life of a drug
Describe the stages of enterohepatic recirculation (6)…
- Drug given orally
- Moves through the gut
- Absorbed into blood
- Travels via hepatic portal vein
- Tramsfered tp gall bladder in bile
- Secreted back into intestine (back to step 2)
The ability of a drug to bind to blood plasma proteins affects…
Distribution
At equilibrium, the rate of clearance from the plasma (is greater than / less than / equal to) rate of clearence from the blood…
Equal to
To move from blood vessels into the tissues, drug can exit via…
Slit junctions (which are gaps between endothelial cells)
Drugs with a high molecular weight…
a) Do not bind to plasma proteins
b) Bind less readily to plasma proteins
c) Always bind to plasma proteins
d) Are highly bound to plasma proteins
d) Are highly bound to plasma proteins
If a drug is highly bound to plasma proteins, it tends to stay in the plasma, leading to poor…
Distribution
Only a ( bound / unbound) drug can partition into tissues/organs
Unbound
2 important plasma proteins…
- Alpha-1 acid glycoprotein (AAG)
* Albumin (Human serum albumin, HSA)
AAG binds mostly ( acidic / basic ) drugs…
Basic (and some neutral)
Higher levels of AAG are found in (2)…
Cancer and inflammatory diseases
If AAG levels are raised (such as by cancer), the dose may need to be ( increased / decreased )…
Increased
Albumin binds mostly ( acidic / basic ) drugs…
Acidic
Malnutrition and cirrhosis tend to ( increase / decrease ) HSA levels…
Decrease
If HSA levels are decreased (such as by cirrhosis), the dose may need to be ( increased / decreased )…
Decreased