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CLINICAL PHARMACOKINETIC - PowerPoint Presentation

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CLINICAL PHARMACOKINETIC - PPT Presentation

EQUATIONS AND CALCULATIONS ONECOMPARTMENT MODEL EQUATIONS FOR LINEAR PHARMACOKINETICS Intravenous Bolus Equation t time after the intravenous bolus was given t 0 at the time the dose was administered ID: 933829

infusion dose 693 ket dose infusion ket 693 time concentration distribution rate constant volume hours state steady absorption elimination

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Slide1

CLINICAL PHARMACOKINETIC

EQUATIONS AND CALCULATIONS

Slide2

ONE-COMPARTMENT MODEL EQUATIONS FOR

LINEAR PHARMACOKINETICS

Slide3

Intravenous

Bolus

Equation

t= time

after the intravenous bolus was given (t = 0 at the time the dose was administered), C is the concentration at time = t, V is the volume of distribution, ke is the elimination rate constant.

C = (

D/V)e

ket

Slide4

1) A patient is given a theophylline loading

dose of 400 mg

intravenously over

20 minutes

, volume of distribution is 30 L, the elimination rate constant equals 0.115 h-1. compute the expected theophylline concentration 4 hours after the dose was given.t1/2 = 0.693/ke = 0.693/0.115 h-1 = 6 hC = (D/V)e−ket = (400 mg/30 L)e −(0.115 h)(4 h)

=

8.4

mg/L

Slide5

Distribution phase & Elimination phase

Slide6

2) A patient

is given an intravenous dose of vancomycin 1000 mg. the volume of distribution equals 50 L, the elimination rate constant is 0.077

h

1, calculate the expected vancomycin concentration 12 hours after the dose was given.t1/2 = 0.693/ke = 0.693/0.077 h−1 = 9 hC = (D/V)e −ket

=

(1000 mg / 50 L

)

e

−(0.077 h−1)(12 h)

=

7.9

mg/L

Slide7

Pharmacokinetic

parameters for patients can also be computed for use in the equations.

The elimination

rate constant, half-life and volume of distribution can be calculated

Slide8

3) A patient

was given an intravenous loading dose of phenobarbital 600 mg over a period of about an hour. One day and four days after the dose was administered phenobarbital serum concentrations were 12.6 mg/L and 7.5 mg/L, respectively

t1/2

is determined by measuring the timeneeded for serum concentrations to decline by 1/2 2. ke = 0.693/t1/2 = 0.693/4d = 0.173d−13. The concentration/time line can be extrapolated to the concentration axis to derive the concentration at time zero (C0 = 15 mg/L) volume of distribution

V = D/C0

=

600 mg

/ (

15 mg/L

)

= 40

L

Slide9

k

e

= −(ln C

1 − ln C2)/(t1 − t2)t1 and C1 are the first time/concentration pair t2 and C2 are the second time/concentration pairke=−[ln(12.6 mg/L) − ln(7.5 mg/L)]/(1 d − 4 d) = 0.173 d−1t1/2 = 0.693/ke = 0.693/0.173

d

−1

= 4

d

C

0

= C/e

ket

= (12.6 mg / L) / e−(0.173

d−1)(1 d) = 15.0 mg/LV = D/C0 = 600 mg / (15 mg/L) = 40 L

Alternatively

Slide10

Continuous and Intermittent Intravenous Infusion Equations

Slide11

If infusion is running

C = (k

0

/Cl)(1-e

-ket) = [k0/(keV)](1 – e-ket) k0 is the drug infusion rate (amount per unit time,

mg/h

or

μg

/min),

Cl

=

k

e

V

, this substitution was made in the second version of the equation),

ke

is the

elimination rate

constant

,

t is

the time that the infusion has been running.

Css

= k0 / Cl = k0 / (keV)

C = (k

0

/Cl)(1-e

-ket

)

Slide12

If the infusion is

stopped

C

postinfusion

= Cende−ketpostinfusiont post infusion is the post infusion time (t post infusion = 0 at end of infusion and increases from that point).

Slide13

4) A

patient is administered

60

mg/h of

theophylline, V = 40 L and ke = 0.139 h−1. calculate The serum concentration of theophylline in this patient after receiving the drug for 8 hours and at steady state.C = [k0/(keV)](1 − e−ket

)

= [(60 mg/h)/(0.139

h

1

⋅ 40 L)](1 −

e

−(0.139 h−1)(8 h

)

)

= 7.2

mg/L

Css

= k

0

/(

ke

V) = (60 mg/h)/(0.139 h−1 ⋅ 40 L) = 10.8 mg/L

Slide14

Continue…

If the

infusion only ran for 8 hours,

C

postinfusion = Cend e −ke tpostinfusion

=

(7.2 mg/L

) e

−(0.139 h−1)(6 h

)

=

3.1

mg/L

If the

infusion ran

until steady state was achieved

,

Cpostinfusion

=

C

end

e

−ke tpostinfusion = (10.8 mg/L) e−(0.139 h−1)(6 h) = 4.7 mg/L

compute the theophylline serum concentration 6 hours after the infusion stopped

Slide15

5) A

patient was given a single 120-mg dose of tobramycin as a 60-minute infusion, and concentrations at the end of infusion (6.2 mg/L) and 4 hours after the infusion ended (1.6 mg/L) were obtained.

1-

t

1/2 can be determined by measuring the time it takes for serum concentrations to decline by one-half = 2hr2- ke = 0.693/t1/2 = 0.693/2 h = 0.347 h−1

Slide16

Or without a plot

1- k

e

= −(ln C1− ln C2)/(t1 − t2) = −[ln (6.2 mg/L) − ln (1.6 mg/L)] / (1 h − 5 h) =0.339 h

−1

2- t

1/2

= 0.693/

k

e

= 0.693/0.339

h

1

= 2

h

Slide17

The

volume of distribution (V)

Can

be computed using the following

equations: At steady state and when we know C0 V= Dose / C0 or V= Cl/K in I.V infusion or before steady state[k0(1-e

-ket’

)] / k

e

[

Cmax

-(

Cpredose

e

-

ket

)]

V= Dose / C

0

or V= Cl/K

[k0(1-e

-ket’)] / ke[Cmax-(

Cpredose

e

-

ket

)]

Slide18

Extravascular Equation

The absorption rate

constant describes

how quickly drug is absorbed with a large number indicating fast absorption

and a small number indicating slow absorption

Slide19

Extravascular Equation

C = {(

FkaD

) / [V(

ka − ke)]}(e−ket − e−kat) F is the bioavailability fraction, ka

is the absorption rate constant,

D

is the dose

Slide20

example

500 mg

of

oral procainamide -----

Da half-life equal to 4 hours ----- t1/2an elimination rate constant of 0.173 h−1 ---- kevolume of distribution of 175 L -----

V

absorption

rate constant equal to 2

h

1

------

k

a

oral

bioavailability fraction

of 0.85 ----- F

C = {(

Fk

a

D

) / [V(

ka − ke)]}(e

ket

− e

kat

)

Slide21

After the end of absorption phase the C can be calculated by equation of I.V bolus

C

= [(FD)/

V]e −ket C is the concentration at any post absorption, post distribution time

Slide22

The hybrid volume

of distribution/bioavailability (V/F

) parameter

Since

volume of distribution relate the dose given with the obtained concentration and since in extravascular route not all the dose enter the blood stream so we use (V/F) to indicate the value of volume of distribution V/F = D/C0…………….or V = D/ [C0 − Cpredose], if not first dose C0 = C/e −

ket

K

e

= − (ln C

1

− ln C

2

) / (t

1

− t

2

)

Slide23

After

graphing the serum

concentration/time data----

k

e = 0.693 / t1/2 = 0.693/14 h----At time = 0 ----- hybrid volume of distribution/bioavailability V/F = D/C0 = 750 mg/70 L = 10.7 L

t

1/2

=14 hours

(C

0

= 70 mg/L)

k

e

= 0.0495

h

1

6)

An

oral dose of valproic acid 750 mg as capsules. 6 and 24 hours after the dose, the valproic acid serum concentrations are 51.9 mg/L and 21.3 mg/L, respectively.

Slide24

Slide25

ke

= −(ln C

1

− ln C

2)/(t1 − t2)t1/2 = 0.693/keC0 = C/e −ketV = D/C0

Alternatively

Slide26

Multiple-Dose and Steady-State Equations

change

a single dose equation to the multiple

dose version

, multiply each exponential term in the equation by the multiple dosing factor: n is the number of doses administered, ki is the rate constant, τ

is the

dosage interval

.

(1 −

e

nk

i

τ

)/(1 − e

k

i

τ

)

Slide27

At steady state

number

of doses (n) is large,

the

exponential term in the numerator of the multiple dosing factor (−nkiτ) becomes a large negative number-------exponent approaches zero. Therefore, the steady-state version of the multiple dosing factorbecomes the following:1/(1 − e

k

i

τ

)

Slide28

Multiple-Dose and Steady-State Equations

C = (

D/V)e

ketC = (D/V)[e−ket/ (1 − e −keτ)]

Slide29

To be

continued….