Elimination of Sineobatrics (Part 2)

Introduction

• Study about elimination of sineobatrics, Part 2
• Part 1 focused on metabolism or biothermation in the liver

Metabolism Factors

Factors affecting liver metabolism

• Polymorphic Prism
  • Affects enzyme activity
  • Causes metabolism to increase or decrease
• Substances that alter enzyme activity
  • Such as drugs, food, herbs
  • Enzyme inhibitors or inducers

Genetic Polymorphic Prism

• Occurs from a single nucleotide polymorphism (SNP) at a specific location in the population
• Common in phase 1 and phase 2 enzymes
• Example: CYP2D6
  • Has multiple alleles with different activities

Metabolizer Types

• Normal, Rapid, Slow metabolizer
• Affects drug dosage and duration of use

Enzyme Inhibitors and Inducers

Enzyme Inhibitors

• Types of Inhibition: competitive, non-competitive
• Grapefruit: Example of an enzyme inhibitor

Enzyme Inducers

• Increase enzyme production
• Affect enzyme levels in the body

Excretion

Liver Excretion

• Enterohepatic circulation
  • Circulation of drugs and their metabolites

Kidney Excretion

• Consists of 3 processes: filtration, secretion, reabsorption
• Filtration: Passes through Bowman's capsule
• Secretion: Active transport in the proximal tubule
• Reabsorption: Passive diffusion in the distal tubule

Urine pH Adjustment

• Urine acidification
  • Adjust urine to be acidic to enhance drug excretion
  • Example substances used: Ammonium Chloride

Biologic Drugs

• Metabolism and excretion differ from chemical substances
• Examples: Insulin, growth hormone

Recommended Reading

• Goodman and Gilman's The Pharmacological Basis of Therapeutics
• Basic and Clinical Pharmacology, by Bertram Katzung

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