Pharmacokinetics kinetics

Pharmacokinetics is the study of how the body affects an adiriinistered dmg. It measures the kinetic relationships between the absorption, distribution, metaboHsm, and excretion of a dmg. To be a safe and effective dmg product, the dmg must reach the desired site of therapeutic activity and exist there for the desired time period in the concentration needed to achieve the desired effect. Too Htde of the dmg at such sites yields no positive effect ( MTC) leads to toxicity (see Fig. 1). For intravenous adininistration there is no absorption factor. Total body elimination includes both metabohc processing and excretion. 

Alcohol dehydrogenase is a cytoplasmic enzyme mainly found in the liver, but also in the stomach. The enzyme accomplishes the first step of ethanol metabolism, oxidation to acetaldehyde, which is further metabolized by aldehyde dehydrogenase. Quantitatively, the oxidation of ethanol is more or less independent of the blood concentration and constant with time, i.e. it follows zero-order kinetics (pharmacokinetics). On average, a 70-kg person oxidizes about 10 ml of ethanol per hour. 

Kawai R, Mathew D, Tanaka C, Rowland M Physiologically based pharmacokinetics of cyclosporine A extension to tissue distribution kinetics in rats and scale-up to human. J Pharmacol Exp Ther 1998 Nov 287(2) 457-68. 

Koizumi A. 1989. Potential of physiologically based pharmacokinetics to amalgamate kinetic data of trichloroethylene and tetrachloroethylene obtained in rats and man. Br J Ind Med 46 239-249. 

A. Rescigno, Mathematical foundations of linear kinetics. In Pharmacokinetics Mathematical and Statistical Approaches to Metabolism and Distribution of Chemicals and Drugs. (J. Eisenfeld and M. Witten, Eds.), North-Holland, Amsterdam, 1988. 

Our pharmacokinetic data indicate that detectable PCP levels may remain in the urine for 4 to 5 weeks after the last use, similar to previous reports (Khajawall and Simpson 1983). The observed elimination kinetics were equally consistent with a one- or two-compartment model, but methodological problems with our data make... 

Ethnic differences have been shown to influence response to psychotropic medications. Much of the focus on the explanation for such differences has been on drug-metabolizing (CYP) enzymes of the liver and their sway over pharmacokinetic factors. It is now well recognized that differences in the distribution of polymorphic variants of CYP enzymes exist between different ethnic groups. However, within ethnic groups there are considerable inter-individual variations in drug kinetics, which may not be accounted for solely by genetic variation. Responses to pharmacotherapy are multifaceted and involve the interaction of environmental and... 

On some occasions, the body does not behave as a single homogeneous compartment, and multicompartment pharmacokinetics are required to describe the time course of drug concentrations. In other instances certain pharmacokinetic processes may not obey first-order kinetics and saturable or nonlinear models may be required. Additionally, advanced pharmacokinetic analyses require the use of various computer programs, such as those listed on the website http //www.boomer.org/pkin/soft.html. 

T. F. Blaschke, Protein binding and kinetics of drugs in liver disease, Clin. Pharmacokinet, 2, 32-44 (1977). 

L. Hendeles, R. Iafrate, and M. Weinberger, A clinical and pharmacokinetic basis for the selection and use of slow release theophylline products, Clin. Pharmaco-kinet, 9, 95 (1984). 

PBPK and classical pharmacokinetic models both have valid applications in lead risk assessment. Both approaches can incorporate capacity-limited or nonlinear kinetic behavior in parameter estimates. An advantage of classical pharmacokinetic models is that, because the kinetic characteristics of the compartments of which they are composed are not constrained, a best possible fit to empirical data can be arrived at by varying the values of the parameters (O Flaherty 1987). However, such models are not readily extrapolated to other species because the parameters do not have precise physiological correlates. Compartmental models developed to date also do not simulate changes in bone metabolism, tissue volumes, blood flow rates, and enzyme activities associated with pregnancy, adverse nutritional states, aging, or osteoporotic diseases. Therefore, extrapolation of classical compartmental model simulations... 

While these models simulate the transfer of lead between many of the same physiological compartments, they use different methodologies to quantify lead exposure as well as the kinetics of lead transfer among the compartments. As described earlier, in contrast to PBPK models, classical pharmacokinetic models are calibrated to experimental data using transfer coefficients that may not have any physiological correlates. Examples of lead models that use PBPK and classical pharmacokinetic approaches are discussed in the following section, with a focus on the basis for model parameters, including age-specific blood flow rates and volumes for multiple body compartments, kinetic rate constants, tissue dosimetry,... 

Nonetheless the approach can provide - both routinely and rapidly - large amounts of pharmacokinetic or other distribution information on several compounds without significantly increasing the burden on the animals, whilst also minimizing the number of animals used. It is common to include a compound of known pharmacokinetics that acts as a control in each of these studies. This can help in identifying when the co-administered compounds have changed the kinetics. However, such marker compounds will not necessarily highlight problems with compounds that are subject to different clearance mechanisms [35],... 

The original proposal of the approach, supported by a Monte Carlo simulation study [36], has been further validated with both pre-clinical [38, 39] and clinical studies [40]. It has been shown to be robust and accurate, and is not highly dependent on the models used to fit the data. The method can give poor estimates of absorption or bioavailability in two sets of circumstances (i) when the compound shows nonlinear pharmacokinetics, which may happen when the plasma protein binding is nonlinear, or when the compound has cardiovascular activity that changes blood flow in a concentration-dependent manner or (ii) when the rate of absorption is slow, and hence flip-flop kinetics are observed, i.e., when the apparent terminal half-life is governed by the rate of drug input. 

If the unbound drug concentrations in plasma are higher than their K values on the transporters, then transporter function may be significantly affected [106], Following a pharmacokinetic analysis of the effect of probenecid on the hepatobiliary excretion of methotrexate, it has been shown the extent of an in vivo drug-drug interaction can be quantitatively predicted from the kinetic parameters for transport across the sinusoidal and bile canalicular membranes determined in vitro [107]. 

In addition to the mechanistic simulation of absorptive and secretive saturable carrier-mediated transport, we have developed a model of saturable metabolism for the gut and liver that simulates nonlinear responses in drug bioavailability and pharmacokinetics [19]. Hepatic extraction is modeled using a modified venous equilibrium model that is applicable under transient and nonlinear conditions. For drugs undergoing gut metabolism by the same enzymes responsible for liver metabolism (e.g., CYPs 3A4 and 2D6), gut metabolism kinetic parameters are scaled from liver metabolism parameters by scaling Vmax by the ratios of the amounts of metabolizing enzymes in each of the intestinal enterocyte compart-... 

Burman WJ, Gallicano K, Peloquin C Comparative pharmacokinetics and pharmacodynamics of the rifamycin antibiotics. Clin Pharmaco-kinet 2001 40 327-341. 

---