Transcript lect. 3.ppt
Dr. Nayira A. Abdel Baky Associate Professor Pharmacology and Toxicology It is the study of the time course of toxicant absorption, distribution, metabolism, and excretion These are factors affecting : • Amount of and time a chemical stays at the site of absorption. • Rate of absorption and amount absorbed. • Distribution of the chemical throughout the body. • Speed of biotransformation and nature of the metabolites formed. • Whether a chemical can pass through cell membranes. • Whether a chemical, or its metabolites are stored in the body. • Rate of excretion — if a chemical is administered faster than it is excreted, it will accumulate in the body. ABSORPTION xenobiotic EXTERNAL MEMBRANE BARRIERS skin G.I. tract lungs DISTRIBUTION BLOOD PLASMA TISSUES pools depots sinks METABOLISM EXCRETION PHASE-1 Oxidation KIDNEYS LIVER lungs saliva sweat breast milk PHASE-2 conjugation 4 Ingestion Inhalation Intravenous Intraperitoneal Subcutaneous Gastrointestinal tract absorption Intramuscular Lung Dermal Liver Blood and lymph Bile extracellular fluid fat distribution Kidney Bladder feces Urine Lung soft tissue Alveoli Expired Air body organs Secretory Structures bone excretion Secretions 5 • Absorption is the first step in the toxicokinetics of a chemical. • If a toxic substance is not absorbed, it is not a health hazard. • Skin, lungs and GIT may be considered as barriers separating the organisms from the environment containing chemicals. • Chemicals must cross one of these barriers to exert an adverse effect on the body and then pass through various cell membranes Route of exposure The ROUTE (site) of exposure is an important determinant of the ultimate DOSE – different routes may result in different rates of absorption. Dermal (skin) Inhalation (lung) Oral (GI) Injection The ROUTE of exposure may be important if there are tissue-specific toxic responses. Toxic effects may be local (in a specific tissue) or systemic (throughout the organism) Ingestion Toxicity may be modified by enzymes, pH and flora…. etc Respiration Toxicity may be modified by dissolution in the blood, volume of distribution…etc Body surface Lipid soluble toxicants such as carbon terta chloride and organophosphate. Absorption of a substance from the site of exposure may occur by: 1. Simple diffusion (most common) Rate of diffusion determined by: Concentration Chemistry of the chemical. 2. Facilitated diffusion 3. Active transport 4. Pinocytosis and phagocytosis ► In general, the greater the amount of the chemical in contact with the absorbing surface, the greater the amount of the dose that is absorbed. • Uncharged molecules may diffuse along conc. gradient until equilibrium is reached • No substrate specific • Small MW < 0.4 nm (e.g. CO, N20) can move through cell pores • Lipophilic chemicals may diffuse through the lipid bilayer 10 First order rate diffusion, depends on • Concentration gradient • Surface area (alveoli 25 x body surface) • Thickness • Lipid solubility & ionization • Molecular size (membrane pore size = 4-40 A, allowing MW of 100-70,000 to pass through) 11 dD/dt = KA (Co - Ci) / t Where; dD/dt = rate of mass transfer across the membrane K = constant (coefficient of permeability) A = Cross sectional area of membrane exposed to the compound C0 = Concentration of the toxicant outside the membrane Ci = Concentration of the toxicant inside the membrane t = Thickness of the membrane 12 • Carried by trans-membrane carrier along concentration gradient • Energy independent • May enhance transport up to 50,000 folds • Example: Calmodulin for facilitated transport of Ca++ 13 • Independent of or against conc. gradient • Require energy • Substrate –specific • Rate limited by no. of carriers • Example: P-glycoprotein pump for xenobiotics Ca-pump (Ca2+ -ATPase) 14 •For large molecules •Outside: in-folding of cell membrane •Inside: release of molecules •Example: Airborne toxicants across alveoli cells Carrageenan across intestine 15 Must cross several cell layers (stratum corneum, epidermis, dermis) to reach blood vessels. Factors important here are: lipid solubility hydration of skin site (e.g. sole of feet vs. scrotum) 16 -Newborn (thin delicate skin). -Lipophilicity -Cutting , abrasions & dryness of skin Toxicity 1. Condition of the skin: Stratum corneum serves as the main barrier. When abraded, increased absorption will result 2. Skin permeability coefficient This represents the rate at which a particular drug penetrates the skin 3. Body region Not all regions of the body have the same skin thickness (Forehead versus palm). 4. Lipid solubility The more lipid soluble the drug is the more it will be absorbed 5. Skin hydration For gases, vapors and volatile liquids, aerosols and particles In general: large surface area, thin barrier, high blood flow rapid absorption 19 1-Solubility of the drug in the blood 2-Particle size Large particles are deposited in the nasal tract > 5 microns; 2-5 micron particles are deposited mainly in the tracheobronchial region; while particles less than 1 micron penetrate into the alveolar sacs and absorbed into the blood 3. Water solubility High water solubility volatile drugs are absorbed in the nasal tract; while low water solubility drugs will reach the bronchioles to alveoli Absorption can occur at any point along the GIT, however, the degree of absorption at a particular site depends on the chemical (a) Mouth and oesophagus Little absorption occurs due to the short time the chemical remains there, exceptions include nitroglycerin. (b) Stomach -Weak organic acids are absorbed from the acidic medium in the stomach. Some other drugs can be also absorbed in the stomach, e.g. alcohol , aspirin . --The acid may break some chemicals down. (c) Small intestine Absorption of alkaline chemicals (and food) is greatest from small intestine. soluble molecules are absorbed by diffusion. – Carrier mediated mechanisms exist for some larger chemicals. (d)Colon and rectum Little absorption takes place here -Disintegration of dosage form and dissolution of particles -Stability of chemical in gastric and intestinal juices and enzymes -Rate of gastric emptying -Presence and type of food 23 • Rapid process relative to absorption and elimination • Extent depends on - blood flow - size, M.W. of molecule - lipid solubility and ionization - plasma protein binding - tissue binding 24 Main mechanisms opposing distribution of the toxicants are: a-Plasma proteins b-Storage c-Special barriers (B.B.B.) Alter plasma binding of chemicals 1000 molecules A 99.9 1 % bound molecules free B 90.0 100 B has 100-fold increase in free pharmacologically active concentration at site of action than A. NON-TOXIC TOXIC 26 Competition-displacement between xenobiotics Extracellular Fluid low bioavailability high Bioavailability and toxicity capillary wall Blood Plasma ac tive molecules free in solution inactive molecules bound to albumin Al bumi n Al bumi n Al bumi n Al bumi n tolbutamide (hypoglycemic drug) drug 1 ( ) moderate affinity for plas ma albumin binding sites drug 2 ( ) greater affinity for plasma albumin binding sites tolbutamide + warfarin (antocoagulant) Displacement of one highly bound drug by another 27 Barriers to movement of chemicals from blood into tissues • Blood-brain barrier. Many toxic chemicals are prevented from entering the brain by a BBB. •Placental barrier The placenta transports nutrients from the mother to the fetus and wastes from the fetus to the mother.The placenta protects the developing fetus from many chemicals in the maternal circulation. •Blood-testis barrier Protects the developing sperm from some chemicals brain capillaries are unfenestrated -no gaps cell membrane of capillary endothelium cells sealed shut tight intercellular junctions constitute the blood brain barrier (BBB) hydrophiles dissolved in blood typically cannot pass through the BBB into brain Astrocyte Endothelial cell lipophiles can easily permeate the BBB by transcellular permeation (passive diffusion) Tight junction Basal membrane (porous) 29 -Some toxicants are stored in inert tissues (e.g. bone, fat, hair, nail) to reduce toxicity -Lipophilic toxicants (e.g. DDT) may be stored in milk at high conc and pass to the young Toxicant Pb Cd DDT Target organs Bone, teeth, brain Kidney, bone, gonad Adipose tissue Aflatoxin Liver -Convert toxicants into more water soluble form (more polar & hydrophilic) -Dissolve in aqueous/gas phases and eliminate by excretion (urine/sweat) of exhalation. -May increase or decrease toxicity of toxicants after transformation (e.g turn Benzo[a]pyrene into benzo[a]pyrene diol epoxide, and nitroamines into methyl radicals) -Inducible and inhibited by toxicants -Sequestrate in inactive tissues (e.g bone, fat) -Gas (e.g. ammonia) and volatile (e.g. alcohol) toxicants may be excreted from the lung by simple diffusion -Water soluble toxicants may be excreted through the kidney by active or passive transport -Conjugates with high molecular wt. may be excreted into bile through active transport -Lipid soluble and non-ionised toxicants may be reabsorbed (systematic toxicity) Elimination of chemicals from the body KIDNEY LIVER filtration secretion metabolism excretion (reabsorption) LUNGS OTHERS exhalation mother's milk sweat, saliva etc. 34 MOTHER’S MILK a) By simple diffusion mostly. Milk has high lipid content and is more acidic than plasma (traps alkaline fat soluble substances). b) Important for 2 reasons: transfer to baby, transfer from animals to humans. OTHER SECRETIONS – sweat, saliva, etc.. minor contribution 35