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Chapters 8 and 11
1
Pharmacokinetics and
pharmacodynamics
• Pharmacodynamics is the study of how
drugs interact with a molecular target, i.e;
effect of the drug on the body.
• Pharmacokinetics is the study of how a
drug reaches its target in the body and how
it is affected on that journey, i.e; effect of
the body on the drug.
• Pharmacokinetics is the study of how
is the drug absorbed, distributed,
metabolized and excreted in the body2
Pharmacokinetics &
related topics
3
Pharmacokinetics & related
topics
Drug absorption
• Refers to the route or method by which the
drug reaches the blood supply, this depends
on how the drug is administered.
• The most common and preferred method of
administration is the oral route.
• It depends on hydrophilic/hydrophobic
properties, polarity and ionization of the
drug.
4
Drug absorption
I-Stability:
”Oral drugs have to be chemically stable to survive
the stomach HCl and metabolically stable to survive
the digestive enzymes in GIT and metabolic enzymes
in liver (mainly cytochrome P450 ).
-Insulin, local anaesthetics and first penicillins are
acid labile , so they can't be taken orally but are
given parentrally. 5
Pharmacokinetics & related topics
Drug absorption
• II-Solubility
• The drug should have the correct balance of water
versus fat solubility
• Oral drugs should be sufficiently polar to dissolve
in the GIT and blood supply, but sufficiently fatty
to pass through the cell membranes (optimum
hydrophophobic/hydrophilic balance).
• Most oral drugs obey Lipinski’s rule of five, i.e.
1-A molecular weight less than 500
2-No more than 5 hydrogen bond donor groups
3-No more than 10 hydrogen bond acceptor groups
4-A calculated log P value less than + 5
6
Pharmacokinetics & related topics
Drug absorption
• II-Solubility
A- Polarity:
• Some polar drugs break these rules are usually
poorly absorbed and have to be administered by
injection.
• Highly polar drugs will dissolve in GIT but they will fail to be
absorbed through the lipid cell membrane of the gut wall
while nonpolar drugs will be poorly soluble in the GIT instead
they will dissolve in the fat globules leading to poor surface
contact with cell membranes resulting in poor absorption ,
too. 7
Pharmacokinetics & related topics
Drug absorption
B-Ionization:
The presence of the weak ionizable -NH- group in
many drug structure would have three advantages:
A- good solubility due to =NH2+ cation in stomach
acid
B- good absorption due to conversion to non ionized
form in intestine in slightly alkaline pH
C-good target interactions
due to participation + H+ H
N H N
of ammonium ion in -H +
H
them
8
Drug absorption
-Henderson-Hasselbalch equation
C-Size :
Large molecular weight drugs generally have poor
these drugs.
9
Pharmacokinetics & related topics
Drug absorption
mechanisms:
• Most drugs with proper solubility in
both water and lipid will be absorbed
through the lipid cell membrane of the
gut wall cells .
• Carrier proteins are essential to a cell’s
survival as they transport highly polar
building blocks required for various
biosynthetic pathways.
10
Pharmacokinetics & related topics
Drug absorption mechanisms:
• Some polar drugs, are absorbed by special
carrier proteins such as levodopa
fluorouracil, lisinopril, methotrexate and
erythromycin, which are similar in structure
to (or bear a structural resemblance to) one
of the building blocks (such as amino acid)
then it too may be smuggled into the cell
• Other polar drugs with high molecular weight
are absorbed by pinocytosis (without passing
through the membrane).
11
Pharmacokinetics & related topics
Drug absorption mechanisms:
• Some polar drugs with low molecular weight
(<200) are absorbed by passing through the pores
between cells lining the gut wall.
• Thus polar drugs are orally active if they are
small enough to pass between the cells of the
gut wall or are recognized by carrier proteins or
are taken across the gut wall by pinocytosis.
• N.B: sometimes drugs are designed to be highly
polar to be retained in the gut and not absorbed to
treat gut infections as some antibacterial agents
for gut infections. 12
Pharmacokinetics & related topics
• Dosage:
• Drug dosing or dose regimen (regime) means drug
amount in each dose and frequency of administration.
• Due to the number of pharmacokinetic variables
involved, it can be difficult to estimate the correct
dosing regime for a drug.
• The drug should be administered at the correct dose
levels and at frequency to ensure that blood
concentration remain within the therapeutic window.
• Therapeutic window means drug levels in blood lie
between therapeutic and toxic levels). 13
Pharmacokinetics & related topics
• Dosage:
• In general, the concentration of free drug in blood
(non bound to plasma proteins) is a good indication
of the availability of that drug at its target site.
14
Dosage
Drug administration
• The main routes are oral, sublingual, rectal, topical,
epithelial, inhalation and injections. The method
chosen depends upon the target organ and the
pharmacokinetics of the drug.
17
Methods (routes )of drug
administration
• Oral administration is the preferred method of
administering drugs, but it is also the most
demanding on the drug.
• Drugs administered by methods other than oral
route avoid the first pass effect
– Oral – Inhalation
– Sublingual – Injection
– Rectal • Intravenous
– Epithelial • Subcutaneous
• Topical • Intramuscular
• Nasal spray • Intrathecal
• Eyedrops
– Implants 18
Drug administration
o Drugs can be administered such that they are
absorbed through the mucous membranes of the
mouth, nose, or eyes.
o Some drugs are administered rectally as
suppositories.
o Topically administered drugs are applied to the skin.
Some drugs are absorbed through the skin into the
blood supply.
o Inhaled drugs are administered as gases or aerosols
to act directly on the respiratory system. Some
inhaled drugs are absorbed into the blood supply to
act systemically. 19
Drug administration
22
Drug-drug interactions
These are defined as the effects that one drug has on the
activity of another drug if both drugs are taken together.
Examples are Warfarin or methotrexate bound to albumin
and plasma protein in the blood and they will be
unavailable to interact with their targets.
When another drug is taken which can compete for plasma
protein binding (e.g. sulphonamide), then a certain
percentage of previously bound drug(warfarin or
methotrexate) is released, increasing the concentration
of the drug
and its
effect.
23
Drug Metabolism
• Drugs are exposed to enzyme-catalyzed reactions
which modify their structure. This is called drug
metabolism and can take place in various tissues.
But, most reactions occur in liver.
26
To control chemical and
physical properties…
• Drug design
• Alter functional groups
• Quantitative SARs
• Computational methods
27
Solubility
• Hydrophobic/hydrophilic balance:
• The hydrophobic/hydrophilic character of the drug is the crucial
factor affecting absorption through the gut wall.
• Decrease polarity
By masking a polar functional O
or
group with an alkyl or acyl group.
R OH R OR' R O C R'
O O
R C OH R C OR'
• Increase polarity
By adding a polar or Cl
S
More polar N
N
functional group Cl F
N
polarity.
N N
N N
Cl H F HO
R R' R R'
O O
CH3 C CH3
29
CH3
Stability
O O
C R C R
2- Bioisosteres
CH3 O H2N O
Proocaine or NH2 31
novocaine
Stability
4. Metabolic blockers
Example: R R'
Ox
R R'
introduction of polar
groups at particular
positions in their
R R' Ox
skeleton.
Megestrol acetate is
CH3
oxidized at position 6 to
give a hydroxyl group, O
leading to quick O O
removed or replaced by Ox
O O
H3C S NH Cl S NH
O NH O NH
O O
Tolbutamide Chlorpropamide
34
Stability
6. Group Shifts
OH OCH3
metabolize
OH metabolize
OH OH
HO HO
NH2 NH 36
Noradrenaline C(CH3)3
Stability
• Reducing Toxicity:
• A drug fails clinical trials because of its toxic side
effects. This may be due to toxic metabolites.
38
Other factors in drug design
O
• Prodrugs:
• Prodrugs are inactive
N
N
demethylation into
Nordazepam. The latter
has been used as a
sedative, but loses activity
by metabolism and Cl
excretion. Nordiazepam 39
Other factors in drug design
• Prodrugs:
II-L-dopa → dopamine (approach for carrier
protein):
prodrug---→ active drug
– Levodopa is a prodrug for the neurotransmitter
dopamine which is used in Parkinson’s disease.
levodopa is much more polar than dopamine but
yet it can cross the BBB because it is an amino
acid and is recognized by the carrier proteins
for amino acids.
NH2 HO NH2 HO NH2
O OH HO O OH HO
O OH
O O
OH OH
aspirin salicylic acid
41
Sentry drugs
A second drug is administered alongside the principal drug
where the role of the second drug is to guard or assist
the principal drug.
L-DOPA DOPAMINE
1- Carbidopa: ENZYME
the CNS .
Carbidopa is an inhibitor
of dopa decarboxylase
And thus it allows smaller doses of levodopa to be used with
lower side effects. Furthermore, carbidopa is highly
polar so it can’t pass BBB where the decarboxylation of
levodopa is required.
42
• Sentry drugs
2- Clavulanic acid and amoxicillin
O
O O O
R O
N
OH
HN N
H OH
O
H
H
S
OH
43