Xenobiotics and ADME Pathways
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Questions and Answers

Which phase of drug metabolism primarily involves the introduction of small, hydrophilic functional groups to increase water solubility?

  • Phase II
  • Phase III
  • Phase I (correct)
  • Phase 0

What is the primary function of Phase III in drug metabolism?

  • Cellular uptake by membrane-bound transporters
  • Conjugation of drugs to increase ionization
  • Hydrophilicity modification of drug molecules
  • Cellular efflux of drugs by transporters (correct)

Which of the following represents an oxidation-based enzyme involved in Phase I drug metabolism?

  • UDP-glucuronosyltransferases
  • Aldo-keto reductase
  • Glutathione s-transferase
  • Cytochrome P450 (correct)

Which transporters are not involved in Phase 0 uptake of drugs?

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

What happens during Phase II of drug metabolism?

<p>Addition of large ionized groups to drugs (A)</p> Signup and view all the answers

Which of the following enzymes is NOT associated with Phase I drug metabolism?

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

What is the primary role of ATP-binding cassette transporters in drug pharmacokinetics?

<p>Exporting drugs from cells (B)</p> Signup and view all the answers

Which phase of drug metabolism includes enzymes that can catalyze reactions without prior Phase I modifications?

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

Which functional groups are introduced during Phase I drug metabolism?

<p>Hydrophilic functional groups like OH and NH2 (B)</p> Signup and view all the answers

What is the consequence of drug metabolism rates depending on doses and administration frequency?

<p>Variability in drug efficacy and adverse effects (B)</p> Signup and view all the answers

What is the primary organ responsible for the metabolism and elimination of xenobiotics in the body?

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

In the oral route with first pass metabolism, what is the pathway of the drug after ingestion?

<p>Absorbed through the intestinal wall, then liver (A)</p> Signup and view all the answers

What is true regarding prodrugs?

<p>They require metabolism to become biologically active (C)</p> Signup and view all the answers

What is the general impact of drug metabolism on the therapeutic efficacy of the parent drug?

<p>Typically reduces efficacy to lower levels (C)</p> Signup and view all the answers

How are drugs that follow the IV route ultimately eliminated from the body?

<p>Via urine and bile after undergoing hepatic and renal metabolism (A)</p> Signup and view all the answers

What processes determine the intensity and duration of drug action?

<p>Drug metabolism reactions (B)</p> Signup and view all the answers

Which of the following statements about metabolites is correct?

<p>Metabolites usually possess lower therapeutic efficacy (C)</p> Signup and view all the answers

What is the consequence of xenobiotics being ingested orally without first pass metabolism?

<p>They predominately remain in the GI tract and are excreted unchanged (A)</p> Signup and view all the answers

Which of the following best defines drug metabolism?

<p>The chemical alteration of drugs into metabolites (C)</p> Signup and view all the answers

What potential effects can drug metabolism have on adverse drug reactions?

<p>May increase, decrease, or not influence ADRs (B)</p> Signup and view all the answers

What is a characteristic feature of Phase II in drug metabolism?

<p>It involves the conjugation of drug molecules with large, ionized groups. (A)</p> Signup and view all the answers

Which of the following statements is true regarding Phase 0 of drug metabolism?

<p>It involves the cellular uptake of drugs by transporters. (C)</p> Signup and view all the answers

What type of enzymes is primarily responsible for reduction reactions in Phase I drug metabolism?

<p>Reduction-based enzymes. (C)</p> Signup and view all the answers

Which phase of drug metabolism may occur without the need for prior Phase I metabolism?

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

Which of the following transporters are known to be involved in Phase III drug metabolism?

<p>Organic cation transporters. (C)</p> Signup and view all the answers

What is the consequence of drug metabolism on the rate of adverse drug reactions (ADRs)?

<p>Metabolism can increase, decrease, or not change the rate of ADRs. (A)</p> Signup and view all the answers

Which description best fits the enzymes belonging to the oxidation-based category in Phase I drug metabolism?

<p>They help in the conversion of lipophilic substances to hydrophilic forms. (C)</p> Signup and view all the answers

How do ATP-binding cassette transporters primarily function in drug metabolism?

<p>They facilitate the efflux of drugs out of cells. (C)</p> Signup and view all the answers

In which cellular location are the majority of Phase II drug-metabolizing enzymes found?

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

What is the primary outcome of Phase I metabolism in drug processing?

<p>Modification to include small, hydrophilic functional groups. (C)</p> Signup and view all the answers

What typically happens to most metabolites compared to the parent drug in terms of therapeutic efficacy?

<p>Metabolites have a lower therapeutic efficacy than the parent drug. (B)</p> Signup and view all the answers

In the oral route with first pass metabolism, which sequence correctly describes the pathway after drug absorption?

<p>Into GIT, absorbed through the intestinal wall, travels to liver via hepatic portal vein. (D)</p> Signup and view all the answers

Which route of drug elimination primarily involves both hepatic and renal metabolism?

<p>IV route. (B)</p> Signup and view all the answers

What is a characteristic of prodrugs regarding their efficacy?

<p>Prodrugs must be metabolized to become biologically active. (D)</p> Signup and view all the answers

Which of the following best describes xenobiotics?

<p>Chemical substances that are not normally found in the human body. (B)</p> Signup and view all the answers

How does drug metabolism influence adverse drug reactions (ADRs)?

<p>Metabolism may increase or decrease the incidence of ADRs. (C)</p> Signup and view all the answers

What is the primary purpose of metabolic pathways in processing xenobiotics?

<p>To detoxify and eliminate harmful substances from the body. (A)</p> Signup and view all the answers

After the first pass metabolism, how is the drug typically excreted from the body?

<p>As a mixture of parent drug and metabolites in urine and feces. (D)</p> Signup and view all the answers

What role does drug metabolism play in determining the duration of drug action?

<p>It can influence both the intensity and duration of drug actions. (C)</p> Signup and view all the answers

Which of the following statements is true regarding drug metabolism?

<p>Drug metabolism can cause drugs to become more effective in some cases. (A)</p> Signup and view all the answers

Flashcards

Xenobiotics

Chemical substances not naturally found in the human body.

Oral Route (No 1st Pass)

Drug absorption is low, drug stays in the GI tract and exits in feces.

Oral Route (With 1st Pass)

Drug is absorbed, goes to liver for metabolism, then distributed to other organs, excreted via urine and feces.

IV Route

Drug directly enters the bloodstream, undergoes metabolism in liver & kidneys and eliminated via urine and bile.

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Drug Metabolism

Body chemically alters drugs into metabolites.

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Metabolite

Chemical formed from a drug during metabolism.

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Prodrug

Drug that becomes biologically active only after metabolism.

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ADRs

Adverse drug reactions; negative effects of a drug.

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Hepatic Portal Vein

Brings blood from the GI tract to the liver.

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First Pass Metabolism

Drug metabolism occurring in the liver after oral ingestion.

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Drug Metabolism Phases

Series of processes that transform drugs into more easily eliminated forms by the body.

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Phase 0 Metabolism

Cellular uptake of drugs by membrane-bound transporters.

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Phase I Metabolism

Introduces small hydrophilic functional groups, increasing water solubility.

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Phase II Metabolism

Conjugation, attaching large ionized groups to the drug, greatly improving water solubility.

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Phase III Metabolism

Cellular efflux of drugs by membrane-bound transporters.

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Cytochrome P450 (CYP)

Key enzyme involved in drug oxidation during Phase I.

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UDP-glucuronosyltransferases (UGTs)

Enzyme crucial in drug conjugation during Phase II.

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Drug Pharmacokinetics

Study of how a drug is absorbed, distributed, metabolized, and eliminated in the body.

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Drug Pharmacodynamics

Study of how a drug interacts with its target and produces its effects.

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Drug Toxicity/ADRs

Side effects or harmful effects that can result from drug metabolism.

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Routes of Drug Elimination

The pathways by which the body gets rid of drugs and their metabolites, often involving the liver, kidneys, and bile.

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Impact of Drug Metabolism

Drug metabolism reactions often determine the intensity and duration of drug action.

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CYP450 Enzymes

Key enzymes involved in Phase I drug metabolism, primarily oxidation reactions, which add oxygen atoms to a drug.

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UGTs Enzymes

Important enzymes in Phase II metabolism, attaching glucuronic acid to drugs, making them more water-soluble and easier to eliminate.

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Why does metabolism affect drug toxicity?

Drug metabolism can increase, decrease, or have no effect on drug toxicity. Changes in drug metabolism can alter the concentration of active drug or its toxic metabolites in the body.

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What are the 4 phases of drug metabolism?

Phase 0 (uptake), Phase I (modification), Phase II (conjugation), and Phase III (efflux) collectively describe the stages in which drugs are processed by the body.

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Study Notes

Xenobiotics

  • Xenobiotics are chemical substances not naturally found in the human body
  • These include drugs, pollutants, pesticides, food additives, and synthetic chemicals
  • The body processes them through metabolic pathways, primarily in the liver, to detoxify and eliminate them

Major Routes of ADME

Oral Route Without First Pass Metabolism

  • Drug is ingested and enters the gastrointestinal tract (GIT)
  • Low absorption means the drug mostly stays in the GI tract and is excreted as unmetabolized drug in feces

Oral Route With First Pass Metabolism

  • Drug is ingested, enters the GIT, and is absorbed through the intestinal wall
  • Travels to the liver via the hepatic portal vein
  • Some drug is converted into metabolites in the liver (hepatocytes)
  • The mixture of drug and metabolite(s) travels to target organs via the hepatic vein
  • Excreted via urine or feces (as a mixture of the original drug and metabolites)

IV Route

  • Drug enters the body intravenously
  • Enters systemic circulation
  • Travels to the liver and kidneys for hepatic and renal metabolism
  • Eliminated via urine or bile

The Routes of Drug Elimination

  • Shows the percentage of primary elimination routes (Hepatic, Renal, and Unknown)
  • Provides a breakdown of the roles of P450 enzymes in metabolism (e.g., 3A4/5 is involved)
  • Demonstrates pathways involved in drug metabolism based on percentages

Definition of Drug Metabolism

  • Drug metabolism is the process by which the body chemically alters drugs into metabolites
  • Metabolites often have lower therapeutic efficacy than the parent drug
  • Metabolism helps to deactivate drugs and make them more water-soluble for excretion

Impact of Drug Metabolism

  • Drug metabolism reactions influence the intensity and duration of drug action, playing a role in detoxification and toxification
  • Drug metabolism rates are often influenced by dosage and frequency of administration
  • Affects drug pharmacokinetics (e.g., rates of absorption, distribution, and elimination)
  • Effects drug pharmacodynamics (e.g., target binding, duration of action, efficacy, and potency)
  • Can influence adverse drug reactions (ADRs) and toxicity either increasing, decreasing, or not changing them

Overview of the Phases of Drug Metabolism

Phase 0

  • Involves cellular uptake of drugs by membrane-bound transporters.

Phase I Drug-Metabolizing Enzymes

  • Oxidation-Based Enzymes: Cytochrome P450 (CYP), Flavin-containing monooxygenase (FMO), Alcohol dehydrogenase (ADH), Aldehyde dehydrogenase (ALDH), Molybdenum hydroxylase (AOX & XDH), Monoamine oxidase (MAO)
  • Reduction-Based Enzymes: Aldo-keto reductase (AKR), Quinone oxidoreductase (NQO), Dihydropyrimidine dehydrogenase (DPYD)
  • Hydrolysis-Based Enzymes: Carboxylesterase (CES), Paraoxonase (PON), Epoxide hydrolase (EPHX)

Phase II Drug-Metabolizing Enzymes

  • UDP-glucuronosyltransferases (UGTs)
  • Sulfotransferases (SULTs)
  • Glutathione s-transferases (GSTs)
  • N-acetyltransferases (NATs)
  • Methyltransferases (TPMT, COMT)

Phase 0 Uptake Transporters

  • Organic anion transporters (OATs)
  • Organic anion transporting polypeptides (OATPs)
  • Organic cation transporters (OCTs)
  • Solute carrier organic anion transporters (SLCOs)

Phase III Efflux Transporters

  • ATP-binding cassette transporters (ABCs)
  • P-glycoprotein (P-gp)
  • Multidrug resistance 1 (MDR1, ABCB1)
  • Multidrug resistance-associated protein 2 (MRP2, ABCC2)
  • Breast cancer resistance protein (BCRP, ABCG2)
  • Solute carrier transporters (SLCOs)

Subcellular Location of ADME Proteins

  • Cell membrane: All uptake and efflux transporters
  • Endoplasmic reticulum: Phase I enzymes (P450, FMO, NQO, EPHX) and some Phase II enzymes (UGTs, GSTs, TPMT)
  • Cytosol: Phase I enzymes (AOX, NQO, EPHX, AHD, ALDH), some Phase II enzymes (GSTs, SULTS, NATs, TPMT)
  • Mitochondria: Phase I enzymes (MAO, ALDH2) and some Phase II enzymes (NATs)

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Description

Explore the fascinating world of xenobiotics, chemical substances not naturally found in the human body. This quiz delves into various routes of absorption, distribution, metabolism, and excretion (ADME), focusing on the mechanisms by which the body processes these substances. Test your knowledge on the oral and intravenous routes and their effects on drug metabolism.

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