Pharmacokinetics and it’s
Importance
By-
Prof. Vedanshu R. Malviya
(M.Pharm (Pharmaceutics), Ph.d (Pursuing)
Dr. Rajendra Gode Institute of Pharmacy, Amravati-444901
PHARMACOKINETICS
“What the body does to the drug”
Pharmacokinetics (PK)
 The study of the disposition of a drug
 The disposition of a drug includes the processes of
ADME
 Absorption
 Distribution
 Metabolism
 Excretion
 Toxicity
Elimination
ADMET
DRUG R&D
Drug discovery and development
•10-15 years to develop a new medicine
•Likelihood of success: 10%
•Cost $800 million – 1 billion dollars (US)
Why drugs fail
Importance of 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
Enteral
Parenteral
Oral
Injection Rectal
Respiratory
Topical
Absorption
 The process by which drug proceeds from the site of
administration to the site of measurement (blood stream) within
the body.
 Necessary for the production of a therapeutic effect.
 Most drugs undergo gastrointestinal absorption. This is extent to
which drug is absorbed from gut lumen into portal circulation
 Exception: IV drug administration
IV vs Oral
I.V Drug Oral Drug
Immediately Delayed
completely incomplete
 Absorption relies on
 Passage through membranes to reach the blood
 passive diffusion of lipid soluble species.
The Process
The Rule of Five - formulation
 There are more than 5 H-bond donors.
 The molecular weight is over 500.
 The LogP is over 5.
 There are more than 10 H-bond acceptors.
Poor absorption or permeation are
more likely when:
Absorption & Ionization
Non-ionised drug
More lipid soluble drug
Diffuse across cell
membranes more easily
First Pass Metabolism
 Bioavailability: the fraction of the administered dose reaching the systemic
circulation
Dose
Destroyed
in gut
Not
absorbed
Destroyed
by gut wall
Destroyed
by liver
to
systemic
circulation
Determination of bioavailability
 A drug given by the intravenous route will
have an absolute bioavailability of 1 (F=1
or 100% bioavavailable)
 While drugs given by other routes usually
have an absolute bioavailability of less
than one.
 The absolute bioavailability is the area
under curve (AUC) non-intravenous
divided by AUC intravenous .
Toxicity
 The therapeutic index is the
degree of separation
between toxic and
therapeutic doses.
 Relationship Between Dose,
Therapeutic Effect and
Toxic Effect. The
Therapeutic Index is Narrow
for Most Cancer Drugs
100× 10×
Distribution
 The movement of drug from the blood
to and from the tissues
DISTRIBUTION
 Determined by:
 • partitioning across various membranes
 •binding to tissue components
 •binding to blood components (RBC, plasma protein)
 •physiological volumes
DISTRIBUTION
 All of the fluid in the body (referred to as the total body water), in which a drug
can be dissolved, can be roughly divided into three compartments:
 intravascular (blood plasma found within blood vessels)
 interstitial/tissue (fluid surrounding cells)
 intracellular (fluid within cells, i.e. cytosol)
 The distribution of a drug into these compartments is dictated by it's physical
and chemical properties
TOTAL BODY WATER
Vascular
3 L
4% BW
Extravascular
9 L
13% BW
Intracellular
28 L
41% BW
Distribution
 Apparent volume of distribution (Vd) =
Amt of drug in body/plasma drug conc
 VOLUME OF DISTRIBUTION FOR SOME DRUGS
DRUG Vd (L)
cocaine 140
clonazepam 210
amitriptyline 1050
amiodarone ~5000
Factors affecting drugs Vd
 Blood flow: rate varies widely as function of tissue
Muscle = slow
Organs = fast
 Capillary structure:
•Most capillaries are “leaky” and do not impede diffusion of drugs
•Blood-brain barrier formed by high level of tight junctions between cells
•BBB is impermeable to most water-soluble drugs
Blood Brain Barrier
•Disruption by osmotic means
•Use of endogenous transport
systems
•Blocking of active efflux
transporters
• Intracerebral implantation
•Etc
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.
Physiochemical properties-
Po/w
 The Partition coefficient (Po/w) and can be used to determine
where a drug likes to go in the body
 Any drug with a Po/w greater than 1(diffuse through cell
membranes easily) is likely be found throughout all three fluid
compartments
 Drugs with low Po/w values (meaning that they are fairly water-
soluble) are often unable to cross and require more time to
distribute throughout the rest of the body
Physiochemical Properties-
Size of drug
•The size of a drug also dictates where it can go in the body.
•Most drugs : 250 and 450 Da MW
•Tiny drugs (150-200 Da) with low Po/w values like caffeine can passively diffuse through cell
membranes
•Antibodies and other drugs range into the thousands of daltons
•Drugs >200 Da with low Po/w values cannot passively cross membranes- require specialized
protein-based transmembrane transport systems- slower distribution
•Drugs < thousand daltons with high Po/w values-simply diffuse between the lipid molecules that
make up membranes, while anything larger requires specialized transport.
Elimination
 The irreversible removal of the parent drugs
from the body
Elimination
Drug Metabolism
(Biotransformation)
Excretion
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
•From 1898 through to 1910 heroin was marketed as a non-addictive morphine
substitute and cough medicine for children. Bayer marketed heroin as a cure for
morphine addiction
•Heroin is converted to morphine when metabolized in the liver
METABOLISM
Phases of Drug Metabolism
 Phase I Reactions
 Convert parent compound into a more polar (=hydrophilic) metabolite
by adding or unmasking functional groups (-OH, -SH, -NH2, -COOH,
etc.) eg. oxidation
 Often these metabolites are inactive
 May be sufficiently polar to be excreted readily
Phases of metabolism
 Phase II Reactions
 Conjugation with endogenous substrate to further increase
aqueous solubility
 Conjugation with glucoronide, sulfate, acetate, amino acid
Mostly occurs in the
liver because all of the
blood in the body
passes through the liver
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.
• Found in liver, small intestine, lungs, kidneys, placenta
• Consists of > 50 isoforms
• Major source of catalytic activity for drug oxidation
• It’s been estimated that 90% or more of human drug oxidation can be attributed
to 6 main enzymes:
• CYP1A2 • CYP2D6
• CYP2C9 • CYP2E1
• CYP2C19 • CYP3A4
In different people and different populations, activity of CYP oxidases
differs.
CYP family of enzymes
Inhibitors and inducers of microsomal
enzymes
Inhibitors: cimetidine prolongs action of drugs or inhibits action of
those biotransformed to active agents (pro-drugs)
Inducers: barbiturates, carbamazepine shorten action of drugs or
increase effects of those biotransformed to active agents
Blockers: acting on non-microsomal enzymes (MAOI,
anticholinesterase drugs)
Phase II
 Main function of phase I reactions is to prepare chemicals
for phase II metabolism and subsequent excretion
 Phase II is the true “detoxification” step in the metabolism
process.
Phase II reactions
 Conjugation reactions
 Glucuronidation (on -OH, -COOH, -NH2, -SH groups)
 Sulfation (on -NH2, -SO2NH2, -OH groups)
 Acetylation (on -NH2, -SO2NH2, -OH groups)
 Amino acid conjugation (on -COOH groups)
 Glutathione conjugation (to epoxides or organic halides)
 Fatty acid conjugation (on -OH groups)
 Condensation reactions
Glucuronidation
 Conjugation to a-d-glucuronic acid
 Quantitatively the most important phase II pathway for drugs and endogenous
compounds
 Products are often excreted in the bile
Phase I and II - Summary
 Products are generally more water soluble
 These reactions products are ready for (renal) excretion
 There are many complementary, sequential and competing pathways
 Phase I and Phase II metabolism are a coupled interactive system interfacing with
endogenous metabolic pathways
Excretion
 The main process that body eliminates "unwanted"
substances.
 Most common route - biliary or renal
 Other routes - lung (through exhalation), skin (through
perspiration) etc.
 Lipophilic drugs may require several metabolism steps before
they are excreted
ADME - Summary

Pharmacokinetics

  • 1.
    Pharmacokinetics and it’s Importance By- Prof.Vedanshu R. Malviya (M.Pharm (Pharmaceutics), Ph.d (Pursuing) Dr. Rajendra Gode Institute of Pharmacy, Amravati-444901
  • 2.
  • 3.
    Pharmacokinetics (PK)  Thestudy of the disposition of a drug  The disposition of a drug includes the processes of ADME  Absorption  Distribution  Metabolism  Excretion  Toxicity Elimination
  • 4.
  • 5.
    DRUG R&D Drug discoveryand development •10-15 years to develop a new medicine •Likelihood of success: 10% •Cost $800 million – 1 billion dollars (US)
  • 6.
  • 7.
    Importance of PKstudies  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.
  • 8.
    Routes Of Administration RoutesOf Drug Administration Enteral Parenteral Oral Injection Rectal Respiratory Topical
  • 9.
    Absorption  The processby which drug proceeds from the site of administration to the site of measurement (blood stream) within the body.  Necessary for the production of a therapeutic effect.  Most drugs undergo gastrointestinal absorption. This is extent to which drug is absorbed from gut lumen into portal circulation  Exception: IV drug administration
  • 10.
    IV vs Oral I.VDrug Oral Drug Immediately Delayed completely incomplete
  • 11.
     Absorption relieson  Passage through membranes to reach the blood  passive diffusion of lipid soluble species. The Process
  • 12.
    The Rule ofFive - formulation  There are more than 5 H-bond donors.  The molecular weight is over 500.  The LogP is over 5.  There are more than 10 H-bond acceptors. Poor absorption or permeation are more likely when:
  • 13.
    Absorption & Ionization Non-ioniseddrug More lipid soluble drug Diffuse across cell membranes more easily
  • 14.
    First Pass Metabolism Bioavailability: the fraction of the administered dose reaching the systemic circulation Dose Destroyed in gut Not absorbed Destroyed by gut wall Destroyed by liver to systemic circulation
  • 15.
    Determination of bioavailability A drug given by the intravenous route will have an absolute bioavailability of 1 (F=1 or 100% bioavavailable)  While drugs given by other routes usually have an absolute bioavailability of less than one.  The absolute bioavailability is the area under curve (AUC) non-intravenous divided by AUC intravenous .
  • 16.
    Toxicity  The therapeuticindex is the degree of separation between toxic and therapeutic doses.  Relationship Between Dose, Therapeutic Effect and Toxic Effect. The Therapeutic Index is Narrow for Most Cancer Drugs 100× 10×
  • 17.
    Distribution  The movementof drug from the blood to and from the tissues
  • 18.
    DISTRIBUTION  Determined by: • partitioning across various membranes  •binding to tissue components  •binding to blood components (RBC, plasma protein)  •physiological volumes
  • 19.
    DISTRIBUTION  All ofthe fluid in the body (referred to as the total body water), in which a drug can be dissolved, can be roughly divided into three compartments:  intravascular (blood plasma found within blood vessels)  interstitial/tissue (fluid surrounding cells)  intracellular (fluid within cells, i.e. cytosol)  The distribution of a drug into these compartments is dictated by it's physical and chemical properties
  • 20.
    TOTAL BODY WATER Vascular 3L 4% BW Extravascular 9 L 13% BW Intracellular 28 L 41% BW
  • 21.
    Distribution  Apparent volumeof distribution (Vd) = Amt of drug in body/plasma drug conc  VOLUME OF DISTRIBUTION FOR SOME DRUGS DRUG Vd (L) cocaine 140 clonazepam 210 amitriptyline 1050 amiodarone ~5000
  • 22.
    Factors affecting drugsVd  Blood flow: rate varies widely as function of tissue Muscle = slow Organs = fast  Capillary structure: •Most capillaries are “leaky” and do not impede diffusion of drugs •Blood-brain barrier formed by high level of tight junctions between cells •BBB is impermeable to most water-soluble drugs
  • 23.
    Blood Brain Barrier •Disruptionby osmotic means •Use of endogenous transport systems •Blocking of active efflux transporters • Intracerebral implantation •Etc
  • 24.
    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.
  • 25.
    Physiochemical properties- Po/w  ThePartition coefficient (Po/w) and can be used to determine where a drug likes to go in the body  Any drug with a Po/w greater than 1(diffuse through cell membranes easily) is likely be found throughout all three fluid compartments  Drugs with low Po/w values (meaning that they are fairly water- soluble) are often unable to cross and require more time to distribute throughout the rest of the body
  • 26.
    Physiochemical Properties- Size ofdrug •The size of a drug also dictates where it can go in the body. •Most drugs : 250 and 450 Da MW •Tiny drugs (150-200 Da) with low Po/w values like caffeine can passively diffuse through cell membranes •Antibodies and other drugs range into the thousands of daltons •Drugs >200 Da with low Po/w values cannot passively cross membranes- require specialized protein-based transmembrane transport systems- slower distribution •Drugs < thousand daltons with high Po/w values-simply diffuse between the lipid molecules that make up membranes, while anything larger requires specialized transport.
  • 27.
    Elimination  The irreversibleremoval of the parent drugs from the body Elimination Drug Metabolism (Biotransformation) Excretion
  • 28.
    Drug Metabolism  Thechemical 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
  • 29.
    •From 1898 throughto 1910 heroin was marketed as a non-addictive morphine substitute and cough medicine for children. Bayer marketed heroin as a cure for morphine addiction •Heroin is converted to morphine when metabolized in the liver METABOLISM
  • 30.
    Phases of DrugMetabolism  Phase I Reactions  Convert parent compound into a more polar (=hydrophilic) metabolite by adding or unmasking functional groups (-OH, -SH, -NH2, -COOH, etc.) eg. oxidation  Often these metabolites are inactive  May be sufficiently polar to be excreted readily
  • 31.
    Phases of metabolism Phase II Reactions  Conjugation with endogenous substrate to further increase aqueous solubility  Conjugation with glucoronide, sulfate, acetate, amino acid
  • 32.
    Mostly occurs inthe liver because all of the blood in the body passes through the liver
  • 33.
    The Most ImportantEnzymes  Microsomal cytochrome P450 monooxygenase family of enzymes, which oxidize drugs  Act on structurally unrelated drugs  Metabolize the widest range of drugs.
  • 34.
    • Found inliver, small intestine, lungs, kidneys, placenta • Consists of > 50 isoforms • Major source of catalytic activity for drug oxidation • It’s been estimated that 90% or more of human drug oxidation can be attributed to 6 main enzymes: • CYP1A2 • CYP2D6 • CYP2C9 • CYP2E1 • CYP2C19 • CYP3A4 In different people and different populations, activity of CYP oxidases differs. CYP family of enzymes
  • 36.
    Inhibitors and inducersof microsomal enzymes Inhibitors: cimetidine prolongs action of drugs or inhibits action of those biotransformed to active agents (pro-drugs) Inducers: barbiturates, carbamazepine shorten action of drugs or increase effects of those biotransformed to active agents Blockers: acting on non-microsomal enzymes (MAOI, anticholinesterase drugs)
  • 37.
    Phase II  Mainfunction of phase I reactions is to prepare chemicals for phase II metabolism and subsequent excretion  Phase II is the true “detoxification” step in the metabolism process.
  • 38.
    Phase II reactions Conjugation reactions  Glucuronidation (on -OH, -COOH, -NH2, -SH groups)  Sulfation (on -NH2, -SO2NH2, -OH groups)  Acetylation (on -NH2, -SO2NH2, -OH groups)  Amino acid conjugation (on -COOH groups)  Glutathione conjugation (to epoxides or organic halides)  Fatty acid conjugation (on -OH groups)  Condensation reactions
  • 39.
    Glucuronidation  Conjugation toa-d-glucuronic acid  Quantitatively the most important phase II pathway for drugs and endogenous compounds  Products are often excreted in the bile
  • 40.
    Phase I andII - Summary  Products are generally more water soluble  These reactions products are ready for (renal) excretion  There are many complementary, sequential and competing pathways  Phase I and Phase II metabolism are a coupled interactive system interfacing with endogenous metabolic pathways
  • 41.
    Excretion  The mainprocess that body eliminates "unwanted" substances.  Most common route - biliary or renal  Other routes - lung (through exhalation), skin (through perspiration) etc.  Lipophilic drugs may require several metabolism steps before they are excreted
  • 42.