Administration and Absorption of Drugs Factors that effect the action of a drug • 1. Rate of accumulation at its site of action • 2. Concentration of the drug at the site of action • 3. The duration of the drug’s contact at those sites Pharmocokinetics • Refers to the movement of chemicals in a biological system • This includes: – Administration and absorption – Distribution – Binding properties – Metabolic mechanisms – Elimination from the system Administration of drugs • To be effective a drug must enter the body and get to its site of action • Best method of administration of a drug depends on the drug • Most drugs dissolved in a fluid (saline) or contained in a mixture as in pills or capsules – type of substance is important • Injections tend to be fast acting, oral administration is usually slow acting and of a longer duration Routes of administration – Enteral routes • Administered through the alimentary canal – oral or anal • Common problem is that absorption rate can be highly variable – Absorption of orally administered drugs is greatly influenced by stomach contents – Hostile acid environment can interfere with absorption • Other problems: – Some people cannot take pills – Uncooperative patients may refuse or “cheek” them Routes of administration – Parenteral routes • Injection – Intravenous – drug injected into vein • Advantages – fastest way administer drug and dosage most accurate • Disadvantages – chance of infection if conditions not sterile and no way to retrieve the drug in case of allergic or toxic reaction – Intramuscular – drug injected into muscle mass – slower but safer – Subcutaneous – injection under the skin or implanted under the skin – Direct injection in the nervous system Routes of administration – Parenteral routes • Pulmonary routes – inhalation into the lungs • Topical routes – placing drug on the surface usually a surface with a mucous membrane – Sublingual – placed under the tongue – Intranasal – powder or liquid absorbed through mucous membrane in the nose – Skin – skin patches or topical anesthesia Absorption of Drugs • With the exception of drugs directly injected into the nervous system and topical anesthesia, drugs have to cross at least 2 membranes to reach its site of action – At a minimum, it has to cross into the blood stream, out of the blood stream, and into the cell • Walls of blood vessels and cell membranes are semi-permeable The bloodstream and drug movement • How fast a drug gets into the bloodstream depends on route of administration • Once in the blood, a drug has access to all types of tissue, muscle, fat skin, lungs, etc. Structure of capillaries • Capillaries in most of the body are made up of cells with gaps in between the cells • These gaps allow some substances, but not blood cells of large proteins, to move in and out of the capillaries • Some drug molecules will bind to these large proteins reducing the amount of “free” molecules in the blood • When these free molecules leave the blood stream, bound molecules become unbound to maintain a stable concentration Blood – brain barrier • In the brain, the cells are more tightly packed so molecules have to move through the cells themselves – this makes up part of the blood-brain barrier • Astrocytes make up the rest of the blood-brain barrier by sending out “feet” that help seal the capillary walls Blood-brain barrier • Very few substances can cross this barrier • Membranes of the capillary cells and astrocytes are made up of lipids • Only lipid soluble substances can be absorbed into the cells and pass through them • This barrier important because the brain has no immune system Movement across semi-permeable membranes • Three types of fluid – Fluid in the bloodstream – Fluid outside the cells – extra cellular fluid – Fluid inside the cells – intracellular fluid • These fluids can move back and forth across membranes • Example thirst – Lack of fluid in blood – Extra cellular fluid moves into bloodstream – Intracellular fluid moves out of the cells – Loss of fluid detected; signal sent to drink Movement across semi-permeable membranes • Filtration – as fluid moves into a cell the membrane filters out large molecules which include many drug molecules • Movement through diffusion – follows chemical gradient – chemicals flow from areas of high concentration to areas of low concentration – If a chemical is highly concentrated outside a cell, and openings exist, it will move into the cell Placental Barrier • A weak barrier between mother and fetus • Large amounts of materials are exchanged between mother and fetus • Most drugs easily cross the placental barrier – almost every drug a mother takes the fetus takes Solubility • Lipid soluble drugs – drugs that can be dissolved in lipids – fatty substances that make up cell membranes – including the blood-brain barrier • Water soluble drugs – drugs that can dissolve in water – they will not passively move through a cell membrane so they require active transport