Pathopharmacokinetic

ABSORPTION
process of drug movement from the administration site to the systemic circulation.
disturbances of absorption
Diseases can change:
-diseases with lack or deficiency of HCL b) motor activity of gut ( speed of stomach emptying and intestinal passage ) - patients with slow stomach emptying and patients with pylorostenosis - patients with slow stomach emptying and patients with slow intestinal passage - ↑ intestinal passage ( enteritis, gastritis and diarrhoea ) → ↓ absorpition c) surface of absorption ( quantitative and qualitative changes ) - patients after partial gastrectomy, ileostomy and colon resection - ↓ permeability of cell membrane- diabetes, adrenocotrtical failure - ↑permeability of cell membrane – jaundice, allergic diseases d) vascularity of absorption place cardiogenic shock, myocardial infarction, heart failure →↓ visceral blood flow → ↓ absorption of drugs administered orally and parenterally e) contents of substances conditioned drug absorption - enteropathy and hepatopathy – disturbanes of bile secretion and bile transport ↓ absorption of lipid-soluble drugs DISTRIBUTION
Transfer of drug between regions of the body
Disribution between blood/plasma, tissues, organ and body fluids
disturbances of distribution
- cardiogenic shock - ↓blood supply of muscles and fatty tissue → ↓drugs distribution to
these tissues
- changes of compartment volume - ↑extracellular fluid ( edema ) – changes of Vd
- disturbances of acid-base equilibrium - interferences of tissue drug uptake
- deficiency of transport activator through cell membrane
- quantitative and qualitative changes of plasma protein composition in hepatic and renal diseases → changes of drugs binding of by plasma proteins
METABOLISM ( BIOTRANSFORMATION )
Biochemical modification or degradation of drug, usually through specialized enzymatic systems. Drug metabolism often converts lipophilic chemical compounds into more readily excreted polar products. Drug metabolism can result in toxication or detoxication - the activation or deactivation of the chemical. disturbances of biotransformation ( metabolism )
Metabolism of drugs can be disturbed by: - hepatic cirrhosis - chronic active hepatitis - hepatocellular damage ( toxic factors and starvation ) - mechanical jaundice These pathological states can altered the drugs metabolism by: - change of hepatic blood flow - quantitative and qualitative changes of plasma proteins - presence of joints between portal and systemic circulation - impairment of hepatocyte ability to drugs uptake from blood, drugs biotransformation by enzymatic system and their excretion to bile
first-pass effect
the elimination of drug that occurs after administration buy before it reaches the systematic
circulation, eg, during passage through the gut wall, portal blood, and liver for orally
administered drug
EXCRETION
Process by which the drug/nutrient or metabolites are removed from the body primarily by
the kidneys. Other routes of excretion from the body can include in bile, saliva, sweat, tears,
faeces, milk and exhaled air.
The disturbances of excretion
The drugs excreted in bile:
ampicillin, rifampicin, tetracycline, daunorubicin, doxorucicin, vinblastine, vincristine,
can be cumulated in the body in:
-hepatic cholestasia
- mechanical jaundice
In renal failure – changes of:
1) glomerular filtration
2) tubular secretion
3) tubule reabsorption

Source: http://www.zfk.ump.edu.pl/doc/pathopharmacokinetic.pdf