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Lecture Contents -- Unit 4 • The Basics of Pharmacology – – – – – Drug delivery Absorption and distribution Metabolism Excretion Case studies: teramisole and rapifen Pharmacokinetics: A Highly Specialized Science Drug Delivery: „How To Get In“ • Oral (p.o. = per os) • Injection – intravenous (i.v.) – intramuscular (i.m.) – subcutaneously (s.c.) • Transdermal – Iontophoresis – enhanced diffusion • Mucosal – nasal or pulmonary – sublingual – rectal, vaginal From the Pill to the Intestines From Absorption To Excretion Barrier Penetration By Drugs Multiple Doses, Half-Life, Drug Cumulation, and Steady-State Sustained Release (SR) Formulations The Capsule: Flexible, PreProgrammed Intestinal Release Drug Delivery With „Tailored Particles“ Liposome Technology: Making Hydrophobic Molecules Bioavailable Microcapsules Externally Triggered Drug Release Devices Pulmonary Drug Delivery: Making Use of 100 m2 Surface Inhalers Transcytosis: a natural uptake path Transdermal Route Advantages • • • • Non-invasive No infection risk Pain-free Drug delivery rate profiles can be preprogrammed • Convenient -- high patient compliance • Simplifies handling of geriatric patients Transdermal Delivery: The „Patch“ Utility of Transdermal Patches • Wherever constant delivery of limited amounts (<200mg/day) of drug at constant rate is required over prolonged periods: – Hormone replacement therapy (HRT) – Chronic pain (cancer): fentanyl • Can be the only applicable route of administration for compounds with unfavorable pharmacokinetics Skin Penetration Enhancers • Solvents (alkanols, glycols, acetamide, ...) • Ionic compounds (monoalkylphopsphates, lauroylcholine, ascorbate, ...) • DMSO and related cyclic sulfoxides • Azone and related compounds (azacycloalkanes and -alkenones, ...) • Fatty alcohols, fatty acids, liposomes • Complexing agents (macrocyclic lactones, ketones, and anhydrides; unsaturated cyclic ureas) Transdermal Delivery: Iontophoresis Requirements for iontophoretic drug delivery: •Low molecular weight •Hydrophilic •Carries a charge at near-neutral pH Biodegradable Implants: Post-Surgery Treatment of Glioma Carboxyphenoxy propane:sebacic acid (polifeprosan 20) in a 20:80 copolymer [poly(CPP:SA)20:80] Directly implanted into brain cavity remaining after surgery Delivered agent: carmustine http://www.guilfordpharm.com/products/gliadel.htm Drug Distribution in the Body: „How To Reach The Target“ • Compartment model: – – – – – – Muscle Fatty tissue Intestine Blood Peripheral organs Brain • Effective capacity can vary acutely (dehydration) or as a consequence of body remodeling (age) Exchange Between Body Compartments Dynamics of Drug Distribution Drug Metabolism: The „Biofate“ • Four main metabolic patterns: – Oxidation – Reduction – Hydrolysis Phase I – Conjugation Phase II Oxidative Metabolic Reactions Hydroxylation S-oxidation Dealkylation Deamination (monoamine oxidase) Formylation (alcohol dehydrogenase) Reductive and Hydrolytic Metabolic Reactions Reduction of azo and nitro groups Cleavage of ester bond Cleavage of amide bond Conjugation / Coupling Reactions • Addition of molecules naturally present in the body: – – – – Glucuronidation (in the liver; e.g., alcohols) Acylation (e.g. sulfonamides) Glycination (e.g. nicotinic acid) Sulfatation (e.g. paracetamol, morphine) • Metabolite is generally more hydrophilic facilitated renal excretion Drug Excretion: „How To Get Out“ • • • • Urine Feces Skin (sweat) Respiratory tract Renal Excretion Case Study: An Antiparasitic Drug • Starting point: An aminothiazole is an effective deworming agent in chicken but not in mammals • Explanation: A rather unstable metabolite, imidazothiazole (which is not formed in mammals) is the actual antiparasitic agent Aminothiazole prodrug Active metabolite (imidazolthiazole) Tetramisole, an Acceptable Active Analog • Stable after oral administration • Bioavailable at target site • Antiparasitic activity S N S N progenitor Tetramisole Targeted Acceleration of Metabolism for Short Duration of Action Fentanyl (long-acting) Rapifen (short-acting)