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Kinetics > 4 - Excretion > Flashcards

4 - Excretion Flashcards

1
Q

Which drugs are excreted renally?

A

Hydrophilic drugs

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2
Q

Which drugs are excreted through the bile?

A

Steroids, morphine

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3
Q

What are other routes for excretion besides renal and biliary?

A
  • Skin

- Lung

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4
Q

What is renal clearance?

A

Volume of plasma that is freed of the drug per unit time

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5
Q

What is the formula for renal clearance (Clr)?

A

Excretion rate of drug / [drug]plasma

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6
Q

What is the formula for excretion rate of a drug?

A

[drug]urine * F (bioavailability)

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7
Q

What can be determined if you know the renal clearance of a drug?

A

Nothing, need to compare it to something

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8
Q

How is GFR (glomerular filtration rate) determined?

A

1) PAH (para-aminohippuric acid) - no longer used b/c some secretion by proximal tubules
2) Inulin *best one b/c not secreted or reabsorbed and is filtered by kidneys, so a good reflection of GFR
3) Creatinine *2nd best b/c some secretion occurs, so it will overestimate GFR slightly, but still used

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9
Q

What can be determined about the possible excretion mechanism if renal clearance and inulin clearance are relatively similar?

A

Only filtration is occurring

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10
Q

What can be determined about the possible excretion mechanism if renal clearance is greater than inulin clearance?

A
  • Drug is being secreted into the urine

- Filtration is also occurring

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11
Q

What can be determined about the possible excretion mechanism if renal clearance is lower than inulin clearance?

A
  • Drug is reabsorbed

- Filtration is also occurring

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12
Q

How are drugs secreted into the tubules? What can be done about this?

A

Through transporters, so they can be blocked

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13
Q

___ of a drug can be altered to increase/decrease elimination of the drug

A

pH

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14
Q

What can be concluded if the biliary clearance of a drug is very high (around 500 mL/min)?

A

There must be a transporter, likely an ATP transporter, bringing the drug into bile

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15
Q

MW < 300 = ____ excretion

A

Urinary

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16
Q

MW > 300 = ______ excretion

A

Biliary

17
Q

Describe the enterohepatic recirculation

A

Liver (glucuronidation) -> common bile duct -> small intestine -> superior mesenteric vein -> portal vein -> liver

18
Q

What are some examples of drugs excreted in bile?

A
  • Morphine
  • Digitoxin
  • Bile acids
  • Steroids
19
Q

What can happen if a women taking birth control is simultaneously taking an antibiotic?

A

Concentration of birth control can be decreased

20
Q

What are pharmaceutical equivalents? Give an example

A
  • Drug products w/ same active ingredient, same strength/concentration, same dosage form, and same route of administration
  • Ex: erythromycin stearate from 2 different manufacturers
21
Q

What are pharmaceutical alternatives? Give an example

A
  • Drug products w/ same therapeutic moiety but as different salts, esters, or complexes (dosage form)
  • Ex: erythromycin stearate and erythromycin ethylsuccinate; tablet vs capsule
22
Q

What are bioequivalent drug products?

A

Pharmaceutical equivalents that have similar bioavailability when given in the same molar dose and studied using similar experimental conditions

23
Q

Can excipients affect the solubility of their active ingredient?

A

Yes

24
Q

Which concentrations should be looked at when comparing 2 drugs?

A

Concentrations after steady state has been reached

25
Q

Clinically, __ half lives is enough for drug to be considered eliminated

A

3

26
Q

In the lab, __ or even ___ half lives are needed for a drug to be considered eliminated

A

5 or even 10

27
Q

What are the units for renal clearance?

A

mL/min

28
Q

What is creatinine?

A

End-product of metabolism

29
Q

___% of cardiac output flows into kidney

A

25%

Kinetics (4 decks)

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