Podgorski - Pharmacokinetics I Flashcards
Rate equation
Rate = Constant * [Drug]^n where n is the kinetic order.
Drug kinetic order definition:
Dependence of rate of a process on the exponent of the drug concentration
Zero order vs. first order
If n=0, [Drug]^0 = 1. The process is not dependent on the drug concentration. The process
proceeds at a constant rate. For drug elimination, a constant amount is lost per unit time.
If n=1, [Drug]^1 = [Drug] and the rate of the process is directly dependent on the drug
concentration. For drug elimination, a constant percent or fraction is lost per unit time.
Processes the follow first order kinetics
hepatic metabolism under ordinary circumstances -therapeutic plasma concentrations below Km
renal excretion under ordinary circumstances -therapeutic plasma concentrations below Km
Examples of zero-order kinetics
Alcohol and aspirin overdose (overwhelms elimination process)
Both are first order at lower concentrations
Phenytoin (Dilantin)
- 100% bioavailable by oral and IV dosing
- liver at almost maximum metabolic capacity when Dilantin is in the therapeutic range
Blood alcohol level considered to be the threshold for a fatal level
Blood alcohol levels of 500 mg/dl are considered to be the threshold for a fatal level.
Graphic test for zero order
Straight-line behavior when concentration data are plotted on a normal (nonlogarithmic) Y axis.
Graphic test for first order
Straight-line behavior when concentration data are plotted on a logarithmic Y axis.
First order behavior for alcohol is seen only when blood levels are below 10 mg/dl.
Between 10 and 100 mg/dl is a transition region between zero and first order.
rate of drug input =
rate of drug input = f(D/T)
Equation for first order disappearance
Amount (time=t) = Amount(start) * e^-kt
Amount at t = starting amount * e^-kt
Significance of t1/2
Time required for amount to decrease to 1/2 of the starting amount.
Each drug has its own characteristic t1/2 value that is determined by the associated elimination process(es)
t1/2 value for a given drug assumes a normal patient with normal liver and kidney function.
t1/2 determines the rate at which blood concentration rises during a constant infusion and falls after administration is stopped.
Factors altering t1/2 value
Changes in volume of distribution – due to age, obesity, etc.
Induction/downregulation of metabolizing enzymes
Drug accumulation in pathologic fluids
Cardiac failure
Kidney failure
Liver failure
Ke=
ke = (0.7)/t1/2
Significance of rate constant: Ke
If t1/2 = 2 day
k = (0.693)/2 day = 0.347/day
This indicates that about 35% of the starting amount will be eliminated in 1 day.
Rate of Drug Output =
Rate of Drug Output = X ke