Drug Metabolism Flashcards

1
Q

What does metabolism tend to do to a drug?

A

Metabolism tends to eliminate or reduce the pharmacological and toxicological activity of a drug. It makes the drug more polar and soluble so that it can more easily be excreted.

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2
Q

What is hepatic first pass metabolism?

A

Metabolic conversion of the drug into something that is different before the drug enters the circulation. In other words – the effect that occurs the very first time the drug passes through the liver.

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3
Q

What effect does extensive first pass metabolism have on bioavailability?

A

Extensive first pass metabolism -> low bioavailability

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4
Q

How can you avoid hepatic first pass metabolism?

A

Gibing a drug intravenously

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5
Q

What are the three types of reaction that fall under phase I reactions?

A

Oxidation Reduction Hydrolysis

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6
Q

What is the purpose of Phase I metabolism?

A

It is meant to release or unmask functional groups that can be used in phase II reactions

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7
Q

How do phase I reactions affect polarity of the drug?

A

They have little effect on the polarity of a drug

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8
Q

What enzyme system is extremely important to drug metabolism?Where are these enzymes found?

A

Cytochrome P450 It is a family of 57 enzymes that are mainly found in the liver and they are capable of metabolising loads of xenobiotics

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9
Q

What are the substrates and products of the Cytochrome P450mediated oxidation reaction?

A

Substrates = drug, NADPH, oxygen (O2), protons (H+) Products = hydroxylated drug, NADP+, water

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10
Q

What do P450 enzymes have in their catalytic site?

A

They all have a porphyrin ring and an iron group (Fe3+)

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11
Q

Describe the oxidation cycle of Cytochrome P450.

A

The drug binds to the iron in the catalytic site of CYP450 An electron is fed in from NADPH, which is picked up by the Fe3+ making it Fe2+ Then molecular oxygen binds to the catalytic site and Fe2+ loses its electron to become Fe3+ again, and oxygen picks up the extra electronand becomes unstable Then a second electron is donated by NADPH, which, again, reduces Fe3+ to Fe2+ Fe2+ then donates this electron to the already unstable oxygen to make it even less stable Then we get conversion of the drug to the hydroxylated derivative and we lose reactive oxygen as water with the uptake of two protons The drug is released and P450, along with its Fe3+, is ready to undergo another cycle

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12
Q

What is N-demethylation? What does this reaction produce?

A

This is the oxidation of a methyl group in a nitrogen environment (carbon on a nitrogen) It produces formaldehyde (HCHO)

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13
Q

What does N-demethylation do to a drug?

A

It is an effective way of removing the pharmacological activity of a drug

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14
Q

What is O-demethylation?

A

Oxidative attack of P450 on a methyl group attached to oxygen This converts oxygen to the hydroxyl group and release formaldehyde (HCHO)

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15
Q

What is N-oxidation? Describe the type of bond formed.

A

It is the oxidation of the nitrogen group itself Nitrogen has two free electrons that can form a dative bond with oxygen This generates an amino oxide

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16
Q

Which enzyme catalyses the N-oxidation reaction?

A

Flavin containing monooxygenase

17
Q

Describe a condition involving the enzyme that catalyses the N-oxidation reaction

A
  • Flavin containing monooxygenase deficiency (fish odour syndrome)
  • Trimethylamine is produced in the GI tract as a product of protein metabolism
  • Trimethylamine is foul smelling but is converted by flavin containing monooxygenase in the liver to trimethylamine N-oxide, which is odourless and can be excreted in the urine
  • People without flavin containing monooxygenase are unable to do this conversion so they produce trimethylamine that they can’t excrete so they end up smelling terrible
18
Q

Describe alcohol oxidation.

A

Alcohol is first converted to acetaldehyde by alcohol dehydrogenase It is then converted from acetaldehyde to acetic acid by acetaldehyde dehydrogenase, which is excreted

19
Q

Where, within the ultrastructure of a cell, are flavin containing monooxygenase and cytochrome P450 enzymes found?

A

Endoplasmic reticulum

20
Q

Where, within the ultrastructure of a cell, is alcohol dehydrogenase found?

A

Cytoplasm

21
Q

Where do reduction reactions tend to take place within the body and why?

A

GI tract because this is a low oxygen environment Most reductases are bacterial enzymes that are colonising our gut, which is why these tend to happen in the GI tract

22
Q

State two types of hydrolysis enzymes.

A

Esterases and Amidases

23
Q

What at the six types of phase II reactions?

A
  • Glucuronidation
  • Acetylation
  • Sulphation
  • Methylation
  • Amino Acid Conjugation
  • Glutathione Conjugation
24
Q

State each of the enzymes that are responsible for carrying outthese six types of phase II reactions.

A
  • Glucuronyl Transferase
  • Acetyl Transferase
  • Sulphotransferase
  • Methyl Transferase
  • Acyl Transferase
  • Glutathione S-Transferase
25
Q

What effect do phase II reactions have on the drugs?

A

They make drugs more polar and water-soluble (less lipid-soluble) so that they can be excreted more easily

26
Q

What are some features of conjugating agents?

A

Large Polar Endogenous

27
Q

What is the most common type of phase II reaction?

A

Glucuronidation (addition of a sugar to a molecule)

28
Q

What is the importance of glutathione conjugation?

A

Glutathione is conjugated with electrophiles so that they can be excreted Electrophiles are damaging species that are often generated during metabolism – they must be removed because they can cause DNA and protein damage

29
Q

State a conjugating agent that is used for glucuronidation.

A

UDPGA

30
Q

State an important property of the conjugates formed fromglucuronidation and its impact on its excretion.

A

They are large molecular weight products so it has a problem withglomerular filtration High molecular weight molecules are often excreted in the bile

31
Q

What is the conjugating agent in acetylation and what is the product?

A

Acetyl Choline The product is the acetylated derivative of the drug and CoA (CoA then goes into intermediary metabolism)

32
Q

What is the conjugating agent/high energy intermediate for methylation?

A

S-adenosyl methionine

33
Q

What effect does methylation have on polarity?

A

It DECREASES polarity

34
Q

What is the conjugating agent used in sulphation?

A

PAPS – 3’-phosphoadenosine-5’-phosphosulphate

35
Q

What are the properties of the derivative formed in sulphation?

A

The product is the sulphuric acid derivative of the drug This is very polar and water-soluble

36
Q

What type of molecule is glutathione?

A

Tripeptide consisting of: Glycine Glutamine Cysteine

37
Q

What effect does drug metabolism have on biological half-life, duration of exposure and accumulation of drugs in the body?

A

Decreases biological half-life Decreases duration of exposure Avoids accumulation of drugs in the body