Lecture 4: Basic Principles of Pharm IV Flashcards
What are the purpose of biotransformation?
- drug detoxification
2. prepare drug for exretion
What are the sites of biotransformation?
- liver
2. anywhere else in the body
Hepatic Microsomal Drug Metabolizing Systems
- both phase I and II processes
- induction
- inhibition
Non-microsomal systems
- other organs, plasma, red cells
2. usually phase 1 (eg: acetyl cholinesterase, alcohol dhydrogenase inhibition)
What are phase I reactions?
- drug oxidation
- reduction
- hydrolysis
What is drug oxidation?
add oxygen or change the proportion of oxygen in the molecule, the most common metabolic transformation
what is phase II rxn?
conjugation - synthesize a new molecule by combining the drug or metabolic product of phase I with a molecule provided by the cell
what are the resulting molecules after phase II
- larger
- charged
- water soluble
- inactive
biotransformation is
one method of clearing drug from plasma, ultimately terminating the drug effect
alcohol and smoking induces
P450
biotransformation of toxicants
can have a widespread influence on drug use
- route of administration
- dose
- effectiveness
- toxicity, safety
- duration of effect
phase 2 actions mainly take place in the
liver
what happens in phase 2 rxn?
- conjugation - synthesis of a new molecule, enxymes using endogenous substrates
what are the 4 consequences of conjugation?
larger, charged, water soluble, inactive
chronic alcoholics with liver dz will not do
the glucuronide formation
the enzyme system may be a rate limiting step in the
clearance of drug from plasma
A. when metabolism is more important than renal elimination (lipid, soluble drugs)
B. Rate limiting step for clearance when enzyme is relatively slow
if there is conc of drug is less than Km (efficient enzyme systems)
first order
if the drug is saturated, the conc of drug is more than Km (inefficient enzyme systems = saturated)
zero order
only free drug molecules are
filtered
inhibiton
usually competitive
saturation can occur at
therapeutic doses or with overdoses (changes primary processes to zero processes)
drugs are reabsorbed by
- passive
2. active
two ways to enhance renal excretion?
- forced diuresis
2. manipulate the pH or the urine - trapping of ionized drug
alkalization (sodium bicarbonate for phenobarbital overdose) change urinary excretion by
4 fold to 6 fold
clearance is
a combination of biotransformation and excretion
factors that influence clearance?
- body surface area
- protein binding
- cardiac output
- renal function
- hepatic function
- blood flow to systemic organs