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PHARMACOKINETICS
MERLYN A.
BARACLAN, RN, RMT
pharmacokinetics
 Definition:
- refers on how the body acts on the drug
- involves the study of absorption,
distribution, metabolism
(biotransformation) and drug excretion
I. Overview
 Aim of drug therapy
- To prevent, cure or control various disease
states
adequate drug doses must be
delivered to the target tissues
so that therapeutic yet NON – toxic
levels are obtained
Overview
 Too much of a drug will result into toxic
effects & too little will not result into the
desired therapeutic effects.
4FundamentalPathwaysofDrugMovement&
ModificationintheBody
 drug in tissues
metabolites in tissues
Drug at the site of Administration
1 . ABSORPTION
(INPUT)
Drug in plasma
2. DISTRIBUTION
3. METABOLISM
4. ELIMINATION
(OUTPUT)
Drug & metabolites in urine, feces, or bile
II.RoutesofDrug
Administration
- Determined primarily
by the properties of the
drug
2 MAJOR ROUTES OF
DRUG
ADMINISTRATION
1. Enteral
2. Parenteral
ENTERALroutes
A. ORAL
B. SUBLINGUAL
C. RECTAL
PARENTERALroutes
SC / subcutaneous
IM /
intramuscular
IV / intravascular
parenteral Advantages
 Fast: 15–30 seconds for IV,
3–5 minutes for IM and
subcutaneous (SC)
 100% bioavailability
 suitable for drugs not
absorbed by the gut or
those that are too irritant
(anti-cancer)
 IV can deliver continuous
medication, e.g., morphine
for patients in continuous
pain, or saline drip for
people needing fluids
 Disadvantages
 more risk of addiction
when it comes to injecting
drugs of abuse
 Belonephobia, the fear of
needles and injection.
 If needles are shared, there
is risk of HIV and other
infectious diseases
 It is the most dangerous
route of administration
 If not done properly,
potentially fatal air boluses
(bubbles) can occur.
 Need for strict asepsis
Parenteral
 Used for drugs which are
poorly absorbed in the
GIT
 Unstable drugs
 For unconscious patients
 Circumstances that
require a rapid onset of
action
 Provides the most
control over the actual
dose delivered to the
body
RoutesofDrug
Administration
 1. ENTERAL
A. ORAL
- most common route of administration
- Most variable
- most complicated pathway
- Cheapest
- Non - invasive
[NOTE: most drugs are absorbed in the GIT &
encounter the liver before they are distributed
into the general circulation]
RoutesofDrug
Administration 1. Enteral
B. SUBLINGUAL
- Placement under the tongue
- Allows the drug to diffuse into the capillaries
& therefore to enter the systemic circulation
Advantage: the drug bypasses the intestine &
liver & thus avoids 1st pass metabolism
RoutesofDrug
Administration1. Enteral
c. Rectal
- Useful if the drug induces vomiting if given orally or
if the patient is already vomiting
- Drainage of the rectal region bypasses the portal
circulation
- Similar to the sublingual route, it prevents the
destruction of the drug by intestinal enzymes or by
the low pH in the stomach
[note: commonly used to administer anti – emetic
agents]
RoutesofDrugAdministration
2. Parenteral
a. IV / intravascular
- IV injection is the most
common parenteral route
- For drugs which are not absorbed orally
- Bypasses the liver
- Permits a rapid effect and a maximal degree of
control over the circulating levels of the drug
- Can introduce bacterial contamination at the site
- Can cause hemolysis
RoutesofDrugAdministration
2. Parenteral
b. IM / intramuscular
aqueous sol’n
Drugs administered
specialized depot
preparations
Routes of Drug Administration
2. Parenteral
c. SC / subcutaneous
- This route of
administration like IM
requires absorption &
somewhat slower than
the IV route
Routes of Drug Administration
3. Others
a. Inhalation
- Provides a rapid
delivery of a drug
across a large surface
area of the mucus
membranes of the
respiratory and the
pulmonary epithelium
- Effect is as rapid as IV
injection
- For gaseous drugs
 Advantages
 Fastest method, 7–10
seconds for the drug to
reach the brain
 Disadvantages
 Typically a more addictive
route of administration
because it is the fastest,
leading to instant
gratification.
 Difficulties in regulating
the exact amount of
dosage
 Patient having difficulties
administering a drug via
inhaler
Routes of Drug Administration
3. Others
b. Intranasal
- Through the nose
eg. : desmopressin,
salmon calcitonin,
cocaine
Routes of Drug Administration
. Others
c. Intrathecal, intraventricular
- Introducing drugs directly into
the cerebrospinal fluid / CSF
Eg., amphotericin B
Routes of Drug Administration
 3. Others
d.Topical
- Is used when a local effect
of a drug is required
- Eg., clotrimazole, atropine
Routes of Drug Administration
3. Others
e.Transdermal
- This route of administration
achieves systemic effects by
application of drugs to the
skin, usually by using a
transdermal patch.
- Rate of absorption varies
markedly
- Eg., nitroglycerin
III. ABSORPTION OF
DRUGS
 Is the transfer of a drug
from its site of
administration to the
bloodstream
 IV delivery – absorption
is complete
III. ABSORPTION OF DRUGS
 A.Transport of Drug
from the GIT
1. PASSIVE DIFFUSION
- The driving force for
passive absorption of a
drug is the
concentration gradient
- The drug moves from a
region of high
concentration to one of
a lower concentration
- Does not involve a carrier
- Vast majority of drugs
gain access to the body
by this mechanism
III. ABSORPTION OF DRUGS
2. ActiveTransport
- Involves a specific carrier protein
- Is “energy dependent” & is driven by the
hydrolysis of ATP
- Also capable of moving a drug against a
concentration gradient
III. ABSORPTION OF DRUGS
B. Physical Factors Influencing Absorption
1. Blood flow to the absorption site
2.Total surface area available for absorption
3. Contact time at the absorption surface
IV. Bioavailability
- Refers to the fraction of an
administered drug that reaches the
systemic circulation
V. Drug
Distribution
- Is the process by
which a drug
reversibly leaves the
bloodstream &
enters the
interstitium
(extracellular fluid)
and / or the cells of
the tissues.
- Affected by the following
factors:
- 1. Blood Flow
- 2. Capillary permeability
 capillary structure
 blood brain barrier
- 3. Binding of Drugs to
proteins
VI. Binding of Drugs to Plasma
Proteins
 Bound drugs are
pharmacologically
INACTIVE, only the
FREE, UNBOUND drug
can act on target sites
in the tissues, elicit a
biologic response & be
available to the
processes of
elimination
A. Binding capacity of
albumin
- Reversible
low capacity high capacity
Note : ALBUMIN has the
strongest affinity forANIONIC
DRUGS & HYDROPHOBIC
DRUGS.
VII. DRUG METABOLISM
 Drugs are often
eliminated by
biotransformation and
or excretion into the
URINE OR BILE.
 LIVER – the MAJOR
SITE FOR DRUG
METABOLISM
Reactions of Drug Metabolism
 The kidney cannot
efficiently eliminate
lipophilic drugs ,
therefore lipid soluble
agents must 1st be
metabolized in the liver
using 2 general sets of
reactions
PHASE I
PHASE II
Phase I
 Converts lipophilic
molecules into more
polar molecules
 Phase I metabolism
may increase,
decrease, or leave
unaltered the drug’s
pharmacologic activity.
Often uses the P 450
system
Phase II
 Consists of conjugation
reactions
 Uses substrates like
glucuronic acid, sulfuric
acid, acetic acid, or an
amino acid
 Renders the
metabolites INACTIVE
and more water soluble
 The highly polar drug
conjugates may then
be excreted by the
kidney or bile
DRUGELIMINATION
 Removal of a drug
from the body may
occur via a number of
routes, the most
important being the
kidney or urine
 Other routes:
- bile, intestine, lung,
milk,
 Drugs that have been
made water soluble in
the liver are often
readily excreted in the
kidneys.
 Kidney dysfunction can
lead to toxic levels of
the drug in the body
because the drug
cannot be excreted.
Thankyoufor
listening!!!
 Self-respect
is the fruit of
discipline; the
sense of
dignity grows
with the ability
to say no to
oneself.

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Pharmacokineticsppt 130126012953-phpapp02

  • 2. pharmacokinetics  Definition: - refers on how the body acts on the drug - involves the study of absorption, distribution, metabolism (biotransformation) and drug excretion
  • 3. I. Overview  Aim of drug therapy - To prevent, cure or control various disease states adequate drug doses must be delivered to the target tissues so that therapeutic yet NON – toxic levels are obtained
  • 4. Overview  Too much of a drug will result into toxic effects & too little will not result into the desired therapeutic effects.
  • 5. 4FundamentalPathwaysofDrugMovement& ModificationintheBody  drug in tissues metabolites in tissues Drug at the site of Administration 1 . ABSORPTION (INPUT) Drug in plasma 2. DISTRIBUTION 3. METABOLISM 4. ELIMINATION (OUTPUT) Drug & metabolites in urine, feces, or bile
  • 6. II.RoutesofDrug Administration - Determined primarily by the properties of the drug 2 MAJOR ROUTES OF DRUG ADMINISTRATION 1. Enteral 2. Parenteral
  • 8. PARENTERALroutes SC / subcutaneous IM / intramuscular IV / intravascular
  • 9. parenteral Advantages  Fast: 15–30 seconds for IV, 3–5 minutes for IM and subcutaneous (SC)  100% bioavailability  suitable for drugs not absorbed by the gut or those that are too irritant (anti-cancer)  IV can deliver continuous medication, e.g., morphine for patients in continuous pain, or saline drip for people needing fluids  Disadvantages  more risk of addiction when it comes to injecting drugs of abuse  Belonephobia, the fear of needles and injection.  If needles are shared, there is risk of HIV and other infectious diseases  It is the most dangerous route of administration  If not done properly, potentially fatal air boluses (bubbles) can occur.  Need for strict asepsis
  • 10. Parenteral  Used for drugs which are poorly absorbed in the GIT  Unstable drugs  For unconscious patients  Circumstances that require a rapid onset of action  Provides the most control over the actual dose delivered to the body
  • 11. RoutesofDrug Administration  1. ENTERAL A. ORAL - most common route of administration - Most variable - most complicated pathway - Cheapest - Non - invasive [NOTE: most drugs are absorbed in the GIT & encounter the liver before they are distributed into the general circulation]
  • 12. RoutesofDrug Administration 1. Enteral B. SUBLINGUAL - Placement under the tongue - Allows the drug to diffuse into the capillaries & therefore to enter the systemic circulation Advantage: the drug bypasses the intestine & liver & thus avoids 1st pass metabolism
  • 13. RoutesofDrug Administration1. Enteral c. Rectal - Useful if the drug induces vomiting if given orally or if the patient is already vomiting - Drainage of the rectal region bypasses the portal circulation - Similar to the sublingual route, it prevents the destruction of the drug by intestinal enzymes or by the low pH in the stomach [note: commonly used to administer anti – emetic agents]
  • 14. RoutesofDrugAdministration 2. Parenteral a. IV / intravascular - IV injection is the most common parenteral route - For drugs which are not absorbed orally - Bypasses the liver - Permits a rapid effect and a maximal degree of control over the circulating levels of the drug - Can introduce bacterial contamination at the site - Can cause hemolysis
  • 15. RoutesofDrugAdministration 2. Parenteral b. IM / intramuscular aqueous sol’n Drugs administered specialized depot preparations
  • 16. Routes of Drug Administration 2. Parenteral c. SC / subcutaneous - This route of administration like IM requires absorption & somewhat slower than the IV route
  • 17. Routes of Drug Administration 3. Others a. Inhalation - Provides a rapid delivery of a drug across a large surface area of the mucus membranes of the respiratory and the pulmonary epithelium - Effect is as rapid as IV injection - For gaseous drugs
  • 18.  Advantages  Fastest method, 7–10 seconds for the drug to reach the brain  Disadvantages  Typically a more addictive route of administration because it is the fastest, leading to instant gratification.  Difficulties in regulating the exact amount of dosage  Patient having difficulties administering a drug via inhaler
  • 19. Routes of Drug Administration 3. Others b. Intranasal - Through the nose eg. : desmopressin, salmon calcitonin, cocaine
  • 20. Routes of Drug Administration . Others c. Intrathecal, intraventricular - Introducing drugs directly into the cerebrospinal fluid / CSF Eg., amphotericin B
  • 21. Routes of Drug Administration  3. Others d.Topical - Is used when a local effect of a drug is required - Eg., clotrimazole, atropine
  • 22. Routes of Drug Administration 3. Others e.Transdermal - This route of administration achieves systemic effects by application of drugs to the skin, usually by using a transdermal patch. - Rate of absorption varies markedly - Eg., nitroglycerin
  • 23. III. ABSORPTION OF DRUGS  Is the transfer of a drug from its site of administration to the bloodstream  IV delivery – absorption is complete
  • 24. III. ABSORPTION OF DRUGS  A.Transport of Drug from the GIT 1. PASSIVE DIFFUSION - The driving force for passive absorption of a drug is the concentration gradient - The drug moves from a region of high concentration to one of a lower concentration - Does not involve a carrier - Vast majority of drugs gain access to the body by this mechanism
  • 25. III. ABSORPTION OF DRUGS 2. ActiveTransport - Involves a specific carrier protein - Is “energy dependent” & is driven by the hydrolysis of ATP - Also capable of moving a drug against a concentration gradient
  • 26. III. ABSORPTION OF DRUGS B. Physical Factors Influencing Absorption 1. Blood flow to the absorption site 2.Total surface area available for absorption 3. Contact time at the absorption surface
  • 27. IV. Bioavailability - Refers to the fraction of an administered drug that reaches the systemic circulation
  • 28. V. Drug Distribution - Is the process by which a drug reversibly leaves the bloodstream & enters the interstitium (extracellular fluid) and / or the cells of the tissues. - Affected by the following factors: - 1. Blood Flow - 2. Capillary permeability  capillary structure  blood brain barrier - 3. Binding of Drugs to proteins
  • 29. VI. Binding of Drugs to Plasma Proteins  Bound drugs are pharmacologically INACTIVE, only the FREE, UNBOUND drug can act on target sites in the tissues, elicit a biologic response & be available to the processes of elimination A. Binding capacity of albumin - Reversible low capacity high capacity Note : ALBUMIN has the strongest affinity forANIONIC DRUGS & HYDROPHOBIC DRUGS.
  • 30. VII. DRUG METABOLISM  Drugs are often eliminated by biotransformation and or excretion into the URINE OR BILE.  LIVER – the MAJOR SITE FOR DRUG METABOLISM
  • 31. Reactions of Drug Metabolism  The kidney cannot efficiently eliminate lipophilic drugs , therefore lipid soluble agents must 1st be metabolized in the liver using 2 general sets of reactions PHASE I PHASE II
  • 32. Phase I  Converts lipophilic molecules into more polar molecules  Phase I metabolism may increase, decrease, or leave unaltered the drug’s pharmacologic activity. Often uses the P 450 system
  • 33. Phase II  Consists of conjugation reactions  Uses substrates like glucuronic acid, sulfuric acid, acetic acid, or an amino acid  Renders the metabolites INACTIVE and more water soluble  The highly polar drug conjugates may then be excreted by the kidney or bile
  • 34. DRUGELIMINATION  Removal of a drug from the body may occur via a number of routes, the most important being the kidney or urine  Other routes: - bile, intestine, lung, milk,  Drugs that have been made water soluble in the liver are often readily excreted in the kidneys.  Kidney dysfunction can lead to toxic levels of the drug in the body because the drug cannot be excreted.
  • 35. Thankyoufor listening!!!  Self-respect is the fruit of discipline; the sense of dignity grows with the ability to say no to oneself.