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Toxicokinetics Lect 5 Factors affecting pulmonary absorption 1. Solubility of the drug in the blood 2. Particle size Large particles are deposited in the nasal tract > 5 microns; 2-5 micron particles are deposited mainly in the tracheobronchial region; while particles less than 1 micron penetrate into the alveolar sacs and absorbed into the blood 3. Water solubility High water solubility volatile drugs are absorbed in the nasal tract; while low water solubility drugs will reach the bronchioles to alveoli Airway anatomy bronchial tree trachea • • diffusion distance: ~20 mm total gas exchange area: ~80 m2 Airway anatomy trachea alveoli capillaries bronchial tree • • diffusion distance blood/air: ~20 mm total exchange gas exchange area: ~80 m2 Factors affecting dermal absorption 1. Condition of the skin: Stratum corneum serves as the main barrier. When abraded, increased absorption will result 2. Skin permeability coefficient This represents the rate at which a particular drug penetrates the skin 3. Body region Not all regions of the body have the same skin thickness. Forehead versus palm 4. Lipid solubility The more lipid soluble the drug is the more it will be absorbed 5. Skin hydration Rate of Absorption • The rate of absorption may be of toxicological importance because it is a major determinant of the peak plasma concentration and, therefore, the likelihood of acute toxic effects. • Transfer of chemicals from the gut lumen, lungs, or skin into the general circulation involves movement across cell membranes, and simple passive diffusion of the unionized molecule down a concentration gradient is the most important mechanism. • Lipid-soluble molecules tend to cross cell membranes easily and are absorbed more rapidly than water-soluble ones. The gut wall and lungs provide a large and permeable surface area and allow rapid absorption; in contrast the skin is relatively impermeable and even highly lipid-soluble chemicals can enter only slowly Extent of Absorption • The extent of absorption is important in determining the total body exposure or internal dose, and therefore is an important variable during chronic toxicity studies and/or chronic human exposure. • The extent of absorption depends on the extent to which the chemical is transferred from the site of administration into the local tissue, and the extent to which it is metabolized or broken down by local tissues prior to reaching the general circulation. • An additional variable affecting the extent of absorption is the rate of removal from the site of administration by other processes compared with the rate of absorption • Chemicals given via the gastrointestinal tract may be subject to a wide range of pH values and metabolizing enzymes in the gut lumen, gut wall, and liver before they reach the general circulation. • The initial loss of chemical prior to it ever entering the blood is termed first-pass metabolism or pre-systemic metabolism; it may in some cases remove up to 100% of the administered dose so that none of the parent chemical reaches the general circulation. The intestinal lumen contains a range of hydrolytic enzymes involved in the digestion of nutrients. The gut wall can perform similar hydrolytic reactions and contains enzymes that can oxidize many drugs Absorption and Bioavailability • Irrespective of the reason that is responsible for the incomplete absorption of the chemical as the parent compound, it is essential that there is a parameter which defines the extent of transfer of the intact chemical from the site of administration into the general circulation. • This parameter is the bioavailability, which is simply the fraction of the dose administered that reaches the general circulation as the parent compound. (The term bioavailability is perhaps the most misused of all kinetic parameters and is sometimes used incorrectly in a general sense as the amount of drug available specifically to the site of toxicity). Bioavailability The fraction of the administered dose reaching the systemic circulation and is thus a measure of first pass elimination for I.V.: 100% for non I.V.: ranges from 0 to 100% e.g. Lidocaine bioavailability 35% due to destruction in gastric acid and liver metabolism First pass effect • The first-pass effect (also known as first-pass metabolism) is a phenomenon of drug metabolism whereby the concentration of a drug is greatly reduced before it reaches the systemic circulation i.e. Propranolol, Diazepam • After a drug is swallowed, it is absorbed by the digestive system and enters the hepatic portal system. It is carried through the portal vein into the liver before it reaches the rest of the body. The liver metabolizes many drugs, sometimes to such an extent that only a small amount of active drug emerges from the liver to the rest of the circulatory system • This first pass through the liver thus greatly reduces the bioavailability of the drug Liver vein Systemic circulation Liver Liver artery 70 Plasma concentration Bioavailability (F) 60 50 (AUC)o (AUC)iv i.v. route 40 30 oral route 20 Time (hours) 10 0 0 2 4 6 8 10 Calculation of Bioavailability • The fraction absorbed as the intact compound or bioavailability (F) is determined by comparison with intravenous (i.v.) dosing (where F = 1 by definition). The bioavailability can be determined from the area under the plasma concentration–time curve (AUC) of the parent compound , or the percentage dose excreted in urine as the parent compound, i.e. for an oral dose: