Lecture 03/04 Key tissues in DMPK Flashcards
In what part of the body does absorption, metabolism, distribution and excretion processes may happen?
Physiology of the tissue in PK processes
- Gastrointestinal tract (GIT) - Mainly absorption / Metabolism and excretion (through bile)
- Liver - Metabolism mainly and distribution
- Kidney - Excretion mainly, minimal metabolism
Absorption in much lesser extent may occur in skin (topical) and lungs (
This is only applicable if you are providing the drug extravascularly
GI Tract
Provide a brief explanation of the physiology of the GI tract
How does it work, what is its purpose
- GI tract digests material at the top, extracts useful products and expells waste at the bottom.
- The whole system is under hormonal control (under the prescence of food in the mouth, a cascade of hormonal actions happens)
- As food enters, the hormones trigger acid secretions, enzyme release and gut mobility
- Nutrients are highly absorbed in the GI tract and transported to the liver to be broken down, stored or distributed (metabolism)
GI tract
What are the major DMPK organs of the digestive system?
Stomach and intestine
What are the parts of the upper GI tract?
Oesophagus, stomach and duodenum
What are the part of the lower GI tract?
Small intestine and large intestine
Where are digestive juices producted?
In the pancreas and gallbladder
What are the parts of the small intestine?
Duodenum, jejunum, and ileum
What are the parts of the large intestine?
Cecum, colon, rectum, anus
What is the oseophagus for?
- Is a fibromuscular tube that food passes through, aided by peristaltic contractions, the pharynx to the stomach
- Saliva moistens food, while amylase (found in saliva) starts to break down starch into simple sugars
What does the stomach do?
Secretes protein-digesting enzymes called proteases and strong acids to aid in food digestion, before sending the partially digested food to the small intestine
What does the duodenum do?
The first section of the small intestine that may be the principal site for iron absorption
What hapens in the stomach with the ingested food?
Include pH of stomach and what can be absorbed there
- Highly gastrict juices (pH 1 - 2) and enzymes mix with partially digested food to produce chyme. Muscularised walls help also with mixing.
- Few substances can be absorbed in the stomach, they are usually broken down by highly acidic conditions (lipophilic drugs and weakly acidic drugs)
What can protect drugs for being broken down by the acid conditions of the stomach?
Enteric coating
The stomach
Name 2 examples of compounds that can be absorbed in the stomach and why
Aspirin and ethanol because they are weakly acidic and become ionised at the low pH of the stomach
The stomach
Name the 4 major cell types in the stomach
Parietal cells, gastric chief cells and mucous neck and pit cells
The stomach
What is the function of parietal cells?
Produce HCl and instrinsic factor (aids absorption of vitamin B12)
The stomach
What is the function of gastric chief cells?
Production of pepsinogen and lipase
The stomach
What is the function of mucous neck and pit cells?
Produce mucin and bicarbonate to create a “neutral zone” to protect the stomach lining from acid or irritants in the stomach chyme
What is the function of G cells
Produce the hormone gastrin (CCKB agonist) in response to distention of the stomach mucosa or protein, and stimulate parietal cells’ production of their secretion
The small intestine
What is the function of the duodenum?
- Digestive enzymes from the pancreas and the gallbladder (bile) mix together, break down proteins and emulsify fats into micelles
- Brunner’s glands that produce bicarbonate
- Pancreatic juice also contains bicarbonate to neutralize hydrochloric acid in the stomach
The small intestine
What is the function of the Jejunum?
- The midsection of the intestine, connecting the duodenum to the ileum
- Contains the plicae circulares (circular folds/flaps) and villi to increase the surface area of that part of the GI tract
The small intestine
What is the function of the Ileum?
Has villi, with an enormous surface area, where soluble molecules are absorbed into the blood (through capillaries and lacteals)
In the small intestine…
What is the mucosa and submucosa?
Mention its composition and its function
- The mucosa is the absorptive and secretory layer
- It is composed of simple epithelium cells and a thin connective tissue in specialized layout – villi, microvilli
- The submucosa is relatively thick, highly vascular, and contains lymph vessels (lymphatic system), glands and nerve plexuses
- The absorbed elements that pass through the mucosa are picked up from the blood vessels of the submucosa
Mucosal increases surface area by 600-fold
The small intestine
What is below the mucosa and submucosa and what is its function?
The muscolaris and serosa.
* Muscolaris: Responsible for segmental contractions and peristaltic movement in the GI tract
* Serosa: Its a protective layer composed by avascular connective tissue and simple squamous epithelium. It secretes lubricating serous fluid
Absorption routes
How are highly hydrophilic substances absorbed?
Absorbed through transporters
Absorption routes
How and where will weak acids and bases be absorbed?
By simple diffusion to a greater extent in the neutral ileum (pH 7-8) in which they exist in the most lipid-soluble (non-ionised) state
Absorption
Usually to where are hydrophilic substances transported?
Name the organ
To the liver by the portal vein
To where are hydrophobic compounds transported?
Is a system, mention how it is transported there
Highly hydrophobic compounds may be absorbed into the lymphatic system via chylomicrons and drained into venous circulation near the heart
What happens if a drug moves through the GI tract quickly (diarrhoea)?
It will not be well absorbed
What is the largest organ inside the body?
What is its weight?
The liver/ 14 kg
Alters in size and shape dependant on the amount of blood present