Week 1: Pharmacokinetics and Drug Distribution Flashcards
Pharmacology
Study of drugs and how they interact with the human body
Science, patient preference, health coverage are involved in the prescription decision (including dose, drug, dosing interval, and route of administration)
Chemical classification of drugs
Small molecules (i.e. morphine) - organic chemicals (natural or synthetic) Molecular weights from 300-900 Da
Peptides (i.e. insulin) - up to tens of amino acids
Small peptidic hormones
Proteins (up to 50% of all new medications; i.e. breast cancer meds)
Enzymes, hormones, antibodies
Oligonucleotides (i.e. mRNA vaccine, lower cholesterol)
Antisense therapeutics
Alter protein expression in the body
Drug names
Chemical name: IUPAC nomenclature (i.e. n-acetyl-p-aminophenol)
Generic name: based on National and International standards (i.e. paracetamol, acetaminophen)
Brand name: chosen by drug company or manufacturer (i.e. tylenol)
Usually use generic name
Pharmacokinetics
What the body does to the drug
- Quantitative description of drug concentrations in the body over time
- The PK of a drug (as it is administered via a specific route in each patient) determines in part the optimum dose (amount and interval) to be prescribed
Dosage regimen –> Blood concentration
Related to dose
Related to the concentration achieved in the blood or tissues affected
Related to the length of time that a chemical persists in the blood/tissues
Concentration of drugs in the body at the site of action better relates to drug effects than dose
Pharmacodynamics
What the drug does to the body
Concentration at site of action –> effects
Relationship between PK and PD
Concentration of drug in the blood will correspond to concentration of the drug at the site of action
They will not be EQUAL but the conc of the drug at the site of action will determine the responsiveness
It is not routine to measure the blood conc of drugs during the treatment but there will be a change in the blood concentration of drugs every time you change the dose = changes in response
Drug Distribution Process (ADME)
- Absorption
Bioavailability: degree of absorption of the drug from the site of the admin to the bloodstream (systemic circulation) - Distribution
Volume of distribution: degree to which a drug accesses the different body tissues outside the blood circulation - Metabolism (conversion of drug into another chemical form = metabolites)
Clearance: efficiency of drug removal by the body (impacted by drug metabolism) - Elimination
Clearance is also affected by elimination (bile, feces)
Half life: length of time for drug concentration to be reduced by 50% in the body
All ADME processes are dependent on drug movement across membranes
PK determinants of a drug
- The drug may be absorbed by GI tract at different rates
- The heart pumps drug through the circ system at defined rates
- Drug enters membranes at specific rates
- Drugs are metabolized at a certain rate
- Drugs inside cells/bloodstream may bind to proteins (Reversible, Different rates for different proteins)
Pathways of Membrane Permeation
Passive diffusion: drug must be hydrophobic (lipid-soluble) OR water-soluble if it moves through an aqueous channel or pore
Not common; only for tiny drugs
Facilitated diffusion: drug binds to protein, which undergoes conformational changes
Active transport: uses ATP
Endocytosis: receptor-mediated or fluid pinocytosis (for large drugs)
Passive Membrane Diffusion
- Drug is transferred down a conc gradient (i.e. high to low conc)
- Membrane plays a passive role; no energy is required beyond what is necessary to maintain its integrity
- Rate of drug transport is proportional to the conc gradient and follows first-order (linear) kinetics
- Rate of Transport = k x conc where k = first-order constant
- Process is independent of other compounds
- Transport rate is determined by physicochemical properties of the drug (i.e. lipophilicity and degree of drug ionization)
Fick’s Law
A drug will favour diffusion if it:
- Is small (MW < 500 Da)
- Has good lipophilicity
- Lacks charge (ionization)
Rate of transport = P x SA x (Chigh - Clow)/X
P=Permeability (size, lipophilicity, ionization)
SA= Surface area
Chigh-Clow=Drug concentration difference
X = membrane thickness
Chemical substituents that increase lipophilicity
Alkyl groups
Carbon rings
Aromatic rings
Fluorine
Small halogen to replace hydrogen -> reduce ability of enzymes to metabolize a drug
Adding fluorine increases lipophilicity - but this is not always the case
Fluorine isn’t a common way to increase lipophilicity
Chemical substituents that decrease lipophilicity
Nitrogen, oxygen, sulfur Alcohols Aldehydes Amides Carboxylic acids (charged) Phosphate (charged)
Measuring Lipophilicity
- Observe the water-oil partitioning of a drug
- Fill a separatory funnel with a buffer at pH 7.4 as well as an oil (i.e. octanol; similar to lipid bilayer of cell membranes)
- Add drug to the funnel and shake the flask to mix the liquids and allow them to completely separate
- The drug will favour either the octanol or the water
- Greater PC = greater lipophilicity
Partition Coefficient (PC)
PC = [drug]octanol/[drug]buffer
Higher PC = Higher Lipophilicity
Log(P) = Log (PC)