PHARMACOKINETICS

-study of the time course of drug absorption, distribution, metabolism and excretion.

CLINICAL PHARMACOKINETICS

-APPLICATION of the pharmacokinetic PRINCIPLES to the safe and effective

therapeutics MANAGEMENT of drugs in an INDIVIDUAL patient.

Knowledge will apply in; PRIMARY GOALS: maximize the therapeutic effect or lessen/
minimize the toxic effect.

1. Enhance the efficacy

2. Decrease the toxicity

KINETIC HOMOGENITY (used amount of drug in plasma)

EXAMPLE: DIGOXCIN Cardiac glycoside - no need to get the tissue in the heart to
measure the drug concentration; Only draw a blood to measure the drug concentration.

-describes the predictable relationship between PLASMA DRUG CONCENTRATION OF

THE RECEPTOR SITE where a given drug produces its therapeutic effect.

DRUG IN BLOOD = DRUG IN TISSUE

-As drug concentration in the plasma increases, the concentration of the drug in most
tissues will increase proportionally.

Plasma Drug Conc. DIRECT RELATIONSHIP

Conc. of drug in tissue

Drug concentration Vs. time profile after IV dose (Fast and high absorption of IV
Metabolism Excretion)

Drug Conc.

Time

- Imporatant for the assumptions made in clinical pharmacokinetics

- Foundation on which all therapeutic and toxic plasma drug concentrations are established
 EXAMPLE: Digoxin , Benzodiaxepine - Anesthetic
Benzodiaxepine poisoning Flumazenil is the treatment

THERAPEUTIC DRUG MONITORING

-Use of assay procedures for determination of drug concentrations in plasma and the
interpretation and application of the resulting concentration data to develop safe and effective drug
regimens.

Note: Three level

Low: Subtherapeutic

Middle: Correct

High: Toxic

-Allow for the ACHIEVEMENT OF THERAPEUTIC CONCENTRATION OF A DRUG more rapidly and
safety than can be attained with EMPIRIC DOSE CHANGES.

Note: It is easy to identify the therapeutic concentration in graph than arranging the dose
regularly.

-Interpatient variability in plasma concentration and drug response are primarily attributed to
one or more of the following:

1. Variations in drug response Kopiko 78

2. Variations in drug distribution Certain factors like diseases and condition (DM,
Congestive Heart Failure)
3. Differences in an individuals ability to metabolize and eliminate the drug
Pharmacogenetic
4. Disease states or physiologic states that alter drug absorption, distribution,
elimination.
*Fast acetylation and Slow acetylation
*Renal or Hepatic chuchu RENAL: Affect (Excretion)
-HEPATIC: Affect (Metabolism)
*Physiological stage: Extreme of age (For young under develop)
: Obesity (Amount of drug distributed inside the body)