Week 1

Question 1

Definition of Pharmacokinetics

Answer 1

Derived from two Greek words: pharmkon (drug or poison) and kinesis (motion)
The study of drug movement throughout the body

Question 2

4 Processes of Pharmacokinetics

Answer 2

1. Absorption
2. Distribution
3. Metabolism
4. Excretion

Question 3

Pharmacokinetics does NOT include which of the following:

Absorption
Distribution
Metabolism
Receptor activity
Excretion

Answer 3

Receptor activity

Question 4

The major barrier to the passage of drugs is?

Answer 4

the cell membrane (double-layer of phospholipids)

Question 5

Three Ways to Cross a Cell Membrane

Answer 5

Channels or Pores
Na+ and K+ use channels (few drugs use)

Transport Systems
Very selective - drugs with a particular structure
Carries drug from one side to the other side
Some require energy, others do not

Direct Penetration of the Membrane
Most drugs use this method

Question 6

Transmembrane protein which transports drugs out of cells
Liver
Kidney
Placenta
Intestine

Answer 6

Bile
Urine
Maternal Blood
Intestinal Lumen

Question 7

Two types of Direct Penetration 
of the Membrane

Answer 7

-Lipophilic (Lipid soluble):Dissolves into lipid that composes the cell membrane and enters the cell
-Non-lipid soluble (Polar Molecules and Ions)
UNABLE to dissolve into membrane

Question 8

Most drugs cross the cell membrane by:

1. utilizing dedicated channels or pores.
2. using selective transport systems.
3. directly penetrating the cell membrane.
4. diffusing between the cells.

Answer 8

3. directly penetrating the cell membrane.

Question 9

About Polar Molecules

Answer 9

1. Uneven distribution of electrical charge
2. No net charge
   Number of protons = number of electrons
3. Dissolves well in water
4. Have a net electrical charge
   -Positive or negative charge
   -Unable to cross cell membranes
   -A few utilize channels: Na, K, Ca

Question 10

Quaternary Ammonium Compounds

Answer 10

At least one nitrogen (N)
N has four rather than 3 bonds
--Carries a positive charge
--Unable to cross most membranes
Ex. Tubocurarine 
-Muscle relaxant

Question 11

P-glycoprotein is a multidrug transporter found in the _________ and transfers drugs _____ the cells.

1. cytoplasm, out of
2. cytoplasm, into
3. cell membrane, out of
4. cell membrane, into

Answer 11

3. cell membrane, out of

Question 12

Definition of ionization

– Acid and Base

Answer 12

Process of when a base or acid become charged, the process

• An acid gives up a proton (H+) and becomes negatively charged
• A base accepts a proton (H+) and becomes positively charged.

Question 13

About pH-Dependent Ionization

Answer 13

• The pH environment plays a role in cell membrane crossing
• Drugs exist as uncharged or charged (ionized) forms of weak bases or weak acids
• A weak base or weak acid carries a charge based on the pH of the environment
• –An acid will ionize in a basic (alkaline) environment
• —A base will ionize in an acidic environment

Question 14

Example of 
pH-Dependent Ionization

Answer 14

Aspirin is a weak acid

• Does NOT ionize in the acidic stomach
• –May be absorbed in the stomach
• Does ionize in the basic intestines
• –Ionized forms are non-lipophilic
• –Unable to be absorbed in the intestines

Question 15

Ion Trapping or pH Partitioning

Answer 15

If the pH gradient differs between 2 sides of a cell membrane

• -Acidic drugs gather on the basic (alkaline) side.
• -Basic drugs gather on the acidic side.

A drug accumulates on the side which most favors its ionization
–Ionized forms are non-lipophilic and unable to cross cell membranes

Question 16

Acidic drugs are trapped on the ________ side of a pH gradient.

1. acidic
2. neutral
3. basic (alkaline)

Answer 16

3. Basic

Question 17

Absorption

Answer 17

• Movement of drug from its administration site into the blood.
• Absorption rate determines onset of action.
• Amount absorbed determines intensity of effects.

Question 18

Factors Affecting Absorption (first 3)

Answer 18

Rate of Dissolution
-The formulation that dissolves quickly has a faster onset of action.

Surface Area

• The larger the surface area, the faster the absorption.
• The small intestines have more surface area than the stomach (due to microvilli).

Blood Flow

• The higher the blood flow, the more rapid the absorption.
• Large diffusion gradient created.

Question 19

Factors Affecting Absorption (last 3)

Answer 19

Lipid Solubility

• The higher the lipid solubility, the faster the absorption.
• Highly lipophilic drugs pass through cell membranes quickly.

pH Partitioning
-Absorption increases when pH partitioning causes drug molecules to ionize in the plasma rather than administration site.

Gastric Emptying

• Some drugs are designed to be absorbed only in the intestine
• Delayed gastric emptying may delay absorption by minutes to hours

Question 20

Routes of Administration

Answer 20

1. Enteral (via the GI tract)- oral or rectal
2. Parenteral (outside the GI tract)
   - -Intravenous
   - -Subcutaneous
   - -Intramuscular

Question 21

Local vs. Systemic Effects

Answer 21

Local
-Effects seen in area of administration only

Systemic

• Effects seen in other areas besides the site of administration
• Drug absorbed from site of administration and distributed to other parts of the body

Question 22

Intravenous Absorption

Answer 22

No barriers to absorption with this method of delivery

Instantaneous complete absorption

Multiple advantages

• -Hallmark – Rapid onset
• -Control over amount of drug delivered
• -Ability to deliver large fluid volumes
• -Ability to give irritating drugs

Question 23

Intravenous Absorption, Disadvantages

Answer 23

Irreversible

• –Give slowly IV push over at least 1 min
• –Reaches brain in 15 seconds
• –Infusing slowly allows stopping medication and preventing dangerous reactions

Fluid overload
—Monitor IV rate of infusion

Infection risk
—Avoid drug contamination

Embolism risk – blockage of vessel distant to site of administration

• –Clots due to RBC destruction from hypertonic or hypotonic solutions
• –Incompletely dissolved drugs

High cost, difficulty, inconveniences

Question 24

Intramuscular Absorption

Answer 24

Only barrier to absorption is the capillary wall

• –Large spaces in between the capillary wall cells
• –Drug passes through these spaces with ease

Rate of absorption

• –Rapid absorption of water-soluble drugs (10-30 minutes)
• –Increased rate of absorption if high blood flow

Question 25

Intramuscular Absorption | - Advantages and Disadvantages

Answer 25

Advantages - Administration of poorly soluble drugs - Administration of depot preparations - --Preparations designed to be absorbed over time - --Less injections Disadvantage - Discomfort and inconvenience - Very painful injections - Local tissue injury - Nerve damage if improperly administered

Question 26

Subcutaneous Absorption

Answer 26

SC administration is almost identical to IM injection - -Passes readily between spaces between capillary wall cells - -Water-soluble drugs absorbed rapidly - -Increased absorption with increased blood flow No significant barriers to absorption

Question 27

Subcutaneous Absorption | - Advantages and Disadvantages

Answer 27

Advantages - -Suitable for poorly-soluble drugs - -Depot preparations Disadvantages - -Discomfort - -Inconvenience - -Potential for tissue injury

Question 28

The advantages of intramuscular absorption include: 1. instantaneous, complete absorption. 2. administration of poorly soluble drugs. 3. convenience of administration.

Answer 28

Answer 2. administration of poorly soluble drugs

Question 29

Oral Absorption

Answer 29

PO abbreviation stands for per os, a Latin phrase meaning by way of the mouth Absorbed by the stomach or intestines

Question 30

Oral Absorption- Three barriers to absorption exist for this route:

Answer 30

Epithelial cell membranes that lines the GI tract Capillary cell membranes P-glycoprotein - -In intestinal epithelial cell membranes - -Transports drug back into intestinal lumen

Question 31

Factors influencing oral absorption | (highly variable)

Answer 31

- Solubility and stability of drug - Gastric and intestinal pH - Gastric emptying time - Food in gut - Coadministration of other drugs and herbals - Special coatings on drug preparations

Question 32

The rate of absorption may be increased by: 1. smaller surface areas. 2. lower blood flow. 3. lower lipid solubility. 4. ionization of the drug at the site of administration. 5. formulations which dissolve quickly. 6. delayed gastric emptying.

Answer 32

answer 5

Question 33

Drug Movement

Answer 33

All drugs taken orally must go through the liver --Except drugs absorbed by the oral mucosa or distal segment of the rectum Some drugs reenter GI tract - -Enterohepatic circulation (reabsorption from the bille) - -Excreted in stools

Question 34

Oral Absorption | - Advantages and Disadvantages

Answer 34

Advantages - -Easy, convenient, inexpensive to administer - -Safer than injection - -No risk of fluid overload, infection, or embolism - -Reversible by giving activated charcoal to soak up drug Disadvantages - Highly variable absorption - Inactivation - --Digestive enzymes - --Liver enzymes with first-pass effect - --Inactivated by other medications, foods, herbals - Difficulty swallowing or unwillingness to take medication

Question 35

Oral versus Parenteral

Answer 35

Oral administration is usually preferred Parenteral administration is necessary when: - Require rapid onset of action. - Need tightly controlled plasma levels. - Drugs are destroyed by gastric acid. - Drugs can cause severe local injury. - Drugs cannot cross cell membranes. - Need prolonged effects of drug (ex. depot preparation). - Unable/unwilling to take oral drugs.

Question 36

Drug Terminology

Answer 36

Chemically Equivalent ---Same amount of identical compound (drug) Bioavailability - --Same drug AND - --Same rate and extent of absorption

Question 37

Preparations of Oral Drugs (Tablets)

Answer 37

Tablets - Compressed mixture - --Drug-Active ingredients - --Binders - --Fillers - --Dyes - Differ in bioavailability as to onset and intensity of effects

Question 38

Preparations of Oral Drugs (Enteric-coated)

Answer 38

Enteric-coated Dissolve in intestines - --Absorption depends on rate of gastric emptying - --Some may fail to dissolve - --Do NOT crush! Protection - ---Drug from acid and pepsin - --Stomach from gastric discomfort Coatings of fatty acids, waxes, shellac

Question 39

Preparations of Oral Drugs (sustained release)

Answer 39

Sustained-release Capsules filled with variable time-release spheres - --Each sphere releases drug at different times - --Maintains steady release of drug - --Do NOT crush! Permits longer times between administration Potential for variable absorption High cost

Question 40

Additional Routes of Administration

Answer 40

Topical --Local treatment of skin, eyes, ears, nose, mouth, vagina Transdermal - skin Inhalation - lungs Suppositories - rectal or vaginal Injections into specific sites

Question 41

Which oral formulation may be crushed? 1. Immediate-release tablets 2. Sustained-release tablets 3. Enteric-coated tablets

Answer 41

Answer 1. Immediate-release tablets