07 - Drug elimination Flashcards

1
Q

Drugs are eliminated by being metabolised. Drug metabolism is…

A

The enzymatic modification of the drug

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2
Q

3 Phases of drug metabolism

A
  1. Drug
  2. Derivative
  3. Conjugate
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3
Q

During metabolism, drugs may be modified by (5)…

A
  • Oxidation
  • Hydroxylation
  • Dealkylation
  • Deamination
  • Hydrolysis
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4
Q

Cytochrome P450 is what kind of enzyme?

A

Isoenzyme

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5
Q

Cytochrome P450 (or CYPs) introduce a functional group. This is called…

A

Functionalisation

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6
Q

Cytochrome P450 contains a heme cofactor (True / False)

A

True

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7
Q

Cytochrome P450s are highly expressed within (2)…

A

Intestines and liver

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8
Q

Cytochrome P450s are found in the…

A

Endoplasmic Reticulum

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9
Q

Ethanol is metabolised by P450 (True / False)

A

False

Ethanol is an exception

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10
Q

Phase II reactions are conjugation reactions, such as…

A

Glucuronidation

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11
Q

Conjugation reactions further decrease…

A

Lipid solubility (usually resulting in an inactive metabolite)

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12
Q

Genetic factors may influence drug metabolism. For example some people may be either…

A

Fast or slow metabolisers

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13
Q

Age influences drug metabolism beyond just the differences in size and weight. Explain this effect for two age groups…

A
  1. Neonates (<6wks) have low CYP, conjugating activity

2. The elderly, as CYP activity declines with age

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14
Q

What is the effect of induction of drug metabolising enzymes on:

a) rate of metabolism
b) pharmocological effect

A

a) increases

b) increases

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15
Q

What is the effect of inhibition of drug metabolising enzymes on:

a) rate of metabolism
b) pharmocological effect

A

a) decreases

b) decreases

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16
Q

Decreased metabolism, decreased…

A

Pharmocological effect

17
Q

Renal excretion can eliminate proteins with a molecular weight (MW) of:

a) > 20,000
b) 10-20,000
c) <20,000
d) <500

A

c) <20,000

18
Q

pKa of a drug is equivalent to the pH at which…

A

50% of the drug is ionised in solution

19
Q

Ionised drugs can’t…

A

Move through membranes

20
Q

To estimate % ionisation, subtract…

A

pKa of the drug from the pH of the solution

21
Q

Drug metabolism involves how many phases?

A

2 (Phases I & II)

22
Q

Phase I metabolism is highly dependent on…

A

Cytochrome P450 isoenzymes

23
Q

Phase II metabolism improves excretion by…

A

Increasing water solubility

24
Q

Drug metabolism can be altered by a variety of Endogenous or Exogenous factors that alter the function of…

A

Enzymes involved in phases I and II