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Flashcards in Drug Metabolism Deck (34)
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1
Q

What does metabolism tend to do to a drug?

A
  • reduce the pharmacological and toxicological activity of a drug.
  • more polar and soluble so that it can more easily be excreted.
2
Q

What is hepatic first pass metabolism?

A

Metabolic conversion of the drug into something that is different before the drug enters the circulation.
In other words – the effect that occurs the very first time the drug passes through the liver.
Make the drug more water soluble to be excreted

3
Q

What effect does extensive first pass metabolism have on bioavailability?

A

Extensive first pass metabolism -> low bioavailability

4
Q

How can you avoid hepatic first pass metabolism?

A

Giving a drug intravenously

5
Q

What are the three types of reaction that fall under phase I reactions?

A

Oxidation
Reduction
Hydrolysis

6
Q

What is the purpose of Phase I metabolism?

A

It is meant to release or unmask functional groups that can be used in phase II reactions as a point of attachment

7
Q

How do phase I reactions affect polarity of the drug?

A

They have little effect on the polarity of a drug

8
Q

What enzyme system is extremely important to drug metabolism?

A

Cytochrome P450

9
Q

What are the substrates and products of the Cytochrome P450 mediated oxidation reaction?

A
Substrates = drug, NADPH, oxygen (O2), protons (H+) 
Products = hydroxylated drug, NADP+, water
10
Q

What do P450 enzymes have in their catalytic site?

A

They all have a porphyrin ring and an iron group (Fe3+)

11
Q

Describe the oxidation cycle of Cytochrome P450.

A

The drug binds to the iron in the catalytic site of CYP450 An electron is fed in from NADPH, which is picked up by the Fe3+ making it Fe2+
Then molecular oxygen binds to the catalytic site and Fe2+ loses its electron to become Fe3+ again, and oxygen picks up the extra electronand becomes unstable
Then a second electron is donated by NADPH, which, again, reduces Fe3+ to Fe2+ Fe2+ then donates this electron to the already unstable oxygen to make it even less stable
Then we get conversion of the drug to the hydroxylated derivative and we lose reactive oxygen as water with the uptake of two protons
The drug is released and P450, along with its Fe3+, is ready to undergo another cycle

12
Q

Where do reduction reactions tend to take place within the body and why?

A

GI tract because this is a low oxygen environment

Most reductases are bacterial enzymes that are colonising our gut, which is why these tend to happen in the GI tract

13
Q

What effect do phase II reactions have on the drugs?

A

They make drugs more polar and water-soluble (less lipid-soluble) so that they can be excreted more easily

14
Q

What are some features of conjugating agents?

A

Large
Polar
Endogenous

15
Q

What is the most common type of phase II reaction?

A

Glucuronidation (addition of a sugar to a molecule)

16
Q

What is the importance of glutathione conjugation?

A

Glutathione is conjugated with electrophiles so that they can be excreted
Electrophiles are damaging species that are often generated during metabolism – they must be removed because they can cause DNA and protein damage

17
Q

State an important property of the conjugates formed fromglucuronidation and its impact on its excretion.

A

They are large molecular weight products so it has a problem withglomerular filtration
High molecular weight molecules are often excreted in the bile

18
Q

What is the conjugating agent used in sulphation?

A

PAPS – 3’-phosphoadenosine-5’-phosphosulphate

19
Q

What type of molecule is glutathione?

A

Tripeptide consisting of:
Glycine
Glutamine
Cysteine

20
Q

What effect does drug metabolism have on biological half-life, duration of exposure and accumulation of drugs in the body?

A

Decreases biological half-life
Decreases duration of exposure
Avoids accumulation of drugs in the body

21
Q

What compounds are formed by oxidation reactions

A

Electrophiles

22
Q

What types of compounds are formed from reduction and hydrolysis

A

Nucleophiles

23
Q

Conjugating agent for acetylation

A

Acetyl CoA

24
Q

Metabolism of paracetamol

A

50% sulfation as high affinity
30% Glucuronidation as low affinity
20% glutathionine conjugation

25
Q

Amino acids used in conjugation

A

Glycine
Glutamine
Taurine

26
Q

Phase 2 reaction on electrophiles

A

Glutathionine conjugation

26
Q

Conjugating agent for glutathionine

A

Glutathionine

26
Q

Phase 2 reactions for nucleophiles

A

Glucuronidation
Acetylation
Sulfation

26
Q

Conjugating agent for glucuronidation

A

UDP glucuronic acid

26
Q

Conjugating agent for sulfation

A

3-phosphoadenosine-5-phosphosulphate

26
Q

Glutathionine conjugation of paracetamol

A

Phase 1 oxidation produces reactive intermediate NAPQI via Cyt P450
This electrophiles can then be detoxified by glutathionine conjugation

26
Q

What to give in paracetamol overdose

A

IV n-acetylcysteine

26
Q

Other Phase 2 reactions

A

Methylation

Amino acid conjugations

26
Q

Conjugating agent for methylation

A

S-adenosyl-methionine