Module 5 Excretion Flashcards

1
Q

Excretion Sites

A
  • Kidney
  • Bile
  • Lung
  • Breast milk
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2
Q

Renal Excretion

A
  • Majority of drug excretion
  • Limit duration & intensity of effects (healthy kidneys)
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3
Q

Nephron Regulated Substances

A
  • Water
  • Electrolyte
  • Drug
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4
Q

Nephron Regulated Processes

A
  • Blood volume
  • Blood pressure
  • pH
  • Solute (drug) excretion
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5
Q

Affecting Factors of Renal Excretion

A
  • Glomerular filtration
  • Tubular secretion
  • Tubular reabsorption
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6
Q

Glomerular Filtration

A
  • Enter through renal artery
  • Low molecular drugs into renal tubules (hydrostatic pressure)
  • Lipid solubility & pH have no effect
  • Non-protein bound drugs ONLY
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7
Q

Glomerular Filtration Rate

A
  • 120mL/min/1.73m2
  • 20% total plasma flow
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8
Q

Tubular Secretion

A
  • Unfiltered drugs leave via efferent arteriole
  • Form capillaries around proximal tubule
  • Drugs secrete from blood into tubules
  • Systems for weak acid & base
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9
Q

Tubular Reabsorption

A
  • Drug concentration increases towards distal tubule
  • Loop of Henle concentrates tubular substances
  • Drug conc > blood conc (distal tubule)
  • Uncharged/lipid soluble reabsorbed into blood
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10
Q

Effects of Aging (Infants)

A
  • Low kidney function
  • GFR of infants 40/mL/min/1.73m2
  • Kidney function reaches normal adult at 2 yrs
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11
Q

Effects of Aging (Elderly)

A
  • Decreased renal function
  • Decreased drug excretion
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12
Q

Billary Drug Excretion

A
  • Bile, feces excretion
  • Molecular weight greater than 300 Da
  • Polar & lipophilic
  • Glucuronidated
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13
Q

Billary Transport

A
  • Transporters on canalicular membrane of hepatocytes
  • Move drugs/metabolites from liver into bile
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14
Q

P-GP Role in Excretion

A
  • Transports amphipathic drugs into bile
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15
Q

MRP2 Role in Excretion

A
  • Transports glucuronidated metabolites into bile
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16
Q

Drugs Released in Bile

A
  • Released into intestine
  • During digestion
17
Q

Drugs Released in Intestine

A
  • Excreted into feces
  • Enterohepatic recycling
18
Q

Enterohepatic Recycling

A
  • Drugs & conjugates excreted in bile
  • Enter intestinal lumen
  • Intestinal bacteria CAN conjugate or leave drug
  • Original drug may be reabsorbed intestinally
  • Drugs persist in body longer
19
Q

Pulmonary Drug Excretion

A
  • Gaseous/volatile drugs
  • Not reliant on drug metabolism
20
Q

Affecting Factors of Pulmonary Excretion

A
  • Respiration rate
  • Cardiac output
  • Solubility of drug in blood (high solubility = low excretion)
21
Q

Breast Milk Excretion

A
  • Prevents infant exposure
  • Breast cancer resistance protein transports drugs
22
Q

Breast Excreted Drug Composition

A
  • Low protein binding
  • Low molecular weight
  • High lipophilicity
23
Q

Breast Milk Composition

A
  • Lower pH
  • High lipid concentration
24
Q

Hair Excretion

A
  • Hair follicles
  • Determine drug exposure time based on hair length
  • Hair grows 1cm/month
25
Q

Saliva Excretion

A
  • Swallowed
  • Intestinal absorption/fecal excretion
26
Q

Sweat Excretion

A
  • Washed away
  • Dermal reabsorption (minimal)