For More Medicine Free PPT - http://playnever.blogspot.com/
For Health benefits and medicine videos Subscribe youtube channel - https://www.youtube.com/playlist?list=PLKg-H-sMh9G01zEg4YpndngXODW2bq92w
For More Medicine Free PPT - http://playnever.blogspot.com/
For Health benefits and medicine videos Subscribe youtube channel - https://www.youtube.com/playlist?list=PLKg-H-sMh9G01zEg4YpndngXODW2bq92w
A brief presentation about the transport of drugs across the cell membrane including the many mechanisms and various transporters and a brief overview of the ABC and SLC superfamily of transporters.
A brief presentation about the transport of drugs across the cell membrane including the many mechanisms and various transporters and a brief overview of the ABC and SLC superfamily of transporters.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Pharmacokinetics of Drug_Pharmacology Course_Muhammad Kamal Hossain.pptxMuhammad Kamal Hossain
Pharmacokinetics is defined as the kinetics of drug absorption, distribution, metabolism and excretion (ADME) and their relationship with the pharmacological, therapeutic or toxicological response in man and animals.
Pharmacokinetics is the study of the movement of drug molecules in the body. It includes absorption, distribution, metabolism, and excretion of drugs. Pharmacokinetics is the study of what happens to drugs once they enter the body (the movement of the drugs into, within, and out of the body). For a drug to produce its specific response, it should be present in adequate concentrations at the site of action. This depends on various factors apart from the dose.
Four pharmacokinetic properties determine the onset, intensity, and the duration of drug action (Figure 1.6.1):
• Absorption: First, absorption from the site of administration permits entry of the drug (either directly or indirectly) into plasma.
• Distribution: Second, the drug may then reversibly leave the bloodstream and distribute it into the interstitial and intracellular fluids.
• Metabolism: Third, the drug may be biotransformed by metabolism by the liver or other tissues.
• Elimination: Finally, the drug and its metabolites are eliminated from the body in urine, bile, or feces.
In short, pharmacokinetics means what the body does to the drug.
Presentation covers the basics of pharmacokinetic. Mechanism for the transport of drug molecule. Absorption, factors affecting on absorption of drugs. Concept of bioavailability. Distribution, plasma protein binding, tissue binding, barriers.
Pharmacokinetics (PK) is the study of how the body interacts with administered substances for the entire duration of exposure (medications for the sake of this article). This is closely related to but distinctly different from pharmacodynamics, which examines the drug's effect on the body more closely.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
2. What is P’cokinetics
how the human body act on the drugs.
Pharmacokinetics is the quantitative study of drug
movement in, through and out of the body.
Intensity of effect is related to concentration of the drug
at the site of action, which depends on its
pharmacokinetic properties
Pharmacokinetic properties of particular drug is important
to determine the route of administration, dose, onset of
action, peak action time, duration of action and
frequency of dosing
5. Membrane transport
Membrane transport is associated with transport
of solute particles across biological membrane
between polar-nonpolar/water soluble-lipid soluble
bilayer.
Regulation of passage through the membrane is due to
selective membrane permeability.
There are different transport proteins are available on the
surface of cells which mediates specific movement across
the bilayer.
these proteins can be activated by cellular signalling
pathways, at the biochemical level,
6. Transport types
Passive transport
1. Diffusion
2. Facilitated diffusion
3. Filtration
4. Osmosis
Active transport
1. Primary active transport
2. Secondary active transport
3. Ponocytosis
9. Remember
The drugs which are Unionized, low polarity and higher lipid solubility are
easy to permeate membrane.
The drugs which are ionized, high polarity and lower lipid solubility are
difficult to permeate membrane.
Filtration
11. Active Transport(energy dependent)
can move solutes against a concentration gradient.
energy dependent
Primary active transport:
• generate energy themselves (e.g. ATP hydrolysis)
Secondary active transporters
• utilize energy stored in voltage and ion gated by a primary active
transporter (e.g. Na+/K+-ATPase)
• Symporters (Co-transporters)
• Antiporters (Exchangers)
13. Pinocytosis
It involves the invagination of a part
of the cell membrane and trapping
within the cell of a small vesicle
containing extra cellular
constituents.
The vesicle contents can than be
released within the cell, or extruded
from the other side of the cell.
Pinocytosis is important for the
transport of some macromolecules
(e.g. insulin through BBB).
16. Absorption
Absorption is the transfer of the unchanged
drug from its site of administration to the
systemic circulation by crossing biological
membrane.
Most of drugs are absorbed by the way of
passive transport.
Intravenous administration has no absorption
because drug is directly reaches to systemic
circulation.
Fraction of administered dose and rate of
absorption are important
18. Drug absorption
If oral-----From stomach and intestine to portal circulation.
If rectal-----from rectum to systemic circulation.
If intramuscular-----from muscle to systemic circulation.
No absorption is needed if drug is taken intravenously.
So absorption is needed to reach the drug to at the site of
action and hence it have to cross the cell membrane.
21. Absorption of drug by passive diffusion
can be explained by Fick’s first law
Rate of diffusion = (C1-C2)
(APC)
T
Where,
C1- Higher concentration
C2- Lower concentration
A – Diffusion surface area
PC- Permeability coefficient
T – Thickness of membrane
22. Role of route of drug
administration
When a drug is administered intravenously, the
entire dose is available in systemic circulation.
Administration of a drug by any other route may result in less availability of
drug due to incomplete absorption.
When a tablet or capsule is swallowed, it must dissolve before its absorption.
The process is called as dissolution.
Once the drug is dissolve the drug will be absorbed by one of the mechanisms
mentioned earlier.
23. Bioavailability
The rate and extent of absorption of a drug is termed as
its bioavailability.
When a graph of plasma concentration of a drug is plotted
against time, one gets a curve as shown as.
The area under curve (AUC) of plasma concentration versus
time represents the total amount of drug reaching systemic
circulation.
AUC will have a different shape depending on the route of
administration.
AUC obtained after IV administration is consider 100% and is termed
as absolute bioavailability.
The ratio of AUC of any other route of administration is compaited
with AUC of IV administration is termed as relative bioavailability of
that drug.
25. Distribution
Once a drug is absorbed in systemic
circulation, it can be carried throughout the body.
Drug distribution is defined as it is an reversible transfer of drug
between one component(blood) to another component(Extra
vesscular/intera vescular tissue).
Some molecules may be interacting with receptors on cell
membranes or inside of cells, while other molecules may move
back into the blood stream.
27. Significance
Pharmacological action depends upon the concentration of
drug reach to the site of action.
Thus distribution plays important role in
• Onset of action
• Intensity of action
• Duration of action MTC
MEC
28. Distribution depends upon
The delivery of a drug from the blood stream to the site
of drug action depends on…
Blood flow
Capillary permeability
Degree of binding to blood and tissue proteins
Lipid solubility of drug
30. Blood flow to different organs of the body is not equal.
The most vitally important organs of the body receive the greatest supply of blood.
These organs include the brain, liver, and kidneys.
Skeletal muscle and bone receive less blood, and adipose tissue (fat) receives the
least.
Blood flow is not the only factor responsible for drug distribution penetration
capacity of drug also plays important role in drug distribution
few drugs exhibit good penetration of the central nervous system.
The anatomical structure of the capillary network in the brain creates a significant
barrier to the passage of many drugs and is commonly referred to as the blood-brain
barrier.
To readily penetrate into the brain, drugs must be fairly small and lipid soluble.
This explains why the small and highly fat-soluble anesthetic gases quickly and
easily penetrate the brain to cause anesthesia, while other larger and water
soluble molecules like penicillin antibiotics penetrate the central nervous system
to a much lesser degree.
31. Factors Affecting Distribution
Most drugs reversibly bind to plasma proteins in varying degree. Albumin is
the most abundant plasma protein with an greatest ability to bind drugs.
Binding to plasma proteins affects drug distribution into tissues, because only
drug that is not bound is available to penetrate tissues bind to receptors, and
exert activity.
Albumin acts as a reservoir for administered drug.
Only free fraction of the drug is biologically active.
Free drug + Albumin Penetrate through tissue Bind to receptor Exert effect
Free drug Penetrate through tissue Bind to receptor Exert effect
Release the bloodstreem
Why serum albumin is checked in pathology lab before medication?
32. Factor cont…
Other patient variables that can affect distribution include body composition,
cardiac decompensation (heart failure), and age of the patient.
volume of distribution is the hypothetical volume required if the amount of
drug in the body was distributed throughout the body at the same
concentration measured in the blood.
V =
Dose administered IV
Plasma concentration
cardiac decompensation
Failure of the heart to
maintain adequate blood
circulation; symptoms
include shortness of breath
and edema.
Dosing of medications in infants and children requires special consideration. It is to be
noted that “children are not simply small adults” Bodies of children/infants contain a
high percentage of water and low percentage of muscle and fat. Especially in neonates,
albumin may be lower. All these variations can alter Vd significantly; hence dosage for
neonates/infants/children should be carefully adjusted.
33. Metabolism
While the drugs are getting distributed in different parts of body, there are
chemical changes in their structures due to interaction with various enzymes
or due to other chemical reactions.
The process of chemical change is called as biotransformation or metabolism.
Liver is major site for drug metabolism
The purpose of metabolism is to convert the drug into more water soluble
compounds.
The kidneys cannot efficiently excrete highly fat-soluble drugs that readily cross
cell membranes because they are reabsorbed in the last stages of filtration. These
compounds must first be metabolized in the liver to more water-soluble
compounds and then removed.
There are two types of metabolic processes which drugs undergo.
1. oxidation-reduction reactions or hydrolysis.
2. conjugation reactions.
34. oxidation-reduction reactions or hydrolysis.
In the first type of reaction drugs are made more polar through
oxidation-reduction reactions or hydrolysis.
These reactions use metabolic enzymes, most often those of the
cytochrome P450 enzyme system, to catalyze the biotransformation.
In enzyme-catalysed reactions, the rate of reaction is accelerated by
presence of enzymes.
Since the quantum of enzymes is limited, metabolism is considered as a saturable
process.
Once enzymes are saturated, blood levels of drug increase exponentially which may
lead to toxicity.
Ex. metabolism of alcohol or phenytoin.
35. conjugation reactions.
In this type of reaction the drug undergoing change is joined with another substance,
such as glucuronic acid, sulfuric acid, acetic acid, or an amino acid.
Glucuronidation is the most common conjugation reaction.
The result of conjugation is a more water-soluble compound that is easier for the
kidneys to excrete.
Some agents are initially administered as an inactive compound (prodrug) in order to
improve availability or reduce side effects.
Eg. Leodopa/carbidopa – dopamine in the treatment of Parkinson’s disease
36. Factors Affecting Metabolism
1. Genetic factor will result in poor tolerance of certain drugs.
Eg. Many asians and native americans have difficulty metabolizing drugs
that require acetylation, such as ethanol. These individuals will exhibit a
low tolerance of such drugs, and can suffer adverse drug reactions at a
much higher rate than the average population.
Age is another important variable, Organ function gradually declines with
age and the elderly may poorly tolerate to drugs. Also those who are very
young due to immaturity of organs system.
Drug interactions may occur between two drugs that are metabolized by
the same enzyme systems in the liver. Because there is a limit on available
enzymes for metabolism, excess drug will remain active and free to exert
an effect elsewhere in the body.
37. Excretion
When a drug is taken into and distributed throughout the body and is getting
metabolised, there has to be some way by which it is excreted; otherwise its
concentration along with its metabolites will continue to rise with each successive
dose.
The complete removal of drug from the body is termed as its elimination.
Elimination of the drug includes its metabolism and excretion through kidneys and to
a lesser degree into bile.
Excretion in urine is one of the most important mechanisms of drug removal.
When drugs have not been converted to water soluble compounds in the liver, they
are likely to be reabsorbed into blood at the end of filtration process and will cycle
through the body again.
If they are water soluble, they will be excreted in urine.
38. Factor affecting on excretion
Steady state
The complete elimination of a drug from the body is dependent
on normal liver and kidney function.
The kidney is the major organ of excretion in the form of urine
liver also contributes to elimination through metabolism and
excretion into the feces via the bile.
Age is also an important factor in drug excretion in elder persons
kidney and lever function is slightly reduced.