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Pharmacology • [email protected] • Phone Number: (203) 467-0094 Pharmacokinetics & Pharmacodynamics Injected Drugs Pharmacokinetics • • • • What the body does to a drug Absorption Distribution Metabolism Excretion Pharmacodynamics What the drug does to the body • Drug effect on receptors Two Compartmental Model • Central Compartment: Intravascular fluid and any highly perfused tissues. Highly perfused tissue receive 75% of CO, but only equal 10% of total body mass. • Peripheral Compartments: Not actual area but calculated. Plasma Concentration Curves a graphic plot of the range of plasma concentrations after an injected drug is given. Plots plasma [ ] against time. Alpha Phase distribution phase • This begins immediately after injection and reflects the drugs movement from the central compartment (circulation) to the peripheral (tissue) compartment. Beta Phase elimination phase • Follows the Alpha phase and is a more gradual decline in plasma concentrations. Plasma Concentration Slide... Terms • Elimination half time: The time necessary for the plasma concentration to fall 50% during the elimination phase (beta phase) • Context-sensitive half time: Measures half time after an infusion is stopped. • Elimination half-life: the time needed eliminate 50% of the drug from the body. • Effect-site equilibrium: delay between IV administration and desired effect. • Bioavailability- fraction of the administered drug available for absorption Distribution • • • • Uptake Volume of Distribution Degree of Ionization Protein Binding Metabolism • A. First order kinetics- Constant fraction broken down in a standard time. Independent of plasma concentrations. • B. Zero order kinetics- Constant amount is metabolized- constant amount each unit of time. example: alcohol Metabolism: Pathways • • • • • • Hepatic microsomal enzymes Non-microsomal enzymes Oxidative Reduction Hydrolysis Conjugation Clearance Hepatic clearance: • Perfusion dependent • Capacity dependent Biliary excretion: Renal clearance: • Glomerular filtration • Tubular secretion • Tubular reabsorption View Dose Response Curves.... (See Slide and Handout) Dose response Curves • ED 50 Effective Dose in 50% of the population • LD 50 Lethal Dose in 50% of the population • Therapeutic Index LD 50/ED 50 Pharmacodynamics • Receptors • Plasma Levels Terms • • • • • Sensitivity Tolerance Tachyphalaxis Immunity Agonist/Anatagonist Any Questions ??????????????????? Pharmacokinetics & Pharmacodynamics Inhaled Anesthetics Pharmacokinetics • • • • Absorption Distribution Metabolism Elimination PA=Pa=Pbr • PA: Alveolar partial pressure of the gas • Pa: Arterial blood partial pressure • Pbr: Brain partial pressure MAC: Minimum Alveolar Concentration The minimum alveolar concentration that will prevent movement to a surgical stimulus in the 50% of the population Distribution:Solubility Coefficients • Blood: Gas Solubility • Oil: Gas Solubility • Tissue: Blood Solubility Factors that Affect MAC Increases • Hyperthermia • Increases in CNS catecholamines • Hypernatremia Decreases • • • • • • Hypothermia Alpha 2 agonists Pregnancy Alcohol ingestion Lithium Decreases in CNS catecholamines • Hyponatremia No Change in MAC... • • • • • Metabolism Chronic alcohol abuse Gender Length of anesthesia Hyperkalemia or hypokalemia Pharmacodynamics Meyer-Overton Theory Protein Receptor Theory GABA Suppression Theory Lecture Finished Go home........