Pharmacology: Drug Distribution Overview
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Questions and Answers

What is the primary factor determining drug distribution to peripheral compartments?

  • Drug metabolism
  • Blood flow to the tissues
  • Drug concentration in the blood
  • Lipid solubility (correct)
  • Which of the following compartments has the largest volume of water in the body?

  • Intravascular
  • Plasma
  • Interstitial
  • Intracellular (correct)
  • What is the primary reason why some drugs are restricted to the extracellular fluid?

  • Plasma protein binding
  • Low lipid solubility (correct)
  • Active transport mechanisms
  • High molecular weight
  • Drugs that can easily penetrate the blood-brain barrier are typically characterized by:

    <p>High lipid solubility (B)</p> Signup and view all the answers

    Which of the following processes can lead to increased drug concentration within cells?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the relationship between drug distribution and drug action?

    <p>Drug distribution is essential for drug action to occur. (B)</p> Signup and view all the answers

    What is the main reason why drug molecules exist in both bound and free forms in the body?

    <p>Interaction with plasma proteins. (C)</p> Signup and view all the answers

    How does the interstitial fluid contribute to drug distribution?

    <p>It serves as a medium for drug transport to cells. (A)</p> Signup and view all the answers

    What is a major factor affecting the distribution of large molecules like heparin?

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

    Which of the following tissues receives the slowest blood flow?

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

    What is the primary function of plasma protein binding of drugs?

    <p>To act as a reservoir for the drug (D)</p> Signup and view all the answers

    Which of the following factors can significantly influence drug distribution?

    <p>Diseases like CHF (C)</p> Signup and view all the answers

    Which of the following statements is TRUE regarding drug distribution?

    <p>Bound drugs are inactive and not available for metabolism or excretion (D)</p> Signup and view all the answers

    Which of the following drugs are most likely to bind to albumin?

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

    What is the clinical significance of a drug having a high binding affinity to plasma proteins?

    <p>Longer duration of action (C)</p> Signup and view all the answers

    Which of the following statements is TRUE regarding drug interactions due to plasma protein binding?

    <p>Drugs with high affinity for the same protein binding site can displace each other. (A)</p> Signup and view all the answers

    Why is hemodialysis less effective in treating drug poisoning for drugs with a large volume of distribution (Vd)?

    <p>A large Vd indicates the drug is widely distributed throughout the body, not just in the blood. (A)</p> Signup and view all the answers

    Which of the following factors influences the volume of distribution (Vd) of a drug?

    <p>All of the above factors influence Vd (D)</p> Signup and view all the answers

    Which of the following is an example of a drug interaction caused by displacement from plasma protein binding sites?

    <p>Salicylates displacing sulphonylureas (B)</p> Signup and view all the answers

    What happens to the concentration of free drug in the plasma when a patient has hypoalbuminemia?

    <p>The concentration of free drug increases. (C)</p> Signup and view all the answers

    Which of the following statements is FALSE regarding the volume of distribution (Vd)?

    <p>A larger Vd indicates that more drug is present in the bloodstream. (B)</p> Signup and view all the answers

    Which of the following drugs accumulates in liver tissue?

    <p>Chloroquine (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the blood-brain barrier (BBB)?

    <p>The BBB is easily crossed by drugs that are highly lipid-soluble. (C)</p> Signup and view all the answers

    Which of the following factors can disrupt the integrity of the blood-brain barrier?

    <p>Inflammation (A)</p> Signup and view all the answers

    What is the primary reason why water-soluble drugs have difficulty crossing the blood-brain barrier?

    <p>They are not lipid-soluble enough to cross the cell membranes. (A)</p> Signup and view all the answers

    What is the likely consequence of a drug having a high volume of distribution (Vd)?

    <p>The drug will be widely distributed to various tissues. (D)</p> Signup and view all the answers

    A patient with a high volume of distribution (Vd) for a particular drug would likely require:

    <p>A higher dose of the drug. (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the placental barrier?

    <p>It is an incomplete barrier, allowing some water-soluble drugs to enter the fetal circulation. (C)</p> Signup and view all the answers

    Which of the following factors can increase the bioavailability of an oral drug?

    <p>Decreased drug efflux from the liver (B)</p> Signup and view all the answers

    Flashcards

    Drug Distribution

    The movement of drug from blood to tissues for action.

    Central Compartment

    The bloodstream where drugs are initially found before distribution.

    Peripheral Compartments

    Tissues and organs where drugs travel after the bloodstream.

    Lipid Solubility

    A major factor affecting drug distribution, especially in the brain.

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    Blood-Brain Barrier (BBB)

    A protective barrier that restricts certain drugs from entering the brain.

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    Ion Trapping

    The accumulation of drugs in cells due to ionization differences.

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    Active Transport

    The process of moving drugs into cells against a concentration gradient.

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    Total Body Water Distribution

    The distribution of water in various body compartments affecting drug distribution.

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    Ionization (pKa)

    A measure of how well a drug ionizes in solution, affecting its distribution and absorption.

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    Blood Flow Distribution

    Drugs distribute faster to highly perfused organs (brain, heart, liver, kidney) than to less perfused ones (muscle, skin).

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    Free vs Bound Drug

    Free drugs are active and available for metabolism; bound drugs are inactive, often bound to proteins like albumin.

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    Plasma Protein Binding

    The process where drugs bind to plasma proteins, affecting their efficacy and duration.

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    Factors Affecting Drug Distribution

    Includes molecular size, body mass, organ blood flow, and diseases like CHF and cirrhosis.

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    Acidic Drugs

    Drugs that bind primarily to albumin in plasma.

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    Basic Drugs

    Drugs that bind primarily to α-1 glycoprotein in plasma.

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    Volume of Distribution (Vd)

    The volume that would contain the total amount of drug in the body at plasma concentration.

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    Drug Displacement Interaction

    When two drugs compete for the same protein binding site, affecting each other's efficacy.

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    Hypoalbuminemia

    A condition of low albumin levels leading to higher free drug concentration.

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    Significance of Protein Binding

    Highly bound drugs last longer circulating but have lower therapeutic activity.

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    Free Drug Action

    Only the unbound portion of a drug can exert a pharmacological effect in tissues.

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    Tissue Drug Accumulation

    Drugs that concentrate in specific body tissues due to various factors.

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    Digoxin

    A drug that accumulates in the heart, used for certain heart conditions.

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    Chloroquine

    A drug that accumulates in the liver and retina, used for treating malaria.

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    Iodine

    A mineral that accumulates in the thyroid, essential for hormone production.

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    Tetracycline

    An antibiotic that accumulates in bone and teeth, impacting them.

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    Blood-Brain Barrier Disruption

    Inflammation can make the BBB leaky, allowing some drugs to enter the brain.

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    Placental Barrier

    Lipoidal membranes that allow some drugs to pass from mother to fetus.

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    Water-Soluble Drug Limitations

    Water-soluble, ionized, and plasma protein-bound drugs can't cross the BBB or placental barrier.

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    Study Notes

    Drug Distribution

    • Drug distribution is the key factor in the onset of drug action. It involves the movement of a drug from the bloodstream to tissues.

    • Drugs are distributed to organs and tissues via the bloodstream, diffusing into interstitial fluid and cells.

    • Most drugs are not evenly distributed throughout the body's water content. Some drugs are limited to the extracellular fluid or plasma.

    • Drugs with high lipid solubility easily diffuse through cell membranes.

    • Other drugs concentrate within cells due to ion trapping.

    • Active transport mechanisms also move drugs into cells.

    Drug Distribution and Body Water

    • Water in the body is divided into compartments: intravascular, interstitial, and intracellular.

    • The total body water is approximately 70% of total body weight in healthy subjects.

    • Extracellular fluid makes up about 25% of the total body water, while intracellular fluid constitutes about 45%.

    Factors Affecting Drug Distribution

    • Lipid solubility: Highly lipophilic drugs readily cross the blood-brain barrier (BBB).

    • Polar and ionized drugs often cannot cross the BBB as easily.

    • Ionization (pKa): Molecular size influences distribution, with extremely large molecules like heparin often confined to the plasma.

    • Organ blood flow: High blood flow to organs like the brain, heart, liver, and kidneys leads to rapid distribution and faster onset of action. Distribution is slower in tissues with lower blood flow.

    • Binding to plasma and tissue proteins: Drugs can bind reversibly to proteins in plasma or tissues, altering the effective concentration in target areas. Active transport and drug metabolism are also relevant.

    Drugs in Vascular Space

    • Drugs exist in two forms in the blood: free and bound.

    • Free drugs are active, diffusible, and available for metabolism and excretion.

    • Bound drugs are mainly bound to albumin, acting as a reservoir.

    • Bound drugs are non-diffusible and thus not usable for metabolism or excretion.

    Plasma Protein Binding

    • Drug binding to plasma proteins is reversible (D + P ⇌ DP).

    • The unbound/free drug is the pharmaceutically active form.

    • Binding sites on plasma proteins become saturated with higher drug concentrations.

    • Highly bound drugs stay in the blood for longer which results in a lower therapeutic activity.

    • Acidic drugs often bind to albumin.

    • Basic drugs frequently bind to α1-glycoprotein.

    Significance of Plasma Protein Binding

    • Highly bound drugs persist longer in the body, lowering therapeutic activity and making them less accessible to dialysis.

    • Hypoalbuminemia (low albumin) leads to a higher concentration of free drug, potentially increasing the risk of side effects.

    Clinically Important Drug Interactions Due to Displacement

    • Drugs can displace each other from plasma protein binding sites.

    • Acidic drugs do not usually displace basic drugs, and vice versa.

    • Drug interactions can affect the efficacy or toxicity of other drugs.

    Volume of Distribution (Vd)

    • Vd is a measure of the apparent volume in the body that would be needed to contain the total amount of drug at a plasma concentration equal to the concentration in the body.

    • Vd is a critical pharmacokinetic parameter.

    • High Vd indicates extensive distribution throughout the body.

    • Lower Vd indicates more drug is retained in the blood, affecting the efficacy and potential toxicity of the drug.

    Clinical Significance of Vd

    • A large volume of distribution suggests that the drug is distributed extensively throughout the body, reducing the efficacy of dialysis in cases of drug poisoning.

    • The volume of distribution correlates to the drug's binding capacity and other properties.

    Drugs Accumulated in Tissues

    • Certain drugs (e.g., digoxin, chloroquine, iodine, chloroquine, tetracycline) accumulate in specific tissues, and these tissues' accumulation can increase the volume of distribution.

    Barriers to Drug Distribution

    • The blood-brain barrier (BBB) and placental barrier limit drug distribution.

    • Tight junctions of endothelial cells limit permeability.

    • Inflammation can decrease this barrier function.

    • Lipid-soluble drugs cross the barriers more easily than water-soluble or protein-bound drugs.

    Placental Barrier

    • The placental barrier allows free passage for lipid-soluble drugs.

    • The barrier for water-soluble or protein-bound drugs is not easily crossed.

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    Drug Distribution PDF

    Description

    Explore the essential concepts of drug distribution in the human body through this quiz. Understand how drugs move from the bloodstream to various tissues and the factors influencing this process. Delve into the significance of body water compartments and the impact of drug solubility on distribution.

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