Pharmacokinetics and Drug Metabolism Flashcards

1
Q

State the five stages of the journey of a drug through the body.

A
Administration 
Absorption 
Distribution 
Metabolism 
Excretion 
(Voiding)
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2
Q

What is the difference between enteral and parenteral administration?

A

Enteral – using the GI tract

Parenteral – everything except the GI tract

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3
Q

What are the advantages of intravenous administration?

A

It gives rapid systemic exposure and a high bioavailability

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4
Q

State the two ways in which drug molecules move around the body.

A

Bulk Flow Transfer – in the bloodstream it will move in bulk to the tissues
Diffusion Transfer – molecule by molecule over short distances

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5
Q

State four methods by which drugs can cross lipid membrane barriers.

A

Diffusion through the lipid membrane (if appropriately lipophilic)
Diffusion through aqueous pores
Carrier molecules
Pinocytosis

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6
Q

Finish the sentence: most drugs are either …… or ……

A

Weak acids or weak bases

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7
Q

Which factors affect the ratio of ionized to non-ionized drug?

A

pKa of the drug

pH of the environment

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8
Q

Describe and explain the difference in absorption of aspirin in the stomach and the small intestine.

A

Aspirin has a pKa of 3.4
The stomach has a pH of around 1 so when the aspirin enters the stomach, as the pH of the stomach is lower than the pKa of aspirin, the equilibrium of the aspirin is shifted towards the unionized state
So in the stomach, aspirin mainly exists in the unionized state and is rapidly absorbed
Eventually, the aspirin will reach the small intestines which has a muchmore basic pH (which is greater than the pKa of aspirin)
This means that aspirin in the small intestine is mainly ionized and hence absorption is SLOWER in the small intestine

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9
Q

What is ion trapping?

A

Some ionized aspirin will enter the systemic circulation, which is an aqueous environment
As it is ionized it will not be able to move into the tissues and hence is ‘trapped

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10
Q

State four factors affecting drug distribution.

A

Regional blood flow
Extracellular binding (plasma-protein binding)
Capillary permeability
Localisation in tissue

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11
Q

In which state can albumin bind to drugs? Ionized or non-ionized?

A

Both ionised and unionised

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12
Q

State three types of capillary architecture.

A

Continuous
Fenestrated
Discontinuous

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13
Q

Give a broad example of localization of a drug in tissue.

A

Lipophilic drugs tend to localise in fatty tissues e.g. brain and testes

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14
Q

What are the two main routes of drug excretion?

A

Kidneys (mainly)

Liver

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15
Q

What types of molecule tend to get excreted via the biliary route?

A

Large molecule weight molecules

The liver allows concentration of large molecular weight molecules that are very lipophilic

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16
Q

Via what form of molecular movement do most drugs tend to get excreted into urine?

A

Active secretion

17
Q

What happens to drug-protein complexes at the glomerulus?

A

They are not filtered into the filtrate

18
Q

Where does active secretion of acids and bases occur in the nephron?

A

Proximal convoluted tubule

19
Q

What can happen to lipid soluble drugs in the proximal and distal convoluted tubules?

A

They could be reabsorbed

20
Q

Why might treatment with I.V. sodium bicarbonate increase aspirin excretion?

A

IV sodium bicarbonate will increase the pH of the blood
This will increase the amount of aspirin that is ionised
Becoming ionised will mean that the aspirin is more water-soluble and less lipid-soluble so the kidneys can more easily excrete it and less aspirin is reabsorbed in the proximal and distal tubules
This increases the rate of aspirin excretion

21
Q

What is the main purpose of the active transport systems that secrete drugs into bile?

A

They are meant to be for the active transport of glucuronides and bileacids into the bile but drugs can hitch a ride on this mechanism

22
Q

What is a potential problem with biliary excretion of xenobiotics?

A

Enterohepatic cycling – it can become reabsorbed and return to the liver via the enterohepatic circulation
This leads to drug persistence

23
Q

Define bioavailability.

A

The proportion of the administered drug that is available within thebody to exert its pharmacological effect

24
Q

Define apparent volume of distribution.

A

The volume in which a drug appears to be distributed – an indicator of pattern of distribution

25
Q

Define biological half-life.

A

The time taken for the concentration of a drug (in blood/plasma) to fall to half its original value

26
Q

Define clearance.

A

The volume of plasma cleared of a drug per unit time

27
Q

Define First-Order kinetics.

A

When the rate of drug excretion is proportional to the concentration of drug remaining within the body
Log of drug concentration is proportional to time

28
Q

Define Zero-Order kinetics.

A

A constant amount of drug is removed from the body per unit time

29
Q

What does zero-order kinetics suggest about the enzymes involved?

A

It suggests that the enzymes are saturated
Once the enzymes are saturated, the rate of removal of a drug peaks and remains constant
NOTE: most drugs follow first-order kinetics

30
Q

Examples of enteral route

A

Oral
Buccal between gums and cheek
Rectal
Sublingual

31
Q

Examples of parenteral routes of administration

A
IV
IM
Subcutaneous 
Intradermal
Inhalation
32
Q

Compartments of the body

A

Aqueous ones such as blood, ICF,ECF and lymph

33
Q

Rules for acids pH and their dissociation

A

If pH of region is less than that of pKa then acid will dissociate less and exist more in its unionised state.
Think of it like concentration gradients

34
Q

Other methods of drug excretion

A
Lungs
Skin
GI secretions 
Saliva
Sweat
Genital secretions
35
Q

What does pKa represent

A

How strong of an acid it is- the lower the pKa the stronger the acid