Pharmacokinetics Flashcards
What does ADME stand for
Absorption, Distribution, Metabolism, Excretion
What is absorption
The process by which a drug enters the blood stream from site of administration
What is distribution
The process by which a drug leaves the circulation and enters the tissues perfused by blood. Blood independent distribution can occur in tissues by diffusion
What is metabolism
The process by which tissue enzymes catalyse the chemical conversion of a drug to a more polar form that is more easily excreted
What is excretion
The processes that remove the drug from the body
Where does metabolism usually happen
Liver - Hepatic metabolism
Where does excretion usually happen
Kidneys - Renal Excretion
What are the physiochemical factors controlling drug absorption
Solubility
Chemical stability
Lipid to water partition coefficient
Degree of ionisation
How does drug solubility affect absorption
The drug must be dissolved to be absorbed
How does the chemical stability of a drug affect absorption
Some drugs can be destroyed by acid in the stomach or enzymes in the GI tract. Must be stable to avoid this
How do drugs get from the stomach/intestines to the liver
Through portal circulation
What is the lipid to water partition coefficient
~LogP
What effect does the lipid to water partition coefficient on drug absorption
Greater lipid solubility (LogP) = higher rate of diffusion across a membrane
Which ionisation form does a drug need to be to cross the lipid bilayer
Unionised.
What is the pKa
The pH at which 50% of the drug is ionised, and 50% is unionised
How can the proportions of [un]ionised drug be calculated
Henderson-Hasselbalch equation: pKa - pH = log (HA/A-) or log(BH+/B)
How does the degree of drug ionisation affect drug absorption
Must be in unionised state to cross membrane. Acid drug = less ionised in acid environment. Basic drug = less ionised in basic environment.
Where is a slightly acidic drug likely to be absorbed
Stomach (and small intestine because >surface area)
Where is a slightly basic drug likely to be absorbed
Small intestine
Which factors affect GI absorption
Motility (rate of movement) pH at absorption site Blood flow to GI tract Drug formulation Physicochemical interaction
Define oral availability
The fraction of drug that reaches the systemic circulation after oral ingestion
(amount in circulation / amount administered)
Define systemic availability
The fraction of drug that reaches the systemic circulation after absorption.
(amount in circulation / amount absorbed)
What is the enteral route of administration
Drug administration that involves the intestines / GI tract
What is the parenteral route of administration
Drug administration that does NOT involve the intestines / GI tract
What are the advantages of oral administration
Convenient
Non-sterile route
Generally good absorption
What are the disadvantages of oral administration
Some drugs inactivated by acid/enzymes
Variable absorption
Must deal with 1st pass metabolism
Can cause GI irritation
What are the advantages of sublingual administration
Bypasses portal system
Avoids 1st pass metabolism
Avoids gastric acid
What are the disadvantages of sublingual administration
Infrequent route
Few preparations available
What are the advantages of rectal administration
Bypasses portal system, 1st pass metabolism and gastric acid
Used for nocturnal administration of some drugs
What are the disadvantages of rectal administration
Infrequent route
Variable absorption
Aesthetically unacceptable (in UK… french love it!)
Name some enteral routes of drug administration
Oral, sublingual, rectal
Name some parenteral routes of drug administration
Intravenous, Intramuscular, subcutaneous, inhalation, topical, nasal, vaginal, ocular, intrathecal, intracerebral
What are the advantages of intravenous administration
Rapid onset
Continuous infusion
Complete availability
Allows administration of drugs that might have caused tissue damage
What are the disadvantages of intravenous administration
Sterile prep required
Risk of sepsis/embolism
High drug levels at heart
What are the advantages of intramuscular/subcutaneous administration
Rapid onset of lipid soluble drugs
depot injection for slow release possible
What are the disadvantages of intramuscular/subcutaneous administration
Painful
Tissue damage can be caused
Variable absorption
What are the advantages of inhalational administration
Lungs = high surface area
Good for volatile agents
Good for local effect
What are the advantages of topical administration
Ideal for local effect
What are the disadvantages of inhalational/topical administration
There are ‘few’
Name the fluid compartments found in the body
Plasma water
Interstitial water
Intracellular water
Transcellular water
Where can ionised drugs move in the body
Between the plasma and interstitial water
Where can unionised drugs move in the body
Fat/cells Interstitial water (start point) Intracellular water transcellular water
What is the volume of distribution (Vd)
The volume into which a drug ‘appears’ to be distributed with a concentration equal to that of plasma.
What is the Vd for an i/v administered drug
Vd = dose / plasma concentration
What does a Vd <5L show
Drug retained in vasular compartment (v. protein bound or too big to cross wall)
What does a Vd <15 L show
Drug restricted to extracellular water (like perma charged compounds)
What does a Vd >15 L show
Drug is distributed throughout total body water (or ^ conc in specific tissues)
What does MEC stand for
Minimum Effective Concentration