Oral Drug Absorption: GI Tract Overview
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Questions and Answers

Which scenario would MOST likely decrease the dissolution rate of a drug with limited aqueous solubility in the gastrointestinal (GI) tract?

  • Presence of surfactants in gastric juice and bile.
  • Concurrent intake of antacids that significantly increase gastric pH. (correct)
  • Administration with a large volume of fluid on an empty stomach.
  • Increased gastric motility due to prokinetic agents.

A pharmaceutical scientist is formulating an ophthalmic suspension. Why might they choose to micronize the drug?

  • To decrease the drug's diffusion coefficient in tear fluid.
  • To reduce irritation and improve drug dispersion on the ocular surface. (correct)
  • To ensure the drug dissolves completely before reaching the cornea.
  • To prevent the drug from penetrating the conjunctiva.

A patient consistently achieves subtherapeutic levels of a weak base drug. Knowing the drug's absorption is dissolution rate-limited, which strategy is LEAST likely to improve bioavailability?

  • Administering the drug with cimetidine. (correct)
  • Switching to a salt form of the drug with enhanced dissolution properties.
  • Administering the drug with an acidic excipient.
  • Reducing the particle size of the drug.

A formulator is developing a topical cream containing a sparingly soluble drug. What is the MOST probable reason for choosing micronized drug particles?

<p>To enhance drug penetration into deeper skin layers. (C)</p> Signup and view all the answers

Which statement BEST explains the mechanism by which salt formation enhances the dissolution rate of a weakly acidic drug?

<p>Salts increase the pH of the diffusion layer, increasing the solubility of the drug. (C)</p> Signup and view all the answers

Which of the following scenarios would LEAST favor the oral route of drug administration?

<p>A drug is prone to significant degradation in the acidic environment of the stomach. (D)</p> Signup and view all the answers

The gastric residence time of a drug is least likely to be affected by which of the following factors?

<p>The specific type of polymer used in the enteric coating of a tablet. (C)</p> Signup and view all the answers

Naproxen sodium is preferred over naproxen for treating toothache due to its:

<p>Faster dissolution rate leading to quicker absorption. (A)</p> Signup and view all the answers

Which of the following is a primary function of the mucus layer in the gastrointestinal (GI) epithelium that directly impacts drug absorption?

<p>Creating a physical barrier that can impede the diffusion of lipophilic drugs. (C)</p> Signup and view all the answers

A drug is formulated as a hydrochloride salt to improve its dissolution rate. What is the MOST likely property of the parent drug?

<p>Weak base. (D)</p> Signup and view all the answers

A scientist aims to formulate a sustained-release oral suspension. Which salt form would be most suitable?

<p>A poorly soluble salt. (D)</p> Signup and view all the answers

How does Phase III of the migrating motor complex (MMC), also known as the 'housekeeper wave,' primarily influence drug absorption?

<p>It clears the stomach and small intestine of undigested material, potentially affecting the absorption of drugs taken during the fasting state. (C)</p> Signup and view all the answers

Which factor associated with food intake is MOST likely to decrease the rate of dissolution of a drug in the GI tract?

<p>Increased viscosity of GI fluids. (D)</p> Signup and view all the answers

Which of the following scenarios would LEAST likely result in altered drug absorption in the gastrointestinal tract?

<p>Maintaining constant and consistent dietary habits, avoiding extremes in fiber or fat intake. (B)</p> Signup and view all the answers

Consider a drug that is a weak base with a pKa of 6.0. Where would this drug be expected to exhibit the highest rate of passive diffusion across the GI membrane?

<p>The ileum (pH 7-8), where it is predominantly non-ionized. (C)</p> Signup and view all the answers

In the context of the Noyes-Whitney equation, if the effective surface area of a drug particle in contact with GI fluids is doubled, and all other parameters remain constant, the dissolution rate is:

<p>Doubled. (C)</p> Signup and view all the answers

A novel drug is found to be a substrate for P-glycoprotein (P-gp). How would you expect this to affect the oral bioavailability of the drug?

<p>P-gp would likely decrease oral bioavailability by actively transporting the drug back into the gut lumen. (A)</p> Signup and view all the answers

Which statement best characterizes the 'sink conditions' in the context of drug absorption via passive diffusion across the GI membrane?

<p>The concentration of the drug in the blood is significantly lower than in the GI fluids, maintaining a favorable concentration gradient. (A)</p> Signup and view all the answers

Which scenario would MOST likely result in 'sink conditions' for a drug in the bloodstream?

<p>The drug concentration in the blood is significantly lower than in the gut lumen. (C)</p> Signup and view all the answers

A novel drug is found to be absorbed via active transport. Which characteristic would MOST likely be associated with its absorption?

<p>The absorption mechanism can become saturated at high drug concentrations. (D)</p> Signup and view all the answers

A drug is absorbed into the body via facilitated diffusion. Which statement accurately describes this process?

<p>It utilizes transporters and can be saturated. (D)</p> Signup and view all the answers

Researchers are investigating a new method for delivering macromolecular drugs orally. Which mechanism would MOST likely be involved in the absorption of these large molecules?

<p>Endocytosis (C)</p> Signup and view all the answers

A drug is known to be poorly lipid-soluble with a low molecular weight. By which pathway would this drug MOST likely be transported across the intestinal epithelium?

<p>Paracellular pathway (B)</p> Signup and view all the answers

A drug's oral bioavailability is significantly reduced due to extensive efflux in the small intestine. Which protein is MOST likely responsible for this effect?

<p>P-glycoprotein (P-gP) (A)</p> Signup and view all the answers

Which factor has the MOST significant impact on the transit time of materials through the small intestine?

<p>Whether the patient is in a fed or fasted state (C)</p> Signup and view all the answers

How does the presence of food in the gastrointestinal (GI) tract affect drug absorption?

<p>Food can either increase or decrease drug absorption, depending on the specific drug and conditions. (B)</p> Signup and view all the answers

According to the Noyes-Whitney equation, if the diffusion coefficient of a sparingly soluble drug decreases in the presence of food, how is the dissolution rate MOST likely affected?

<p>The dissolution rate will decrease. (A)</p> Signup and view all the answers

An increase in gastric and intestinal motility typically affects the dissolution rate of a sparingly soluble drug by influencing which factor described by the Noyes-Whitney equation?

<p>Decreasing the thickness of the diffusion layer. (C)</p> Signup and view all the answers

Why is the amorphous form of a drug sometimes preferred over the crystalline form when formulating a medication, particularly for drugs with dissolution rate-limited absorption?

<p>The amorphous form's faster dissolution rate can lead to improved drug absorption and bioavailability, especially when absorption is limited by dissolution rate. (B)</p> Signup and view all the answers

A pharmaceutical company is developing a new drug. During pre-formulation studies, they identify that the drug exhibits polymorphism. Which of the following considerations regarding polymorphism is MOST crucial for ensuring consistent drug performance and bioavailability?

<p>Understanding how different polymorphs affect the drug's melting point, solubility, and dissolution rate, as these properties can significantly impact bioavailability. (C)</p> Signup and view all the answers

During the crystallization process of a new drug, a scientist aims to produce a specific polymorph known for its enhanced bioavailability. Which factor is MOST influential in directing the formation of the desired polymorph?

<p>The solvent system used in the crystallization process because it impacts the interactions and arrangement of drug molecules. (A)</p> Signup and view all the answers

A pharmaceutical formulation scientist is developing a suppository using cacao butter as the base. Why is it important to avoid complete melting of the stable polymorph of cacao butter during the manufacturing process?

<p>Complete melting of the stable polymorph may result in the resolidification into metastable polymorphs, which may not provide the desired melting characteristics for optimal drug release. (D)</p> Signup and view all the answers

For a drug that exhibits polymorphism, what is the primary rationale for a pharmaceutical company to choose the stable polymorph over a metastable polymorph in the formulation of a suspension?

<p>The stable polymorph is less soluble and more resistant to chemical degradation. These properties help maintain consistency and prevent changes in the suspension over time. (C)</p> Signup and view all the answers

A drug is known to exhibit polymorphism, with a significant difference in bioavailability between its polymorphs. Under what circumstances is this difference in bioavailability MOST likely to be clinically significant?

<p>When the drug's absorption is dissolution rate-limited, meaning the rate at which the drug dissolves is a primary factor affecting its absorption into the bloodstream. (C)</p> Signup and view all the answers

A pharmaceutical scientist discovers a new metastable polymorph of an existing drug with significantly enhanced solubility compared to the stable polymorph. What is the MOST important consideration when deciding whether to develop a drug product using this metastable polymorph?

<p>The potential for the metastable polymorph to convert to the stable polymorph during manufacturing or storage, which could affect the drug product's bioavailability and efficacy. (D)</p> Signup and view all the answers

A drug's bioavailability is observed to significantly decrease when administered with certain antidiarrheal medications. Which of the following mechanisms is most likely responsible for this interaction?

<p>The antidiarrheal medication contains solid adsorbents that bind to the drug, hindering its absorption. (C)</p> Signup and view all the answers

A researcher is investigating the use of cyclodextrins to improve the bioavailability of a poorly water-soluble drug. Which statement best describes the expected interaction and outcome?

<p>Cyclodextrins will form a reversible complex with the drug, increasing its water solubility and potentially enhancing bioavailability. (C)</p> Signup and view all the answers

A pharmaceutical scientist aims to enhance the stability of a drug that is prone to acid hydrolysis in the stomach. Which of the following strategies would be most effective?

<p>Decreasing the dissolution rate of the drug in the stomach to minimize exposure to the acidic environment. (B)</p> Signup and view all the answers

Erythromycin, a drug known for its instability in the stomach, is being formulated for oral administration. Which approach would most effectively delay its release until it reaches the intestine?

<p>Employing an enteric coating on the erythromycin free base or using an erythromycin salt like erythromycin stearate. (D)</p> Signup and view all the answers

In the development of a new oral suspension, a formulator must consider the solid-state properties of the drug. For which of the following dosage forms are the crystal properties and solid-state form of the drug most critical?

<p>Suspensions, tablets/capsules, dry powder inhalers, and topical powders. (C)</p> Signup and view all the answers

A drug substance can exist in multiple solid-state forms. Which of the following statements accurately describes the prevalence of these forms in pharmaceutical preparations?

<p>Crystalline solids are the most common form in solid drug preparations and excipients. (D)</p> Signup and view all the answers

Which of the following statements accurately differentiates crystalline and amorphous solid states?

<p>Crystalline materials have molecules aligned in a highly arranged manner with a crystal lattice, while amorphous materials lack regular molecular arrangement. (D)</p> Signup and view all the answers

A pharmaceutical scientist aims to produce an amorphous form of a drug to enhance its dissolution rate. Which method is most likely to yield an amorphous solid?

<p>Subjecting crystalline material to rapid solidification processes. (C)</p> Signup and view all the answers

A research team is investigating methods to increase the amorphous content of a crystalline drug substance post-crystallization. Which technique is most likely to achieve this?

<p>Subjecting the crystals to controlled milling to disrupt the crystal lattice. (C)</p> Signup and view all the answers

For a drug exhibiting dissolution rate-limited absorption, which solid-state form is expected to demonstrate substantially better absorption and bioavailability, and what is the underlying reason?

<p>Amorphous form, due to its increased solubility and faster dissolution rate compared to the crystalline form. (B)</p> Signup and view all the answers

Flashcards

Oral Route Advantages

The oral route is non-invasive, convenient, and often preferred by patients.

GI Mucus Role

Mucus protects the GI epithelium and aids in digestion; it includes mucins and has a turnover time of about 2-4 days.

Stomach Characteristics

The stomach's volume varies; it plays roles in digestion and has a pH of 1.5 to 3.5 in a fasting state.

Factors Affecting Absorption

Age, pH, food contents, and diseases can influence drug absorption in the intestine.

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Gastric Motility Patterns

Gastric motility differs in fasting (MMC) and fed states, influenced by food type and dosage form size.

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Gastric Residence Time

Larger meals or dosage forms increase gastric residence time; water speeds up the process compared to food.

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Drug Absorption Barriers

Barriers include stomach pH, food interactions, and the unstirred water layer affecting drug absorption.

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Passive Diffusion

Drugs pass through membranes from high to low concentration, mainly small lipophilic molecules under sink conditions.

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Dissolution Rate

Rate at which drug particles dissolve in GI fluids.

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Diffusion Coefficient (D)

A measure of how fast a drug diffuses in GI fluids.

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Effective Surface Area (A)

Surface area of drug in contact with GI fluids.

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Saturation Solubility (Cs)

Maximum concentration of a drug that can dissolve in a fluid.

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Influence of Food

Food can alter drug dissolution by changing viscosity.

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Particle Size Reduction

Smaller particles increase surface area for faster dissolution.

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Weak Electrolyte Solubility

Weak acids have higher solubility in the small intestine than in the stomach.

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Salt Forms of Drugs

Salt forms can enhance the dissolution rate by changing the pH.

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Factors Beyond Bioavailability

Other factors influencing salt selection include stability and manufacturability.

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Influence of Agitation

Degree of agitation affects the thickness of the diffusion layer.

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Sink conditions

When the concentration gradient is at least 10x greater outside the cell than inside.

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Active transport

Drug transport mechanism requiring energy to move substances against a concentration gradient.

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Saturable mechanism

Active transport can only transport a limited amount of substance, depending on the number of available transporters.

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Facilitated diffusion

Passive transport using specific carriers, requiring no energy and driven by a concentration gradient.

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Endocytosis

Process by which cells engulf materials, forming vesicles to bring substances inside.

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Paracellular pathway

Transport route between adjacent cells, often used by small, poorly lipid-soluble drugs.

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Drug efflux

Active transport of drugs out of cells, reducing absorption and bioavailability in the intestine.

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Noyes-Whitney equation

Formula that describes factors affecting the dissolution rate of drugs in the GI tract.

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Effects of food on drug absorption

Food presence can increase or decrease drug absorption in the GI tract.

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Transporters for nutrients

Specific carriers needed for the transport of certain vitamins, peptides, and electrolytes.

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Complexation

Interaction of a drug with another substance that can alter absorption.

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Adsorption

Process where drugs bind to solid adsorbents, potentially reducing absorption.

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Chemical stability

Resistance of a drug to degradation in gastrointestinal fluids.

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Micellar solubilization

Process by which bile salts increase the solubility of drugs.

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Enteric coating

A protective layer on drugs to delay dissolution until intestines.

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Crystalline state

A solid state with ordered molecular arrangement.

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Amorphous state

A solid without a regular molecular arrangement, lacking stability.

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Semi-crystalline materials

Materials containing both crystalline and amorphous phases.

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Milling

Process used to increase the amorphous content of a drug.

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Bioavailability

The extent and rate at which active drug ingredients are absorbed.

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Amorphous Drug Form

A less stable drug form with faster dissolution rate and better absorption.

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Crystalline Drug Form

A more stable drug form with slower dissolution rate and absorption.

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Dissolution Rate Limited Absorption

Absorption process limited by how fast a drug dissolves.

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Polymorphism

Ability of a substance to exist in different solid-state forms.

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Stable vs. Metastable Polymorph

Stable forms do not convert to metastable forms; only vice versa is true.

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Impact of Polymorphs on Bioavailability

Different polymorphic forms can affect drug solubility and absorption rates.

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Crystallization Conditions for Polymorphs

Factors like temperature and solvent affect formation of polymorphs.

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Study Notes

Oral Route Advantages

  • Convenient and allows self-administration
  • Avoids injection-related discomfort
  • Potential for sustained drug release

GI Epithelial Mucus

  • Protects the GI tract lining and facilitates nutrient absorption
  • Main components: glycoproteins, mucins, water
  • Turnover time: about 2-3 days, allowing for continuous renewal

Stomach

  • Fed state: ~1.5 liters
  • Fasting state: ~25-50 ml
  • Function: food storage, initial digestion (especially proteins), and antimicrobial action
  • pH: ~1.5-3.5
  • Secretions: HCl, pepsinogen, mucus
  • Phase III (housekeeper wave) of the migrating motor complex (MMC) occurs in the fasting stomach.

Small Intestine and Colon

  • Small Intestine:
    • Length: ~6-7 meters
    • pH: ~5.5-7.5
    • Role: primary site of nutrient absorption and drug absorption
    • Factors affecting drug absorption: surface area, length, motility
  • Colon:
    • Length: ~1.5 meters
    • pH: ~6-7.5
    • Role: water and electrolyte absorption, microbial fermentation, formation of feces
    • Factors affecting drug absorption: bacterial microflora, slower transit time

Gastric Motility

  • Fasted Stomach:
    • Migrating motor complex (MMC) responsible for motility control
  • Fed Stomach:
    • Reduced motility to allow for food digestion
  • Major factors affecting gastric residence time: dosage form size, meal size
  • Roles of the pyloric sphincter: restricts the flow of food into the small intestine, regulates emptying rate

Drug Transit Times

  • Small intestine: variable, depending on the type and amount of material
  • Large intestine: 8-72 hours

Barriers to Drug Absorption

  • Gut lumen
  • Unstirred water layer
  • GI pH: variations affect drug ionization and permeability
  • Food: can affect drug absorption, including the effect of grapefruit juice
  • Disease states: conditions impact absorption mechanisms
  • Luminal enzymes: often affect drugs, particularly by degrading the compounds (e.g., peptides) and dosage forms
  • Excipients: targets of lipases

GI Membrane & Drug Transport

  • Mechanisms: passive diffusion, active transport, facilitated diffusion, endocytosis, paracellular
  • Passive diffusion most common for drug absorption

Passive Diffusion

  • Primarily for small, lipophilic molecules
  • Factors affecting transport: drug properties, membrane properties, concentration gradient
  • Sink conditions maintained when drug concentration in blood considerably less than in the gut lumen.

Active Transport

  • Carrier-mediated, requiring ATP; saturable
  • Transporters relevant to drug absorption: peptides, sugars, electrolytes, vitamins, bile salts
  • Specific chemical structures needed for transport

Facilitated Diffusion

  • Less important for drug absorption than passive diffusion
  • Requires transporters but no ATP, operating along a concentration gradient

Endocytosis

  • Three major types: pinocytosis, receptor-mediated endocytosis, phagocytosis
  • Handles large, macromolecular drugs

Paracellular Pathway

  • Primarily for small, poorly lipid-soluble drugs (e.g., atenolol)

Drug Efflux

  • P-glycoprotein (P-gp) is the main efflux protein in the small intestine
  • Can reduce bioavailability, particularly for substrates like digoxin, paclitaxel, cyclosporine

Review Questions

  • Small intestinal transit is dependent on the material type and gastric emptying rate and is not constant
  • Food can increase or decrease drug absorption.

Noyes-Whitney Equation & Dissolution

  • Equation: dC/dt = D A (Cs - C)/h
  • Factors influencing dissolution rate: food, surfactants, agitation, volume of fluid
  • Dissolution rate is often increased by increasing gastric/intestinal motility
  • Large volumes of fluid increase dissolution rate
  • Food can reduce the diffusion coefficient of the drug

Particle Size, Surface Area & Dissolution

  • Smaller particle size increases surface area and dissolution rate
  • Reduction of particle size does not always increase drug absorption

Micronized Drug Use

  • Micronization beneficial for oral preparations, ophthalmic solutions, topical ointments/creams, and pulmonary delivery systems

Weak Electrolyte Solubility

  • Weak acids have higher solubility in the small intestine; weak bases in the stomach
  • Administration of cimetidine (acid secretion blocker) decreases the bioavailability of weak base drugs.

Salt Forms & Dissolution

  • Salt forms affect dissolution rate by altered pH and solubility
  • Coarse precipitation is less beneficial because of limited surface area
  • Fine precipitate gives higher dissolution rate
  • Weak acids dissolve more easily in the intestine
  • For toothache, naproxen sodium is preferred likely

Strongly Acidic Salts

  • Enhancing dissolution of weakly basic drugs in acidic stomach

Factors Beyond Bioavailability

  • Stability, hygroscopicity, manufacturability, crystallinity

Drug Concentration in GI Fluids

  • Factors affecting concentration: complexation, adsorption, chemical stability, micellar solubilization

Drug Complexation

  • Can increase or decrease absorption; depends on specific drugs. Cyclodextrins can be beneficial.

Drug-Adsorbent Interactions

  • Adsorbents, such as activated charcoal, may reduce drug absorption

Drug Instability

  • Chemical instability is a common issue in the GI tract; it can be addressed by reducing dissolution or using various approaches.

Drug Crystal Properties

  • Powder form common, especially for tablets, inhalers, suspensions
  • Crystal/solid-state form crucial for drug stability and behaviour in dosage forms

Crystalline vs. Amorphous Forms

  • Crystalline: well-ordered structure. Amorphous: disordered structure.
  • Amorphous usually faster dissolution, less stable.
  • Amorphous not always better for all drugs; dissolution, permeation.

Polymorphism & Polymorphs

  • Polymorphism: varying crystal structures of the same molecule.
  • Chemical composition same; physical properties and structure different.
  • Affects solid dosage forms.
  • Metastable polymorphism forms can revert to stable forms over time.

Hydrates, Solvates & Pseudo Polymorphism

  • Hydrates: water molecules incorporated. Solvates: other solvents.
  • Hydrated forms can have different dissolution rates.
  • Anhydrous forms generally dissolve faster if the hydrate forms have strong hydrogen bonds.

pH-Partition Hypothesis

  • Lipid solubility critical for passive diffusion. Stronger lipid drugs absorb more easily.
  • Most drugs are weak electrolytes.
  • Unionized form penetrates GI membrane better (lipid soluble).

pH-Partition & Henderson-Hasselbalch

  • Acidic/basic drugs absorb better in regions with corresponding pH.

pH-Partition Hypothesis Limitations

  • Other factors influencing absorption (local pH, instability, metabolism locally) needed beside ionization.

Lipid Solubility & Partition Coefficient

  • Lipid solubility influences drug absorption.
  • Partition coefficient (log P) useful to quantify lipid solubility.
  • Homologous series: often a correlation between log P and absorption.

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Description

Overview of oral drug absorption focusing on the GI tract. Covers the roles of the stomach, small intestine, and colon. Includes pH levels, sizes, and key functions relevant to drug uptake and digestion.

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