Lipophilic drug absorption

To enhance absorption, it is important to identify the rate-limiting step in this process and to counter the relevant barrier in each case. The possible solutions for the absorption barriers facing lipophilic drug absorption are presented according to their physiological order, i.e., issues concerning the GI lumen (preenterocyte), followed by issues associated with the enterocyte and onward. However, it should be noted that a few concepts affect more than one step of the absorption process. 

The mechanism responsible for improved delivery of lipophilic drugs has not yet been clarified. Absorption of liposomes by cells is unlikely. Adsorption to cells followed by slow release of the drug from the liposome, either via diffusion through the thin aqueous tear film or via direct partitioning from the membrane of the vesicle to the membrane of the cell, was proposed as a possible pathway. 

Figure 22.1 A. Schema for a physiologically based pharmacokinetic model incorporating absorption in the stomach and intestines and distribntion to various tissues. B. Each organ or tissue type includes representation of perfusion (Q) and drug concentrations entering and leaving the tissue. Fluxes are computed by the product of an appropriate rate law, and permeable surface area accounts for the affinity (e.g., lipophilic drugs absorbing more readily into adipose tissue). Clearance is computed for each tissue based on physiology and is often assumed to be zero for tissues other than the gut, the liver, and the kidneys.

Theory and computational aspects of intestinal permeability have been reviewed in detail by Egan and Lauri [27], Briefly, a drug must be somewhat permeable through the membrane of the intestinal tract if it is to be administered orally and achieve systemic exposure. The rate of membrane permeability is strongly related to the lipophilicity and hydrophilicity of the molecule. Thus, models with a small number of descriptors related to those two properties can provide useful predictions of drug absorption. 

As most drugs are preferably given orally, absorption which is complete, consistent and predictable is desirable. Although it may be possible from solubility, lipophilicity, pKa, molecular size, and animal data to make some prediction about likely absorption, only a study in humans will give quantitative data as the mechanisms of drug absorption are complex and still incompletely understood (Washington et al., 2001). It may be helpful here to distinguish between the terms absorption and bioavailability. ... 

Generally, the stratum corneum is considered to be the rate limiting layer of the skin with regard to transdermal drug absorption. However, for the invasion of very lipophilic compounds, the bottleneck moves from the stratum corneum down to the viable, very hydrophilic layer of the epidermis, due to substances reduced solubility in this rather aqueous layer [14],... 

Although there appears to be no significant species differences in absorption rates for small lipophilic drugs, some interspecies differences are noted with water-soluble drugs absorbed from distal airspaces of in vivo mammalian lungs [112], These species differences have not been systematically studied yet. However, some marked differences were reported for protein absorption rates... 

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