Pharm Sci Exam 2: Packet 2

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Distribution

The reversible transfer of drug between various body fluids/tissues

Vascular Fluids
1. Three types
2. Drug mostly in which type?

1. blood, plasma, serum
2. plasma

Cardiac output:
1. Definition
2. Equation

1. volume of blood pumped by heart per minute
2. heart rate x stroke volume

Cardiac output:
1. average bpm
2. average stroke volume

1. 80bpm
2. 60-80 mL

Total blood volume in an adult

~5 mL

Molecules involved with passive transcellular distribution (3)

1. macromolecules
2. polar/hydrophilic drugs
3. lipophilic drugs

Other processes of distribution (2)

1. carrier mediated transport
2. transcytosis

Distribution to Special Tissue: Kidney
1. Capillaries are ________
2. fast/slow distribution out of capillaries?

1. finestrated (large window-like junctions)
2. fast

Distribution to Special Tissue: Liver
1. capillaries are called..
2. what kind of molecules can enter?

1. sinusoids
2. large

Distribution to Special Tissue: Brain
1. ONLY what kind of transport?
2. additional barriers (2)

1. transcellular
2. pericytes and astrocytes

With transcellular transport, molecules must be ____-philic and ionized/unionized?

lipophilic and unionized

Regions of Distribution in 70kg Adult:
1. Total Body Water = __L
2. Intracellular Water = __L
3. Extracellular Water = __L

1. 40 L
2. 28 L
3. 12 L

Regions of Distribution in 70kg Adult:
1. Interstitial fluid: __L
2. Plasma: __L
3. Blood (plasma + cells): __L

1. 9 L
2. 3 L
3. 5 L

Rate of distribution depends on ____ rate of tissues

Perfusion rate

Well-perfused tissues/fast distribution (examples: 4)

1. kidneys
2. heart
3. brain
4. liver

Less perfused, slower distribution (examples: 2)

1. skin
2. muscle

Poorly perfused/very slow distribution (examples: 3)

1. fat tissue
2. connective tissue
3. bone

Volume of Distribution (Vd)

A measure of the extent of drug distribution in body fluids (how much, not how fast)

Between small lipophilic, small polar, and macromolecules, which has the highest Vd? Lowest Vd?

Highest Vd: small lipophilic
Lowest Vd: macromolecule

Low Vd = ______ plasma concentration

high plasma concentration

Macromolecular Drugs:
1. Two examples
2. Calculated Vd is the volume of..
3. Vd value

1. Heparin and asparaginase
2. Plasma
2. ~3L

Polar Small Molecules:
1. Example
2. Calculated Vd is the volume of..
3. Vd value

1. Mannitol
2. Extracellular fluid
3. ~12L

Small Lipophilic Molecules:
1. Calculated Vd is the volume of..
2. Vd value

1. Total body water
2. ~40L

Ionization and Vd: 100% ionized in interstitial fluid:
1. what happens?
2. Vd =

1. Drug can't enter cells
2. ~12L

Ionization and Vd: partially ionized in ISF:
1. what happens?
2. Vd

1. able to enter cells
2. ~40L

Drug binding to plasma proteins can only move into the interstitial fluid if it is..

unbound/free

Plasma protein-binding keeps drug in..

plasma

After an IV dose, is apparent Vd high/low?

Low

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