Pharmacokinetics (PK) The study of the disposition of a drug The disposition of a drug includes the processes of ADME Absorption Distribution Metabolism Excretion Elimination ADME Importance Without the knowledge gained from PK studies, patients may suffer: Toxic drugs may accumulate Useful drugs may have no benefit because doses are too small to establish therapy A drug can be rapidly metabolized. Routes Of Administration Routes Of Drug Administration Parenteral Injection Topical Enteral Respiratory Rectal Oral Absorption The passage of drug from the site of administration into the general circulation. Exception: Intravenous injections I.V Drug Immediately Oral Drug Delayed completely incomplete The Process Absorption relies on Passage through membranes to reach the blood passive diffusion of lipid soluble species. Absorption & Ionization Non-ionised drug More lipid soluble drug Diffuse across cell membranes more easily Site Of Absorption Most drugs are absorbed in the small intestine, because It is the portal for absorption of nutrients into blood It is surrounded by a very thin membrane with a large surface area Rate & Extent Rate - How rapidly does the drug get from its site of administration, to the general circulation? Extent - How much of the administered dose enters the general circulation Distribution The movement of drug from the blood to and from the tissues Plasma Protein Binding Many drugs bind to plasma proteins in the blood steam Plasma protein binding limits distribution. A drug that binds plasma protein diffuses less efficiently, than a drug that doesn’t. Elimination The irreversible removal of the parent drugs from the body Elimination Excretion Drug Metabolism (Biotransformation) Drug Metabolism The chemical modification of drugs with the overall goal of getting rid of the drug Enzymes are typically involved in metabolism Drug Metabolism More polar (water soluble) Drug Excretion Sites of Drug Metabolism Metabolism occurs in many tissues E.g. brain, kidney, lung But mostly in the liver because … all of the blood in the body passes through the liver. Intravenous Administration Oral Administration Metabolism Liver Intestines Consequences Of Metabolism Drug metabolism != Drug inactivation The metabolite may have Equal activity to the drug No or reduced activity Increased activity (Prodrugs) Toxic properties, not seen with the parent drug The Most Important Enzymes Microsomal cytochrome P450 monooxygenase family of enzymes, which oxidize drugs Act on structurally unrelated drugs Metabolize the widest range of drugs. Excretion The main process that body eliminates "unwanted" substances. Most common route - biliary or renal Other routes - lung (through exhalation), skin (through perspiration) etc. Lipophylic drugs may require several metabolism steps before they are excreted ADME - Summary Pharmacodynamics (PD) The study of the biochemical and physiological effects of drugs. Pharmacokinetics Pharmacodynamics what the body does to the drug what the drug does to the body. Drug Interaction When a drug alters the effects of another drug Drug A may alter these factors of drug B: Efficiency Rate of effect Side effects. Drug Interaction Pharmacodynamic: Pharmacokinetic: The drug effect is altered Amount of drug in blood is altered References A First Course in Pharmacokinetics and Biopharmaceutics - available at http://www.boomer.org/c/p1/ http://www.le.ac.uk/pa/msc/pklecture.pdf http://web.vet.cornell.edu/public/pharmacokinetics/pharmacokinetic s.html The Liver and Drug Metabolism - available at http://adultpain.nursing.uiowa.edu/MedGen/Liver.htm http://www.ttuhsc.edu/pharm/Freeman/med/DrugElim1.ppt http://www.bps.ac.uk/epharnet/adme.ppt http://www.usask.ca/medicine/pharmacology/Mon11SEP.pdf http://www.usask.ca/medicine/pharmacology/Fri08SEP.pdf