类别 全部 - pharmacokinetics - equilibrium - distribution - parameters

作者:Fred Watke 7 年以前

294

Introduction and Overview

Pharmacokinetic models, particularly compartment models, are crucial for accurately describing the plasma concentration versus time data of administered drugs. These models help determine the desired plasma concentration and duration of action, and they enable precise estimates of key pharmacokinetic parameters such as the apparent volume of distribution, elimination half-life, and elimination rate constant.

Introduction and Overview

Introduction and Overview

Pharmacokinetic models

The type of model and route of administration influence which equation is used to characterize plasma concentration versus time data
Compartment model
Types

Three or more compartments

Two compartment

Since there are three phases, a two compartment model with

Three phases

Beta (β) post-distribution phase

Alpha (α) distribution phase

Absorption phase

Since there's a two exponent equation and two phases, a two component model is needed

Cp = A * e ^ -αt + B * e ^ -βt

Terms

B & Beta (β) = associated with drug after distribution

A & Alpha (α) = associated with drug distribution

Since there's two phases, a two exponent equation is needed

Two phases, alpha (α) and beta (β)

Beta phase is after some time when the line becomes straight and distribution equilibrium has been reached

Alpha phase is the first part of the curve (curvilinear) and is where the drug is being distributed in the body

One compartment

Extravascular

Intravenous bolus

Plasma concentration (Cp) versus time (SL)

One compartment is appropriate because there is a single phase in the concentration versus time plot and one exponential term in the equation

Cp = (Cp)₀ * e ^ -Kt

(Cp)₀ = plasma concentration at time = 0

Cp = plasma concentration at any time, t

The straight line also suggests distribution is instantaneous

IV administration means there's no absorption phase

The straight line indicates there's only one pharmacokinetic phase, in this case, elimination

Use and selection

The selection of a compartment model depends solely upon the distribution characteristics of a drug following its administration

Depends on availability of plasma concentration versus time data

Physicochemical properties of a drug

How sensitive the analysis of concentration in plasma is

How often plasma samples are taken

The terms rapid and slow distribution refer to the time required to attain distribution equilibrium for the drug in the body

Distribution equilibrium

When distribution equilibrium is attained, the rate of transfer between the blood and tissue and vice versa is equal

Slow distribution

Suggests that the vasculature, tissues, and organs are not behaving the same way towards the drug

The body must be considered as two or more compartments

In this type of model, the rate of drug transfer from compartment 1 to 2 and vice versa becomes equal at at time greater than zero (from several minutes to hours)

Compartments

The tissues that are not highly perfused like the bones, cartilage, fatty tissue, and many others can be pooled together as one compartment

Highly perfused systems like the liver and kidneys may be pooled together with the blood in one compartment

Suggests the distribution equilibrium is attained slowly and at a finite time (from several minutes to a few hours, depending on drug)

Generally, the slower the drug distribution characteristics of a drug, regardless of the route of administration, the greater the number of compartments required to characterize the plasma concentration versus time data and the more complex the nature of the equation employed

Rapid distribution

All organs and tissues are behaving similarly towards the drug

Suggests the rate of transfer between blood and tissues reaches equilibrium instantaneously after administration

If a drug is rapidly distributed following its administration, a one-compartment model will do an adequate job of accurately and adequately characterizing the plasma concentration versus time data

Used in pharmacokinetics when it is necessary to describe the plasma concentration versus time data adequately and accurately

Provides the desired plasma concentration and duration of action for an administered drug

Allows accurate estimates of selected fundamental pharmacokinetics parameters like the apparent volume of drug distribution, the elimination half life, and the elimination rate constant of a drug

Facts and definition

The body is conceived to be composed of mathematically interconnected compartments

The complexity of ADME makes it necessary to sometimes assume a simplified model

The most useful model in pharmacokinetics

Linear pharmacokinetics
Drug transfer in the body is possibly mediated by passive diffusion

Principle of passive diffusion and the relationship between the rate of transfer and the administered dose of a drug

There is a directly proportional relationship between the observed plasma concentration and the amount of drug eliminated in the urine and the administered dose of the drug

Sites of drug administration

Imporant features of extravascular routes of drug administration

Plasma concentration versus time (RL) following oral administration of an identical dose of a drug via identical dosage forms with different formulations

The entire administered dose of a drug may not always reach general circulation (i.e. incomplete absorption)

The onset of action is determined by factors such as formulation and type of dosage form, route of administration, physicochemical properties of drug, and other physiological variables

An absorption phase is present

Inhalation

Rectal

Subcutaneous

Intramuscular

Oral

Sublingual or buccal

Transdermal

Intravascular route
Routes

Intravenous

Intra-arterial

Plasma concentration versus time plot (RL) following the administration of a drug by an intravascular route
Important features of the intravascular route of drug administration

Adverse reactions are difficult to reverse or control

Accuracy in calculations and administration of drug dose is critical

The route is used more often in life-threatening situations

The entire administered dose is available to produce pharmacologic effects

There is immediate onset of action

There is no absorption phase

Review of ADME processes

Disposition
Defined as all processes that occur subsequent to the absorption of the drug
The components of disposition

When the distinction is undesirable or unclear, disposition is the term used

Distinction between elimination and distribution

Once a drug is in systemic circulation, it is distributed simultaneously to all tissues including the organ responsible for its elimination
Elimination
Methods

Excretion

Other organs

Mother's milk (for infants)

Drug may be consumed in sufficient quantity to affect the infant

Not a significant route of elimination for mother

Lungs

Occasionally may be important for the elimination of substances with a high vapor pressure (e.g. gaseous anesthetics, alcohol, etc.)

Principal organs

Kidney

Primary site for removal of a drug in a chemically unaltered or unchanged form (i.e. excretion) as well as for metabolites

Liver

Primary organ where drug metabolism occurs

The irreversible loss of a drug in a chemically unchanged or unaltered form

The irreversible loss of drug from the site of measurement
Metabolism
Usually, metabolites posses little or none of the activity of the parent drug (there are exceptions)
The process of conversion of one chemical species to another chemical species
Distribution
Rate and extent of drug distribution is determined by

Controlled and determined by the physicochemical properties and chemical structures of a drug molecule

The permeability of tissue membranes to the drug molecule

How well the tissues and/or organs are perfused with blood

The binding of a drug to plasma proteins and tissue components

The process of reversible transfer of drug to and from the site of measurement (usually blood or plasma)

Any drug that leaves the site of measurement and does not return has undergone elimination

Absorption
The process by which a drug proceeds from the site of administration to the site of measurement

Important Definitions and Descriptions

Amount of drug in the urine
Cumulative amount of drug in urine (Xu) against time
Used to obtain selected pharmacokinetic parameters of a drug as well as other useful information such as bioavailability
Therapeutic range
The plasma or serum concentration range within which the drug is likely to produce the therapeutic activity or effect
Termination of action
The time at which the drug concentration in the plasma falls below the minimum effective conentration (MEC)
Duration of action
The time span from the beginning of the onset of action to the termination of action
Onset of action
The time at which the administered drug reaches the therapetuic range and begins to produce the effect
Relationship between the administered dose and the amount of drug in the body
Extravascular route

F * Dose = FX₀ = (AUC)₀∞ * KV

The amount of drug that reaches general circulation is the product of the bioavailability fraction (F) and the dose administered

Intravenous solution

Dose = X₀ = (AUC)₀∞ * KV

V = (or Vd) drug's volume of distribution

The apparent volume into which a given mass of drug would need to be diluted in order to give the observed concentration

K = first-order elimination rate constant

(AUC)₀∞ = area under curve of plasma drug concentration versus time (AUC) from time zero to time infinity

The amount of drug that reaches general circulation is the dose administered

Biopharmaceutics
The study of the factors that influence the bioavailability of a drug in humans and animals and the use of this information to optimize pharmacological and therapeutic activity of drug products

Factors

Physicochemical properties of drugs

Polymorphism

Partition coefficient

Size of distribution

Particle size

pKa

Method of manufacture

Wet granulation

Dry granulation

Inert excipients used in the formulation of a dosage form

Others!

Coloring agents

Disintegrating agents

Binding agents

Diluents

Chemical nature of a drug

Weak acid

Weak base

Pharmacokinetics
Applications

Clinical prediction

Using pharmacokinetic parameters to individualize the drug dosing regimen and thus provide he most effective drug therapy

Evaluation of drug interactions

Correlation of pharmacological responses with administered doses

Dosage adjustment of drugs in disease states, if and when necessary

Effects of physiological and pathological conditions on drug disposition and absorption

Bioavailability measurements

The study of kinetics of absorption, distribution, metabolism, and excretion (ADME) of drugs and their corresponding pharmacological, therapeutic, and toxic responses in humans and animals