Biotransformation Flashcards

1
Q

Xenobiotic

A

A chemical found in an organism which is not normally produced or expected to be in it

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2
Q

4 properties of pharmacokinetics

A

Absorption, Distribution, Metabolism, Excretion

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3
Q

What crosses membranes more readily, polar molecules or non-polar molecules?

A

Non-polar molecules

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4
Q

What types of molecules tend to get filtered at the glomerulus?

A

Small, charged, non-protein bound molecules

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5
Q

Where do most metabolic enzymes in the liver appear and what are these enzymes called?

A

In the membranes of the smooth ER (also a little bit in microsomal fraction of tissue homogenate and thus are called microsomal enzymes)

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6
Q

What is the underlying purpose of drug metabolism?

A

To make less polar drugs into more polar drugs so that they can be eliminated via the kidneys

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7
Q

What type of compounds are most readily excreted by the kidneys, hydrophilic or hydrophobic?

A

Hydrophilic (polar)

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8
Q

Phase I metabolism

A

Reactions to introduce or expose a functional group (typically oxidation, reduction, or hydrolysis)

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9
Q

Where does Phase I metabolism usually occur?

A

ER

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10
Q

What type of proteins are cytochrome p450s?

A

Heme-thiolate proteins

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11
Q

How does the activity of CYPs involved in drug metabolism tend to differ from that of CYPs involved in synthesis?

A

Metabolic CYPs tend to have broad specificity, synthetic CYPs tend to be very specific for substrates

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12
Q

Reactions catalyzed by CYP (types of chemical reactions)

A

Aliphatic hydroxylation, aromatic hydroxylation, N-,O-,or S-dealkylation, Oxidative deamination, dehalogenation, N- and S-oxidation

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13
Q

What are the most important CYP in terms of mass of enzyme and number of drugs metabolized?

A

3A4 and 3A5

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14
Q

What CYP is absent in 7% of caucasians while 33% of Ethiopians and Saudia Arabians are ultrarapid metabolizers?

A

2D6

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15
Q

Which CYP is responsible for generation of reactive acetaminophen metabolite and resultant toxicity?

A

2E1

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16
Q

Where are CYP3A enzymes located?

A

Liver and small intestine brush border

17
Q

Fetal form of CYP which disappears soon after birth

A

3A7

18
Q

CYP 3A enzymes interact significantly with what other biotransformation system?

A

P-glycoprotein (PGP)

19
Q

Phase II Metabolism

A

Addition of a pre-formed molecule to a drugs structure (aka conjugation)

20
Q

Groups added by Phase II metabolism

A

Glucuronic acid, sulfate, glutathione, amino acids or acetate (all highly hydrophilic)

21
Q

What is the most important Phase II reaction, what enzyme carries it out, and what other functions does it serve?

A

Glucuronidation, UDP glucoronosyltransferases, also important in metabolism of endogenous steroids, bile acids, bilirubin

22
Q

What is unique about sulfation and acetylation as Phase II metabolic reactions?

A

Sulfation - low capacity, Acetylation - high interindividual variability

23
Q

What effect does enterohepatic recirculation have on the half life of a drug?

A

Extends it

24
Q

What effects does CYP 3A have on pharmacokinetics and why?

A

Increases absorption and decreases elimination (because CYP 3A is in both gut and liver)

25
Q

What is the most potent inhibitor of the CYP 3A family?

A

Ketoconazole (antifungal)

26
Q

What is torsade des pointes, and what causes it?

A

A cardiac arrhytmia, caused by high doses of erythromyicn (can occur with CYP 3A inhibition)

27
Q

What is the effect of Rifampin on the CYP system?

A

Induction (CYP2C9, CYP3A4, others)

28
Q

What is the effect of chronic alcohol intake on the CYP system?

A

Induction of CYP2E1 (metabolizes acetaminophen)

29
Q

Compare the timecourses of CYP induction and CYP inhibition

A

CYP induction much more gradual (requires creation of new protein)

30
Q

Give an example of a drug that causes autoinduction and define the term

A

Autoinduction - a drug inducing its own metabolism. Carbamazepine (anticonvulsant) does this

31
Q

How long does it take for drug levels to drop by 90% assuming first order kinetics?

A

3.3 half lives

32
Q

Name a self-administered drug that follows zero order metabolism

A

Ethyl alcohol

33
Q

Give two reasons that cirrhosis decreases first pass metabolism

A

1) Less working enzymes in the liver (e.g. CYPs), 2) Blood shunted directly into systemic circulation, decreasing direct portal circulation