Pharmacokinetics factors, parameters

The most useful pharmacokinetic variable for describing the quantitative aspects of all processes influencing the absorption (fa) and first-pass metabolism and excretion (Eg and Eh) in the gut and liver is the absolute bioavailability (F) [40]. This pharmacokinetic parameter is used to illustrate the fraction of the dose that reaches the systemic circulation, and relate it to pharmacological and safety effects for oral pharmaceutical products in various clinical situations. The bioavailability is dependent on three major factors the fraction dose absorbed (fa) and the first-pass extraction of the drug in the gut wall (EG) and/or the liver (EH) (Eq. (1)) [2-4, 15, 35] ... 

Obach et al. [27] proposed a model to predict human bioavailability from a retrospective study of in vitro metabolism and in vivo animal pharmacokinetic (PK) data. While their model yielded acceptable predictions (within a factor of 2) for an expansive group of compounds, it relied extensively on in vivo animal PK data for interspecies scaling in order to estimate human PK parameters. Animal data are more time-consuming and costly to obtain than are permeability and metabolic clearance data hence, this approach may be limited to the later stages of discovery support when the numbers of compounds being evaluated are fewer. 

Data adequacy The key study was well designed and conducted and documented a lack of effects on heart and lung parameters as well as clinical chemistry. Pharmacokinetic data were also collected. The compound was without adverse effects when tested as a component of metered-dose inhalers on patients with COPD. Animal studies covered acute, subchronic, and chronic exposure durations and addressed systemic toxicity as well as neurotoxicity, reproductive and developmental effects, cardiac sensitization, genotoxicity, and carcinogenicity. The values are supported by a study with rats in which no effects were observed during a 4-h exposure to 81,000 ppm. Adjustment of the 81,000 ppm concentration by an interspecies and intraspecies uncertainty factors of 3 each, for a total of 10, results in essentially the same value (8,100 ppm) as that from the human study. ... 

The adjustment of dose and dosing regimen for children and the elderly needs a special consideration because of several differences as compared to an adult individual. The differences may be due to many factors which include changes in pharmacokinetic parameters, age, body weight, surface area, and genetic predisposition. The present chapter provides some basic explanation about their differences and the dosage calculations because of these differences. 

Apart from patient-specific parameters, external factors - most importantly the concomitant uptake of certain other chemicals present in diet, environment and especially other drugs - influence drug actions. Possible effects are manifold and can affect all stages of pharmacokinetic and pharmacodynamic processes in the body. Also direct interaction and inactivation of concomitantly administered substances are possible. Drug-drug interactions via modulation of metabolism present a very hot topic in pharmaceutical research and drug design. 

Renwick (1991, 1993) analyzed interindividual differences of healthy volunteers by comparing the maximum and mean values of pharmacokinetic parameters (7 substances) and pharmacodynamic parameters (6 substances). The data indicated that toxicokinetic differences were slightly greater than toxicodynamic differences. With one exception, the ratios between the maximum and mean value for a substance s kinetic parameter ranged from 1.8 to 4.2 with most values between 3 and 4, and it was concluded that a factor of 3-4 would be sufficient to consider toxicokinetic differences for 99% of the healthy, adult population and for 80% of the substances. The ratios between the maximum and mean value for a substance s dynamic parameter ranged from 1.5 to 6.9 with most values between 1.7 and 2.7. Based on the analyses, Renwick proposed to subdivide the interindividual factor of 10 into a factor of 4 for pharmacokinetic differences and a factor of 2.5 for pharmacodynamic differences. The aim of the subdivision of the 10-fold factor was to allow the incorporation of suitable compound-specific data for one particular aspect of uncertainty. 

A Level C IVIVC establishes a single point relationship between a dissolution parameter, for example, t5o%, percent dissolved in 4 hours and a pharmacokinetic parameter (e.g., AUC, C ax. I max)- A Level C correlation does not reflect the complete shape of the plasma concentration time curve, which is the critical factor that defines the performance of ER products. 

Another significant factor is the range of release rates studied. The release rates, as measured by percent dissolved, for each formulation studied, should differ adequately (e.g., by 10%). This should result in in vivo profiles that show a comparable difference, for example, a 10% difference in the pharmacokinetic parameters of interest (Cmax or AUC) between each formulation. 

A physiologically based pharmacokinetic model for predicting ethylene dibromide kinetics and consequent toxicity, based on in-vitro metabolic parameters of rodents and humans and on the use of scaling factors, has been presented (Ploemen et al., 1997). Its most important prediction is that the GST pathway is significantly active even at low ethylene dibromide concentrations, which has important implications for risk assessment. 

It is important to note that the elimination half-life is a derived term, and any process that changes k will change the half-life of the drug. Factors that may affect pharmacokinetic parameters are discussed elsewhere, but in this example may include disease states, changes in urinary pH, changes in plasma protein binding, and coadministration of other drugs. 

Chapter 3 Toxicokinetics and Factors Affecting Pharmacokinetic Parameters.21... 

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