Exam1Lec2Pharmacokinetics Flashcards

1
Q

What is first pass effect?

A

Combined action of bacterial and liver enzyme on drugs before reaching systemic circulation. Drug is not 100% absorbed

a phenomenon in which a drug gets metabolized at a specific location in the body that results in a reduced concentration of the active drug upon reaching its site of action or the systemic circulation.

drug administered orally, gi tract, portal vein, liver for bio transformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Explain the significance of absorption

A

When a drug is administered orally it goes through the liver/portal vein which is the main detoxification center(like a gate) and then it can reach other organs through the plasma compartment such as the brain, kidney, and heart. IV bypasses absorption (going through liver, GI, etc) and going straight into the plasma compartment whihc can reach other organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the factors that influence drug distribution?

A

Blood flow, lipid solubility of drug, molecular size, protein binding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does blood flow affect drug distribution?

A

The most higly perfused organs recieve most of the drug during the first few minutes after absorption. Delivery of drug to musle , viscera, skin and fat is slower

ex: giving propofol, within a few seconds it can reach the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most impt factor for drug distribution?

A

Blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does lipid solubility of drug affect drug distribution?

A

Lipid insoluble drugs that crosses the membrane poorly are restricted in their distribution and hence in their site of action.

propofol and thiopentol can easily cross the BBB cell membrane b/c its very lipophilic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does Molecular size influence drug distribution?

A

Extremely large drugs are mainly confined to the plasma compartment

Ex: heparin is an anticoagulant that stays trapped in plasma compartment, it cant go through non brain capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does protein binding affect drug distribution?

A

distribution may be limited to drug binding to plasma proteins. Only unbound drugs cross the cell memebrane. ACIDIC drugs bind to serum albumin. Basic drugs bind alpha-one glycoprotein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Free drug is free to

A
  1. leave plasma compartment
  2. transported into hepatocytes for biotransformation
  3. go through glomelur filtration in kidneys for secretion
  4. be actively transported into bile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the drug reservoirs?

A

Plasma proteins, fat, bone, cellular reservoirs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Many drugs bind to plasma proteins. Is this reversible?

A

Yes

but whatver stays bound is less destined to be eliminated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A drug is always ____ % bound to plasma proteins

A

90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fat can act as a drug reservoir for what type of drugs?

A

Highly lipophilic drugs

high lipid water coefficient

Ex: thiopental.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do drugs accumulate in the bone?

A

By absorption onto the bone-crystal surface and eventual incorporation into the crystal lattice

Ex: tetracycline and lead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Drugs accumulate in the muscle or other at ____

A

higher concentrations than in EC fluids

Ex: antimalarial agent quinacrine in the liver (high affinity for hepatocytes, you dont have much in plasma comp)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The BBB has____ fenestrations

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

True or False, blood-brain barrier is adaptive

A

True. Note that BBB has very tight junctions b/w epithelial cells, only very hydrophobic drugs can cross cell membrane and reach CNS.

Think about that if you have so much drug concentration it can be toxic.

18
Q

Why would we create different maneuvers to increase the permeability of the BBB?

A

We want more drugs to be able to go through to enhance the efficacy of chemotherapuetic agents used to treat specific infections or tumors localized in the brain.

19
Q

How can drugs move through non-brain capillaries?

A

Drugs can move through fenestrations (openings) by bulk flow

20
Q

How can drugs move thorugh brain capillaries?

A

Drugs cross the cell membrane by passive diffusioln or carrier mediated diffusion.

21
Q

Is placenta a drug barrier? Why or why not?

A

NO because the fetus is to at least some extent exposed to essentially all drugs taken by the mother

22
Q

What is biotransformation?

A

Process of which drugs are enzymatically altered in the LIVER and eventually excreted by the kidneys.

23
Q

Biotransformation ____ water solubility of drugs

A

increases

24
Q

What is elimination?

A

Process by which the drugs are enzymatically altered (biotransf) in LIVER mainly and then eventually excreted by the kidneys.

COMBO of biotrans and excr

25
Q

Biotransformation can result in?

A
  1. inactive metabolite
  2. metabolite that retain similar activity
  3. altered activity
  4. bioactivated metabolites (Pro-drug)
26
Q

what is the term for loss of effect of drug given orally?

A

first pass effect

27
Q

Prodrug

A

a drug administered in an inactive form (no pharmacological activity) and is designed that when it undergoes biotransformation its converted to its active form.

28
Q

What are the two main reactions of biotransformation?

A

Phase 1 and Phase 2

29
Q

What are phase 1 reactions?

A

Mainly DEGRADATIVE resulting in inactivation, change in activity, or conversion of inactice cmpd (prodrug) to active drug

30
Q

What are the main phase 1 reactions?

A

Oxidation (most impt), reduction, hydrolysis

31
Q

Pharmokinetics vs Pharmaodynamic

A

Pharmaokinteics is studying what the body does to the drug vs pharmodynamic is studying what the drug does to the body.

32
Q

What are phase 2 reactions?

A

Mainly involved in COUPLING of the drug or frequently its polar metabolite from the phase 1 reaction to an endogenous substrate (ex: glucuronate)

33
Q

What are the main phase 2 reactions?

A

Conjugation/transferases

34
Q

enzyme system most responsible for oxidation reactions is ____ which is found in _____ mainly in ____

A

Cp450 (CYP) system, microsomal fraction (SER), liver then lung and kindey

35
Q

Cytochrome P450 system consists of two components. What are they and what do they require?

A

CytochromeP450 oxidoreductase
Cytochrome P450
it requires molecular oxygen and NADPH

36
Q

CYP is a family of ____ with ____

A

isoenzymes with overlapping specificities

2 enzymes can deal with the same drug and a single enzymes can deal with different cmpds.

37
Q

What is a key step in oxidation?

A

Insertion of O2 producing a non-stable intermediate which breaks down to yield the final product

38
Q

What are the main reactions catalyzed by oxidation?

A
  1. dealkylation: removal of alkyl group (CH3)
  2. hydroxylation: adding a hydroxyl group
  3. sulfoxide: adding oxygen to sulfur group
  4. N-oxidation: adding oxygen to N
  5. deamination: removal of amine group
39
Q

Non-microsomal oxidation system enzymes are

A

Alcohol dehydrogenase

Aldehyde dehydrogenase

non-microsomal enzymes are located in the cytosol

40
Q

Hydrolysis reactions are carried out by which enzymes?

A

1.Esterases: break down ester grp and hydrolyze ester linkage
2.Amidases: break down amide grp
3.Peptidases” break down peptide grp

these enzymes are mainly found in the liver, plasma, and GI tracr

41
Q

Reduction reaction enzymes can catalyze the reduction of what?

A

Nitro groups, azo, carbonyl groups.

These enzymes are reductases and can be found in the ER, cytosol of the liver, and other tissues