Pharmacokinetics Flashcards
What is pharmacokinetics?
The study of the kinetics of drug absorption and disposition
What is the equation for the concept of distribution (VD) of drugs?
Volume of beaker = Amount added/[Drug]
VD = A/[D]P
Where A = amount of drug in body and [D]P = concentration of plasma in blood
If you want to locate a specific drug in the plamsa what value would you use?
[D]P(target)
A(target) = VD x [D]P(target)
Where Atarget it the amount of drug in the body required to achieve [D]P(target)
What is the equation for loading dose?
LD x B = Atarget
LD = Atarget/B
LD = (VDx [D]P(target))/B
Where B is bioavailability (the fraction od administered dose absorbed from the body)
What is the equation best used for loading dose?
LD = (VD x [D]P(target))/B
What determines the rapid target concentration of a drug in the plasma?
Concentration of drug in plasma, bioavailability and the volume
Which will be better distributed to the body and large VD or a small VD?
Large
As VD goes up, what happens to the [D]P in tissue binding?
Goes down
How is VD obtained from the body?
Give bolus of drug, measure plasma levels over time, extrapolate to find plasma level at time 0
VD = amount in body at time 0/[D]P0 = DoseIV/[D]P0
What is the differncce between 1 compartment and 2 compartment VD?
VD(final) reached in minutes with 1
VD(final) reached only after delay with 2
What equation would you used if the drug exhibited 1-compartment behavior?
LD = (VD x [D]P(target))/B
What equation would you use for a drug that inhibits 2-compartment behavior?
LD = (V? x [D]P(target))/B
? = VD(aplha) or VD(beta) depending on trade offs
Solve for parameters of Digoxin LD. Given:
[D]P(target) = 1.5 ug/L
VD= 580 L
Oral bioavailability = 0.7
Oral LD = (580 L x 1.5 ug/L) /0.7
Oral LD = 1243 ug or 1.2 mg
What is the equation for drug clearance?
Cl = Rate of Drug elimination /[D]P
What are the units for Drug Clearance?
Volume/Time
Solve for drug clearnace. Given:
Rate of drug elimination = 10 mg/hr
[D]P = 4 mg/L
Cl = 10 mg/hr / 4 mg/L
Cl = 2.5 L/hr
How are most drug eliminated by the body?
First order kinetics
Drug clearnance is a determinant of [D]P at….
Steady state [D]PSS
When is the steady state said to exist?
Rate of Drug Administration (R0) = Rate of drug elimination
Input = Output
What is the equation for steady state?
[D]PSS = Rate of drug eliminiation stead state/ Cl
R0 = Rate of Drug administration steady state
What is the maintance dose (MD)?
AMount of drug taken at regular intervals
What is the dosing interval (DI)?
Time between MDs
What is bioavailability?
Fraction of administered dose that is absorbed into systemic circulation
What is the equation for rate of drug administration?
R0 = (B x MD) / DI
What is the equation for drug clearance steady state?
[D]PSS = (B x MD) / (DI x Cl)
What is [D]PSS dependent on?
The ratios of MD and DI
What is [D]PSS a major determinant of?
Therapeutic response
Toxicity
When the goal is to provide [D]P(target) how is the equation for drug clearance stead state rearranged?
MD/DI = ([D]P(target) x Cl) / B
The rate of elimination most occurs in the ____ and ___.
Liver and kidney
What are the rate of renal elimination and the rate of hepatic elimination?
ClR and ClH
What is the equation for drug clearnance determination of full clearance?
(For liver and renal stuff)
Cl = ClR + ClH
What is the rate of renal elimination due to?
Glomerular filtration of drug not bound to plasma proteins
Secretion into renal tubulesof acidic and basic drugs by transport systems in proximal tubule
What is the rate of renal elimination reduced by?
Reabsoprtion of lipophilic drugs from renal tubule
Renal diseases that dec glomerular filtration and tubular secretion of drug
Competition between drugs for secretion by transport systems in the proximal tubule
What is hepatic elimination due to?
Metabolism of drugs by liver enzymes
Secretion of drugs into bile by transport systems in the hepatocytes
What is hepatic elimination reduced by?
Ionization of drugs which limits penetration of drug into hepatocytes
Competition between drigs for metabolism and/ or transport into bile
Liver disease
Genetic variation in drug metabolizing enzyme
What is heptic elimination increased by?
Induction of liver enzymes by same drug, other drug and/or environmental chemicals
Genetic variation in drug metabolizing enzymes
What equation tells the rate of drug administration?
MD/DI = ([D]P(target) x Cl) / B
What is the equation for the therapeuric window?
TW = highest [D]P that is safe/ lowest [D]P that is therapeutically effective
What is the maximum dosing interval (DImax)?
The longest dosing interval that still provides non-toxic peak plasma levels of drug while providing therapeutically effective trough plasma levels of the drug
What is elimination t1/2?
Time required for drug elimination process to decrease by the amount of drug in the body by 50%
What is the equation for maximum dosing interval?
DImax = 1.44 x t1/2 x ln (TW)
Solve for the oral MD/DI for digoxin. Given:
[D]P(target) = 1.5 ug/L
Cl = 6.6 L/hr
Oral bioavailability = 0.7
Oral MD/DI = ([D]P(target) x Cl) / B
=(1.5 ug/L x 6.6 L/hr) / 0.7
= 14.1 ug/L
Calculate DImax for Digoxin: Given:
DP(effect) > 0.8 ug/L
DP(toxic) > 2.5 ug/L
t1/2 = 39 hrs
DImax = 1.44 x t1/2 ln (TW)
= 1.44 x 39 hrs x ln (2.5/0.8)
= 64 hrs
Calculate the convenience use for DI of 24 hours (<64)
Oral MD/DI = 14.1 ug/L
Oral MD/24 hrs = 14.1 ug/L
Oral MD = 14.1 ug/L x 24 hrs
= 338.4 ug
=.34 mg
What is the equation for half life?
t1/2 = (0.693 x VD) / Cl
If there is 2 compartment behavior for half life, what value should be used for distribution volume?
VD(beta)
What is time to steady state (tss)?
Time required to reach [D]PSS if the dosing regimen only involves the repeated adminstration of drug using a specific MD/DI ratio
If you have one compartment behavior, four elimination half lives:
Provide 94% of [D]PSS when treatment is started
Reduce [D]P to 6% of [D]PSS when treatment stopped
If 2-compartment behavior, four elimination half-lives:
Provide > or = 94% of [D]PSS when treatment is started
Reduce [D]P to < or = 6% of [D]PSS when treatment stopped
What is the equaiton for tSS for 1 and 2 compartment behaviors?
tSS = 4 x t1/2
Calculate the tSS for Digoxin. Given:
t1/2 = 39 hrs
tSS = 4 x t1/2
= 4 x 39
= 156 hrs
(loading doses often prescribed)
What are the steps to designing a dose regimen?
- Decide whether LD is required (if so calculate)
- Determine MD/DI ratio
- Determine DI
If a patient has renal disease how would you adjust the drug?
If eliminated by the liver don’t worry about it
- Re-evaluate need for drug; discontinue if possible
- Reduce dose
- Inc dose interval
- Switch to drug eliminated by liver
If a pt has liver disease how would you adjust the drug?
If eliminated by the kidneys don’t worry about it
- Re-evaluate need for drug; discontinue if possible
- Reduce dose
- Inc dose interval
- Switch to drug eliminated by kidney