Blood enters the glomerulus via the____ arteriole, and leaves via the____
afferent, efferent
Excess ethanol consumption can lead to liver steatosis. Explain what liver steatosis is and how ethanol consumption can lead to steatosis
Certainly! Let’s dive into the role of NADH in metabolic processes, particularly its significance in ethanol breakdown and the regulation of fat synthesis and breakdown.
- NADH (Nicotinamide Adenine Dinucleotide, Reduced Form):
- NADH is a coenzyme involved in various cellular reactions.
- It plays a critical role in energy metabolism, particularly during cellular respiration.
- Here are its key functions:
- Ethanol Breakdown:
- When you consume alcohol (ethanol), your liver metabolizes it.
- The primary pathway for ethanol breakdown is through alcohol dehydrogenase (ADH).
- During this process, ADH converts ethanol to acetaldehyde.
- NADH is a crucial player
here:
- ADH oxidizes NADH to NAD+ (nicotinamide adenine dinucleotide, oxidized form) while reducing acetaldehyde to ethanol.
- This reaction helps maintain the balance of NADH/NAD+ in the cell.
- The availability of NAD+ is essential for continued ethanol breakdown.
- Regulation of Fat Synthesis and Breakdown:
- NADH/NAD+ ratio influences several metabolic pathways.
- In fat
metabolism:
- High NADH levels favor lipogenesis (fat synthesis).
- Low NADH levels favor lipolysis (fat breakdown).
- How does this work?
- NADH is involved in the conversion of pyruvate to lactate during anaerobic glycolysis.
- When NADH accumulates (e.g., due to excess glucose), it inhibits the conversion of pyruvate to oxaloacetate.
- As a result, oxaloacetate is diverted toward gluconeogenesis (glucose synthesis) and away from the citric acid cycle.
- This indirectly inhibits fat breakdown because the citric acid cycle is essential for fatty acid oxidation.
- Balance and
Regulation:
- Maintaining an appropriate NADH/NAD+ balance is crucial for overall cellular health.
- NADH is also involved in other redox reactions, such as those in the electron transport chain during aerobic respiration.
- The balance affects ATP production, oxidative stress, and overall metabolic homeostasis.
Remember, NADH is like a cellular currency, shuttling electrons and participating in vital reactions. Understanding its role helps us appreciate the intricate dance of metabolism!
A given drugs has a total clearance value (CL) of 3 L/hr and a volume of distribution (Vd) of 20 L, what is the elimination rate constant (Kel)?
3/20
Asprin (structure below) has a pKa of 3.5. Is it more likely to cross cell membranes in your stomach or in your intestines? Why?
Aspirin is a weak acid with a pKa of 3.5. When aspirin is ingested it is more likely to be absorbed in the stomach then intestine. The stomach pH is acidic (1.5-3.5) and at this state aspirin is in its non-ionization form causing it to be more lipophilic and diffuse more readily across the cell membrane.
Binding to a plasma protein might _______ toxicity and _______ half-life.
decrease; increase
Nitroglycerin is a drug that is used to treat angina (chest pain). When administered orally, it has poor bioavailability and thus it is typically administered sublingually (under the tongue). What is bioavailability and how might this route administration affect the bioavailability of nitroglycerin?
Bioavailability describes the proportion of a substance that is absorbed into the blood, and drugs that are ingested may have lower bioavailability due to the first-pass effect. If nitroglycerin is delivered sublingually it bypasses first-pass metabolism.
Explain why it is dangerous to take NSAIDS and ACE-inhibitors at the same time.
Certainly! Let’s delve into the intricate details of how NSAIDs (nonsteroidal anti-inflammatory drugs) and ACE inhibitors impact renal function, specifically focusing on the efferent and afferent arterioles.
- Efferent and Afferent Arterioles:
- The kidneys have specialized blood vessels called arterioles that play a crucial role in regulating blood flow within the glomerulus (the filtering unit of the kidney).
- The afferent arteriole supplies blood to the glomerulus, allowing it to be filtered.
- The efferent arteriole carries blood away from the glomerulus after filtration.
- Angiotensin II and Its Effects:
- Angiotensin II is a hormone that constricts blood vessels and plays a central role in blood pressure regulation.
- In the kidney, angiotensin II constricts both the afferent and efferent arterioles.
- However, it preferentially increases efferent resistance 1.
- Why? Here
are some factors:
- The efferent arteriole has a smaller diameter initially, so further constriction at this site leads to a greater increase in resistance compared to the afferent arteriole.
- Angiotensin II stimulates the release of nitric oxide from the afferent arteriole, minimizing constriction at that site.
- Angiotensin II also minimizes vasoconstriction at the afferent arteriole via angiotensin II type 2 receptors, resulting in vasodilation1.
- ACE
Inhibitors and Efferent Arterioles:
- ACE inhibitors (angiotensin-converting enzyme inhibitors) block the conversion of angiotensin I to angiotensin II.
- By doing so, they reduce the production of angiotensin II.
- As a consequence, efferent arteriolar vasoconstriction is inhibited.
- This helps maintain or even raise the glomerular filtration rate (GFR) by stabilizing or increasing intraglomerular pressure2.
- NSAIDs
and Afferent Arterioles:
- NSAIDs inhibit the synthesis of prostaglandins.
- Prostaglandins play a protective role in the kidney by dilating the afferent arteriole.
- When NSAIDs are taken, they reduce the ability of the afferent arteriole to dilate.
- Consequently, intraglomerular pressure decreases, potentially leading to ischemia and acute renal failure3.
- Clinical
Implications:
- Understanding these mechanisms is crucial for healthcare professionals.
- On tests, pay attention to:
- Which drug impacts prostaglandins (NSAIDs) and which impacts angiotensin II (ACE inhibitors).
- The specific effects on efferent and afferent arterioles.
- How these alterations influence glomerular filtration and renal function.
Remember, the kidneys are intricate organs, and maintaining their delicate balance is essential for overall health.
Toxicology
Is the study of the adverse effects of chemical on living organisms
is the branch of science concerned with the nature effects and detection of poisons
Ebers Papyrus
oldest medical toxicologist documented
20th century is
where toxicology become a real thing
Paracelsus
made important improvements on dosages
Ebers Papyrus
One of the oldest known writings (1500 B.C.)
Contains information on many recognized poisons
Bioavailability
- In pharmacology, bioavailability refers to the percentage of an administered drug that reaches the systemic circulation.
- When a medication is administered intravenously, its bioavailability is 100% because it directly enters the bloodstream.
- However, when a medication is administered via other routes (such as oral ingestion), its bioavailability is lower due to factors like intestinal absorption and first-pass metabolism.
- Mathematically, bioavailability is expressed as the ratio of the area under the plasma drug concentration curve (AUC) for the extravascular formulation (e.g., oral) to the AUC for the intravascular formulation (e.g., intravenous).
Overdose
An overdose occurs when you take more than the recommended amount of something, often a medicine or drug. It can result in serious, harmful symptoms or even death. If you intentionally take too much of something, it is called an intentional or deliberate overdose 1. In simpler terms, it’s like going beyond the safety limit and facing potentially severe consequences.
De Materia Medica
first book to talk about plant reproduction and plant poisons
Bioavailability
How much is actively poisoning you
Rapidity of the toxic response
onset of action
The effectiveness of the compound
potency
The degree of response of the parts of the body
specificity site of action
Complaints of victims
clinical signs and symptoms
Paracelsus
Dose makes the poison
published on the miners sickness and other disease of miners
Absorption
- In Pharmacology:
- Absorption refers to the process of assimilating substances across the intestinal epithelial cells or other tissues and organs.
- It occurs through active or passive transport.
- Absorption follows the digestion process and never precedes it.
- For example, when you ingest a medication orally, its absorption occurs as it passes through the intestinal wall into the bloodstream or lymphatic system1.
Distribution
- Distribution Process:
- Distribution refers to how an absorbed chemical moves away from the site of absorption to other areas of the body.
- After absorption (whether through the skin, lungs, or gastrointestinal tract), the toxicant enters the interstitial fluid.
- From there, it can be distributed to various compartments within the body.
first scientific journal dedicated to toxicology
Archiv Fur Toxikologie
Mechanism of toxicology
identifies the cellular, biochemical, and molecular
mechanisms
by which chemicals exert toxic effects on living organisms.
Descriptive toxicology:
direct toxicity testing which provides information for
safety
evaluation and regulatory requirements
Regulatory toxicology:
deciding if (based on mechanistic and descriptive
toxicology
data) a drug or another chemical has a low enough risk to be
marketed
• Forensic toxicology
focuses on the medicolegal aspects of the harmful effects
of chemicals
Clinical toxicology:
study of diseases caused by or uniquely associated with toxic
substances
Environmental toxicology:
focuses on the impacts of chemical pollutants in the
environment on biological organisms, mainly focused on nonhuman
organisms.
Ecotoxicology: focuses on the impact of toxins on
population dynamics in an
ecosystem
Developmental toxicology
the study of how exposure to chemicals before
conception,
during prenatal development, or postnatally until the time of
puberty causes adverse effects on development. Teratology is the
study of
defects in development between conception and birth
Reproductive toxicology:
the study of what happens to the male or female
reproductive
system as a result of exposure to chemicals or physical agents
Toxicogenomics:
looks at the interaction between genes and toxicants in toxicity etiology
Transcriptomics
gene expression
Proteomics
protein expression
Metabolomics
small molecule metabolism and functions
Potential questions asked in toxicogenomics
How does a chemical affect genomic DNA, mRNA, or other RNAs?
•
How does a chemical change epigenetics (methylation, acetylation,
etc.)?
• How does a chemical influence gene expression?
Poison
any agent capable of producing a deleterious response in a biological
system
Toxic agents can be classified by their
physical state, chemical stability or
reactivity, general
chemical structure, or poisoning potential
Toxin
toxic substances produced by biological systems
Toxicants
toxic substances that are a product of human activities
Lethal dose 50: LD50
The dose needed to produce death in 50% of
treated animals
(short-term exposure dose)
Side effects that are always deleterious to humans are referred to
adverse, deleterious, or toxic effects of the drugs
• Chemical allergens:
an adverse immune response to a chemical (usually due to
previous exposure)
Chemical idiosyncrasy:
genetically related abnormal reactivity to a chemical
Delayed toxicity:
most toxic effects occur rapidly after a single administration of
a substance, but some can have delayed toxic effects. Example:
carcinogens,
cancer 20-30 years after exposure
Site of action:
Local (place of initial contact) vs systemic toxicity. Target organs
Tolerance
prior exposure = decreased responsiveness to a toxic effect
Additive
2+2=4
Synergistic
combined effect of chemicals is much greater 2+2=20
Potentiation
0+2=10 one chemical doesn't do anything but can if something is mixed within it
Example: Isopropanol and carbon tetrachloride
Functional Antagonism
counter balance. opposite effects. 4+(-4) = 0
Chemical antagonism
Chemical reaction between two toxins that produce a less toxic effect
Dispositional antagonism
About how interference with absorption happens. Biotransformation. distribution. excretion
Receptor antagonism
Two chemicals bind at the same receptor chemical binds receptor
Major routes of exposure
Gastrointestinal tract (ingestion)
• Lungs (inhalation)
•
Skin (topical, percutaneous, or dermal)
Acute
Usually single administration (or within 24 hours
Subacute
repeated exposure for 1 month or less
Subchronic
repeated exposure for 1-3 months
Chronic
more than 3 months
What does line A represent?
a chemical with very slow
elimination
What does line B represent?
A chemical with a rate of
elimination equal to its dosing
What does line C represent?
Rate of elimination faster than its
dosing frequency
What does the purple shading mean
the concentration of the
chemical that elicits a toxic response
Individual refers to
an individual organism
Quantal refers to
a population of organisms
• Individual dose-response relationship:
which describes the response of an individual organism to
varying doses of a chemical, often referred to as a
"graded" response because the measured effect
is
continuous over a range of doses
Quantal dose-response relationships:
all or none
• An individual in a population of organisms is
classified as either a responder or nonresponder
Effective dose (ED) is a
statistical
approach for estimating a population’s
response to a toxic exposure
• ED50 = 50% response level
similar ED 50 btu could have different dosage effects overall (range of error)
Assumptions in deriving the dose-response relationship
The response is due to the administered chemical (cause-and-effect
relationship)
2. The magnitude of the response is related
to the dose
3. There is a quantifiable method of measuring and a
precise means of
expressing toxicity
a) This means a given
chemical could have multiple dose-response
relationships for
different effects
TD
Toxic dose
LD
Lethal dose
ED
Effective dose
Therapeutic index (TI):
ratio of the dose for a toxic effect and dose needed to elicit a
therapeutic response
TI =TD50/ED50
ED50 = 50% response level of the effective dose
TD50= toxic dose is 50% of population
Chemical A is _______ potent than B
• Chemical C is _______
potent than D
More and more
Maximal Efficacy
• Chemicals A and B
• Chemicals C and D
Chemicals A and B = same
Chemicals C and D = c has a lower maximal efficiency then d
Selective toxicity
a chemical produces injury to one kind of living
matter without
harming a different form of life.
• A lot of toxicity studies rely of experimental results being
applicable to humans, BUT responses can have qualitative and quantitative differences
Acute toxicity testing:
Daily examination of animals→ could watch for signs of
intoxication, lethargy, behavioral modifications, and number of
animals that die over a set period
LD50 determined using 1+ routes of exposure and 1+ species
• Identify target organs and other clinical
manifestations
• Identify species differences and susceptible
species
• Establish the reversibility of toxic response
•
Provide dose-ranging guidance for other studies
Subacute
monitoring effects of repeated doses, typically over a period of 14
days (used as an aid to establish doses for subchronic studies
Subchronic
Usually lasts at least 90 days. One of the main goals is to establish the lowest observed adverse effect (LOAEL) or the no observed adverse effect (NOAEL)
Chronic
6 months- 2 years, done similarly to subchronic tests. One of the main goals is often to evaluate potential oncogenicity
idiosyncratic reactions,
- diosyncratic reactions refer to unpredictable and unusual responses to a substance.
- These reactions occur rarely and are not dose-dependent.
- They are not related to the pharmacological action of the substance.
- Examples include severe allergic responses or unexpected adverse effects in specific individuals.
reversible vs irreversible toxic effects
-
Reversible effects occur when the toxic effect
disappears after exposure ends.
- These effects are often associated with low doses or short-term exposure.
- For instance, binge drinking of ethanol for one night or weekend.
-
Irreversible effects persist or worsen even after
exposure ceases.
- These effects are usually associated with long-term and high-dose exposure.
- Examples include carcinomas, teratogenic effects (in offspring), neuronal damage, and liver cirrhosis (common in alcoholics).
local vs systemic effects
-
Local effects occur at the site of
contact with the toxic substance.
- Examples include injuries from strong acids or skin irritation caused by corrosive chemicals.
- Inhaled toxic gases can also cause local effects in the respiratory tract.
-
Systemic effects occur after the toxicant has been
absorbed and distributed throughout the body.
- The toxicant enters the systemic circulation and affects various organs and tissues.
- Target organs may not always have the highest concentration of the toxicant.
LD50
- The LD50 represents the dose of a substance (usually a drug or chemical) that is lethal to 50% of the population exposed to it.
ED50
- The ED50 represents the dose of a drug that produces a therapeutic effect in 50% of the population.
potency
- Potency refers to the concentration (EC50) or dose (ED50) of a drug required to produce 50% of its maximal effect.
maximal efficacy
- Efficacy (also known as maximal efficacy) represents the maximum effect that can be expected from a drug.
• Differentiate between individual and quantal dose-response relationships and understand their graphical representation
Certainly! Let’s explore the differences between individual dose-response relationships and quantal dose-response relationships, along with their graphical representations:
- Individual Dose-Response Relationships:
- Individual dose-response relationships focus on the graded response of an individual to varying doses of a drug or substance.
- These relationships are continuous and represent the effect of different doses on a specific individual.
- The response can be measured on a graded scale, such as blood pressure, pain relief, or enzyme activity.
- Graphically, an individual dose-response curve shows how the response changes with increasing doses of the drug.
- The x-axis represents the dose (usually in logarithmic scale), and the y-axis represents the graded response (e.g., pain relief score, enzyme activity level).
- The curve may exhibit features like potency, maximal efficacy, and slope 1.
- Quantal Dose-Response
Relationships:
- Quantal dose-response relationships focus on the binary outcome (either present or absent) in a population exposed to varying doses of a drug.
- These relationships are discrete and represent the rate of occurrence of a specific effect (e.g., toxicity, adverse event) in a group of individuals.
- The response is typically categorized as either responders (those who exhibit the effect) or non-responders (those who do not).
- Graphically, a quantal dose-response curve shows the percentage of responders at different doses.
- The x-axis represents the dose, and the y-axis represents the percentage of responders.
- The curve may exhibit features like the median effective dose (ED50), which represents the dose at which 50% of the population responds2.
- Graphical
Representations:
- Graded Dose-Response
Curve:
- !Graded Dose-Response Curve
- This curve depicts the graded response (e.g., pain relief) as the dose increases.
- It shows the potency, maximal efficacy, and slope of the drug’s effect.
- Quantal Dose-Response
Curve:
- !Quantal Dose-Response Curve
- This curve represents the percentage of responders in a population.
- The ED50 (dose at which 50% respond) is a key point on this curve.
- Graded Dose-Response
Curve:
In summary, individual dose-response relationships focus on an individual’s graded response, while quantal dose-response relationships analyze binary outcomes in a population. Both provide valuable insights for drug dosing and safety considerations.
Ultimate toxicant
could be original chemical or
a molecule generated during
biotransformation
of the toxicant
Absorption
the transfer of a chemical from the site of exposure into the
systemic circulation (blood)
• Sometimes there are
transporters
• Most chemicals go through epithelial barriers via diffusion
Factors that influence absorption:
Surface area of exposure
• The characteristics of the
epithelial layer where the toxic substance is being absorbed
•
Lipid solubility
Presystemic elimination:
during transfer to systemic circulation
• Example: GI track
•Distribution:
exit blood and reach site(s) of action
Mechanism facilitating distribution to a target
Porosity of the capillary endothelium
• Specialized transport
across plasma membranes
• Accumulation in cell organelles
•
Reversible intracellular binding
• Mechanisms opposing distribution to a target
• Specialized barriers
• Distribution to storage sites
•
Association with intracellular binding proteins (nontarget)
•
Export from the cell membrane
Excretion
removal of the xenobiotic from the blood
• Major excretory
organs: kidney and liver
• Note excretion is a physical
mechanism, biotransformation is a chemical mechanism for
eliminating toxic substance
Reabsorption
Toxic chemicals are filtered and then reenter into the blood
through diffusion
• Example: toxicants delivered to the GI
tract by biliary, gastric, and intestinal excretion can be
reabsorbed by diffusion across intestinal mucosa
•
Dependent on lipid solubility (harder to get rid of fat soluble
because they absorb easily)
Biotransformation
the biochemical modification of a chemical compound
Toxication (or metabolic activation):
Biotransformation to harmful products
• Conversion into
electrophiles, free radicals, nucleophiles, or redox-active reactants
Detoxication
biotransformation that eliminate the toxicant
• Detoxication of
toxicants with no functional groups, nucleophiles, electrophiles, free
radicals,
protein toxins
Most common targets:
nucleic acids (especially DNA), proteins, and membranes
The toxicant reacts with the target and adversely affects its
function
• Reaction types:
non covalent, covalent interactions, hydrogen abstraction, redox reactions, enzymatic reactions
The toxicant reaches effective concentrations at the
target site
The toxicant alters the target in a way that is mechanistically
related to observed toxicity
Molecular repair
Repairing proteins (molecular chaperones, other enzymes, or mark for
degradation if beyond repair)
• Lipids
• DNA (direct repair
of covalent modification by enzymes, excision repair, nonhomologous
end
joining)
Cellular repair
• Autophagy→ removing and degrading damaged cellular components like
organelles
• Regeneration of damaged axons
Tissue repair
Apoptosis and regeneration (replacement of cells and extracellular matrix)
Adaptation
A harm-induced capability
of an organism for increased
tolerance to
the harm itself
• Decrease delivery of
toxicant to target
• Decreased susceptibility of the
target
• Increased capacity for repair
• Strengthened
mechanisms to compensate for
toxicant-induced afflictions
Examples of toxicity resulting from inappropriate repair and
adaptation
Tissue necrosis (tissue cell death—injury overwhelms/disables repair
mechanisms)
• Fibrosis (excess extracellular matrix
deposition with abnormal composition)
• Carcinogenesis
•
Failure of DNA repair, failure of apoptosis, or failure to terminate
cell proliferation
Delivery
Delivery in relation to toxicology encompasses several critical aspects. Let’s explore them:
- Forensic Toxicology and Criminal Justice Delivery:
- Forensic toxicology involves the study of poisons and their effects on biological systems, especially in the context of legal and criminal investigations.
- It plays a crucial role in criminal justice delivery by providing evidence related to toxic substances.
- Forensic toxicologists analyze biological samples (such as blood, urine, or tissues) to detect drugs, toxins, or chemicals.
- Their findings are used in court proceedings to establish whether a substance contributed to an individual’s health condition or death1.
- Post-Mortem Investigations:
- Forensic toxicology is applied in post-mortem examinations to determine if excessive drug intake occurred and whether it played a role in a person’s demise.
- Toxicologists identify substances in tissues and assess their impact on the deceased individual.
- This information aids in understanding the cause of death and may have legal implications.
- Environmental Toxicology and
Public Health Delivery:
- Toxicology also extends to environmental health.
- It helps assess the impact of pollutants, chemicals, and hazardous substances on ecosystems, wildlife, and human populations.
- By understanding toxic effects, regulatory agencies can develop policies and programs to limit exposure and prevent negative health outcomes2.
- Risk Assessment and Safety Delivery:
- Toxicologists evaluate the risks associated with exposure to various substances.
- They assess safe exposure levels, establish guidelines, and recommend safety measures.
- This information is crucial for public health delivery, ensuring that individuals are protected from harmful substances.
In summary, toxicology plays a vital role in delivering justice, safeguarding public health, and understanding the impact of toxic substances on individuals and the environment.
Toxicokinetics
the quantitative study of absorption, distribution,
metabolism
(biotransformation), and elimination
Some factors that affect the rate of absorption
How easily a toxic substance can cross a membrane (lipophilic? Uses a
transporter? Ionized [pH
dependent])
• Route of exposure
Facilitated diffusion:
down the
concentration/electrochemical gradient.
Doesn’t
require energy (some molecules like
glucose and amino acids can
cross
membranes like this)
Active transport
against a gradient, selective
for certain chemical features,
expends energy
Most toxicants cross membranes by
simple diffusion
Getting to the brain
Must cross the blood brain barrier
• Must cross the
blood-cerebrospinal fluid barrier
Placental barrier
Numerous cell layers (~6) between fetal and maternal circulations
that have different
transport proteins that may help protect the
fetus from some xenobiotics
Route of exposure and absorption
Gastrointestinal tract
• Lungs
• Skin
• Other routes
How is Absorption measured?
• Level of chemicals in blood, urine, tissues
• Environmental
tests-sample taken from surrounding media for fish, worms,
shell-fish
• Computational modeling: QSAR-BCF: Bio-Concentration
Factor –could be estimated in EpiSuite
• Radiolabeling monitoring
3H and 14C---generally considered as unequivoqually proof
Distribution
(going from the bloodstream throughout the body)
Volume of distribution (Vd):
the apparent volume of a biological fluid the
xenobiotic is
diluted into
Storage sites include:
liver, kidney, fat, bone, and plasma protein
Distribution and plasma proteins as a storage depot
Some xenobiotics bind to plasma
proteins
• Once bound,
they cannot cross capillary
walls (high molecular weight)
•
This means there is less toxicant
immediately available for
distribution
(usually these interactions are
reversible)
• Toxicity is typically only the result of
unbound xenobiotics
Elimination
Excretion
• Urinary excretion
• Fecal excretion
•
Exhalation
• Cerebrospinal fluid
• Milk
• Sweat and Saliva
Toxicokinetics
the quantitative study of absorption, distribution,
metabolism
(biotransformation), and elimination
If F < 1 then
then less than 100% of the administered dose reaches systemic
circulation
Most toxic substances aren’t delivered intravenously, and Bioavailability (F) describes
the extent of absorption (or the proportion of toxicant that enters
circulation)
Volume of Distribution (Vd):
the apparent volume of a biological fluid the
xenobiotic is
diluted into
• Usually expressed in mL or L of blood, plasma, or
plasma water
Clearance (CL):
the apparent volume of physiological fluid that is cleaned of a
toxicant per unit of time (i.e. mL/min)
• High clearance
values = efficient and generally rapid removal of chemicals from
systemic circulation
The elimination rate constant (Kel) represents
the fraction of the amount of a
chemical that is removed from
systemic circulation per unit of time.
• This is equivalent to
elimination via clearance mechanisms over the volume distribution
(CL/Vd)
• So if CL= 10 L/hr and Vd = 100 L, then what is Kel?
10 L/Hr /100 L = 0.1 per hour
Because the percent of elimination over a given period of time is constant, it is more common to refer to an
elimination half-life (t1/2): the time it takes for the concentration
to reduce by 1/2
Cl= 10 Vd = 100
(0.693 * 100 )/10 = 6.93 hours
Toxicokinetics
the quantitative study of absorption, distribution,
metabolism
(biotransformation), and elimination
Classic model:
chemicals move through the body as if there were
one or more
compartments that have no apparent physiologic or
anatomical reality
Physiologic toxicokinetic models:
attempt to portray the body as an elaborate system of discrete tissue or organ compartments that are interconnected via circulatory system
Know how plasma proteins affect xenobiotic distribution
Certainly! Let’s explore how plasma proteins impact the distribution of xenobiotics (foreign substances, such as drugs or toxins) within the body:
- Plasma Proteins and Xenobiotics:
- In the bloodstream, xenobiotics can interact with various plasma proteins.
- The most significant protein involved is albumin.
- Albumin has high binding affinity for many xenobiotics due to its large size and hydrophobic pockets.
- When xenobiotics encounter albumin, they can bind reversibly to it.
- Effects of Plasma Protein Binding:
- Reduced Free Concentration: When xenobiotics bind to plasma proteins, their free (unbound) concentration decreases.
- Equilibrium: The non-bound (free) portion of xenobiotics is in equilibrium with the bound portion.
- Buffering Effect: Plasma proteins act as a buffer, preventing sudden changes in xenobiotic concentration.
- Transport: Bound xenobiotics can be transported throughout the body by the bloodstream.
- Clinical
Implications:
- Altered Distribution: Plasma protein binding affects the distribution of xenobiotics to various tissues.
- Competition: Different xenobiotics may compete for binding sites on plasma proteins.
- Drug Interactions: Co-administration of drugs that bind to the same protein can lead to drug interactions.
- Toxicity: If a xenobiotic is highly bound to plasma proteins, it may have limited access to target tissues (e.g., the brain), affecting its therapeutic or toxic effects.
- Volume of Distribution
(Vd):
- The volume of distribution (Vd) describes how a drug or xenobiotic distributes within the body.
- It considers both the free and bound fractions.
- Standard values for a typical adult
are:
- Plasma volume = 3 liters
- Extracellular fluid volume = 12 liters
- Total body water = 41 liters
In summary, plasma proteins play a crucial role in determining the distribution of xenobiotics, affecting their availability to target tissues and potential toxic effects.
Distinguish between classic and physiologic toxicokinetic models
Certainly! Let’s delve into the differences between classic and physiologically based toxicokinetic (PBTK) models:
- Classic Toxicokinetic Models:
- Description: Classic toxicokinetic models describe the time- and dose-dependent processes of absorption, distribution, and elimination of a chemical substance and its metabolites in animals and humans.
-
Characteristics:
- Compartmental: These models represent the organism as a set of compartments, each characterized physiologically or empirically.
- Mathematical Functions: They rely on mathematical functions to fit concentration-time data and predict concentration-time courses of the parent chemical and metabolites, typically in blood or plasma.
- Applications: Classic models are used for both repeated and continuous exposures.
- Limitations: They do not account for detailed physiological and anatomical variations.
-
Examples:
- One-Compartment Open Model: Describes concentration-time courses using a single compartment.
- Two-Compartment Open Model: Incorporates two compartments to better represent distribution and elimination processes.
- Physiologically Based Toxicokinetic (PBTK) Models:
- Description: PBTK models quantitatively describe the absorption, distribution, metabolism, and excretion of chemicals across various exposure routes and doses in organisms.
- Characteristics:
- Physiological and Anatomical Data: PBTK models require detailed physiological, anatomical, physicochemical, and biochemical data.
- Tissue-Specific Predictions: Unlike classic models, PBTK models can predict concentration-time courses in various tissues and organs.
- Realistic Representation: They consider interspecies scaling and account for individual variability.
- Applications: Widely used in toxicology studies and risk assessment.
- Advantages:
- Precision: PBTK models provide a more realistic representation of chemical behavior.
- Predictive Power: They enable predictions beyond blood or plasma concentrations.
- Customization: Can be tailored to specific chemicals and exposure scenarios.
In summary, classic models are simpler but lack physiological detail, while PBTK models offer a more comprehensive understanding of toxicokinetics by incorporating anatomical and physiological complexities1 2 3 4.
The liver is the main organ facilitating
metabolic homeostasis
• Process/ delivery of nutrients absorbed
in the intestinal tract
The liver is the main organ where
exogenous chemicals are
metabolized for eventual excretion
into bile
Dual blood supply:
Heaptic artery from:
hepatic portal vein from:
Heart: (supplies oxygen rich
blood to the liver)
stomach and
small intestines
Steatosis
Fatty liver→ increased lipid content in liver cells
• Most
common cause is insulin resistance, some toxicants (i.e. carbon
tetrachloride, valproic acid)
• Bile duct damage
• Inflammation
Fibrosis
scaring when chronic liver injury overwhelms the capacity of the organ to repair
Liver cancers come from
chronic abuse of alcohol, androgens, and aflatoxin-contaminated diets
Some of the functions of the kidney
Filter blood and produce urine
• Excretion of metabolic
wastes
• Synthesis of renin and erythropoietin
• Regulation
of extracellular fluid volume,
electrolyte composition, and
acid-base
balance
• Transport, accumulation, and
biotransformation of xenobiotics
Why are kidneys susceptible to toxicity?
Kidneys receive 20-25% of cardiac
output
how does blood flow trough the Glomerulus
• Blood enters via the afferent arteriole
• Blood flows exits
via the efferent
arteriole
• Together the afferent and
efferent
arterioles control pressure and plasma
flow rate
egulating factors of
the blood flow
Angiotensin II: vasoconstrictor effect on
efferent
arteriole
• Prostaglandins: vasodilation of afferent
arteriole
Example of kidney toxicity: NSAIDS
Nonsteroidal Anti-Inflammatory
Drugs (NSAIDS): relieve pain,
reduce
inflammation
• NSAIDS block the production of
prostaglandins
• Prostaglandins regulate the pressure
of blood flow through the kidneys
• Prostaglandins:
vasodilation of afferent
arteriole
Example of kidney toxicity: ACE-Inhibitors
Angiotensin-converting enzyme (ACE)-inhibitors: medications that
lower blood pressure
• Inhibit the enzyme making
angiotensin II
• Angiotensin II: vasoconstrictor effect on
efferent arteriole
Taking NSAIDS and ACE-inhibitors at the
same time can lead to
nephrotoxicity
because of significantly decreased
pressure
Toxic responses of the reproductive system include any adverse
effects on sexual
function and fertility in adult males and females
Example:
Expose adult animals whatever chemical for 2 weeks prior to breeding:
1) are they ovulating normally
2) is the same amount of sperm being
3) How many embryos implanted
4) How many are giving birth
Toxic responses of the brain: cyanide
• cyanide binds and inhibits
cytochrome c, causing a
disruption in ATP synthesis
cyanide inhibits what in the brain
cytochrome C, and thus ATP synthesis
More than 90% of a dose of ethanol is metabolized in the liver
•
Excess NADH leads to steatosis by signaling a down regulation
of
fatty acid breakdown and upregulating fatty acid synthesis
liver steatosis → liver fibrosis → liver cirrhosis
neoplasia
new growth or autonomous growth of tissue
Neoplasm
The lesion resulting from neoplasia
Benign
Lesion characterized by expansive growth, frequently exhibiting slow rates of proliferation they do not invade surrounding areas
Malignant
Lesions demonstrating invasive growth, capable of metastasis to other tissues or organs
metastases
Secondary growths derived from a primary malignant neoplasm
Tumor
Lesion characterized by swelling or increasing in size, may or may not be neoplastic
Cancer
Malignant neoplam
Carcinogen
A physical or chemical agent that causes or induces neoplasia
Genotoxic
Carcinogens that interact with DNA resulting in mutation
Non-genotoxic
Carcinogens that modify gene expression but do not damage DNA
Carcinogen
A physical or chemical agent that causes or induces neoplasia
Direct acting carcinogens:
highly reactive
electrophilic molecules which bind to DNA
without
biotransformation
Indirect acting carcinogens
: (more common)
chemicals that require biotransformation to be
carcinogenic
The ultimate carcinogenic forms are
frequently strong electrophiles (nucleophiles
are DNA bases and
phosphodiester backbone)
Chemicals containing these moieties frequently cause
tumor formation at the site of chemical exposure
Mismatch repair
mechanism to repair point mutations
Excision repair:
mechanism to repair DNA regions containing
chemically modified
bases, or DNA chemical adducts
Homologous recombination and nonhomologous end-joining:
mechanism to repair double stranded breaks
oncogene
a gene that is capable of transformation cells in a
culture or
inducing cancer in animals.
Proto-oncogenes
are genes that regulate cell proliferation, growth, and differentiation, and control the cell cycle.
Tumor-suppressor genes
are genes that inhibit cell proliferation or cell survival
Examples of non-genotoxic carcinogens
Receptor mediated:
example phenobarbital
Examples of non-genotoxic carcinogens
Hormonal mode of action:
example estrogen
Examples of non-genotoxic carcinogens
Immunosuppression
cancer immune surveillance is
vital, if immune cells are
destroyed then that is a
problem
Connect genotoxic carcinogens with the development of cancer
Certainly! Let’s delve into the connection between genotoxic carcinogens and the development of cancer.
- Genotoxic Carcinogens:
- Genotoxic carcinogens are substances that can cause damage to an organism’s genetic material (DNA) and potentially lead to cancer.
- These substances induce mutations, deletions, or rearrangements in the DNA, disrupting its normal structure and function.
- Examples of genotoxic carcinogens include certain chemicals, radiation (such as UV rays), and some viruses.
- Cancer Development:
- The process of cancer development involves two main steps: initiation and promotion.
-
Initiation:
- Genotoxic carcinogens initiate the process by causing DNA damage in a cell.
- This damage creates an abnormal cell with altered genetic material.
- These initiated cells have the potential to become cancerous.
-
Promotion:
- After initiation, promoters come into play.
- Promoters stimulate the replication of these neoplastic (abnormal) cells.
- They facilitate the progression of the tumor.
- Genotoxic chemicals act as initiators in this context1.
- Mechanisms and Implications:
- Genotoxic effects, such as DNA deletions, breaks, and rearrangements, can lead to cancer if the damage is not immediately repaired or if the cell does not undergo apoptosis (cell death).
- Regions in the genome that are sensitive to breakage, known as fragile sites, may result from exposure to genotoxic agents.
- Understanding these mechanisms is crucial for identifying potential markers that drive cancer progression and developing new therapeutic strategies to prevent diseases caused by pathogens2 3.
In summary, genotoxic carcinogens play a pivotal role in cancer development by damaging DNA and initiating abnormal cell growth. Researchers continue to explore these mechanisms to improve cancer prevention and treatment strategies.
Distinguish between direct and indirect acting carcinogens and understand that genotoxic carcinogens are typically electrophiles
Certainly! Let’s explore the differences between direct-acting and indirect-acting carcinogens, as well as the role of genotoxic carcinogens as electrophiles:
- Direct-Acting Carcinogens:
- Direct-acting carcinogens are substances that can directly interact with cellular components, including DNA, without requiring metabolic activation.
- They are typically electrophilic and can form covalent bonds with cellular macromolecules.
- Examples include certain alkylating agents (such as mustard gas) and some aromatic amines.
- These carcinogens directly cause DNA damage, leading to mutations and potentially cancer development.
- Indirect-Acting Carcinogens:
- Indirect-acting carcinogens are compounds that require metabolic activation within the body to become carcinogenic.
- They are usually not electrophilic in their native form.
- Metabolic enzymes (such as cytochrome P450) convert these compounds into reactive intermediates.
- These intermediates can then react with DNA, proteins, or other cellular components, causing damage.
- Examples include polycyclic aromatic hydrocarbons (PAHs) found in tobacco smoke and some heterocyclic amines formed during cooking of meat at high temperatures.
- Genotoxic Carcinogens as
Electrophiles:
- Genotoxic carcinogens are typically electrophiles, meaning they have an affinity for electron-rich sites in cellular molecules.
- They react with nucleophilic sites in DNA, leading to the formation of DNA adducts.
- These adducts can disrupt normal DNA replication and repair processes, ultimately contributing to cancer development.
- Electrophilic genotoxic agents include alkylating agents, aromatic amines, and certain reactive oxygen species.
In summary, direct-acting carcinogens directly interact with cellular components, while indirect-acting carcinogens require metabolic activation. Genotoxic carcinogens, often electrophiles, play a critical role in initiating DNA damage and promoting cancer progression. Understanding these distinctions helps in cancer prevention and risk assessment.
basic understanding of the stages of carcinogenesis
Certainly! Let’s explore the stages of carcinogenesis, which describe the process by which normal cells transform into cancerous cells:
- Initiation:
- Initiation is the first step in carcinogenesis.
- It involves exposure to a carcinogenic agent (such as genotoxic chemicals, radiation, or viruses) that causes DNA damage in a cell.
- The damaged DNA leads to the formation of an initiated cell with altered genetic material.
- These initiated cells have the potential to become cancerous.
- Promotion:
- After initiation, promotion occurs.
- Promoters stimulate the growth and replication of initiated cells.
- These promoters do not cause DNA damage directly but enhance the survival and proliferation of the altered cells.
- Factors like hormones, inflammation, and growth factors play a role in promotion.
- Progression:
- During progression, initiated cells accumulate additional genetic alterations.
- These alterations lead to the development of a premalignant lesion or dysplasia.
- Dysplastic cells exhibit abnormal growth patterns and may invade nearby tissues.
- Further genetic changes can transform dysplastic cells into malignant tumors.
- Malignant Transformation:
- Malignant transformation involves the conversion of premalignant cells into cancerous cells.
- These cells acquire the ability to invade surrounding tissues and spread to distant sites (metastasis).
- The tumor becomes clinically detectable and poses a threat to health.
- Metastasis:
- Metastasis is the final stage.
- Cancer cells detach from the primary tumor, enter the bloodstream or lymphatic system, and establish secondary tumors in distant organs.
- Metastatic spread significantly worsens the prognosis.
In summary, carcinogenesis is a complex process involving initiation, promotion, progression, malignant transformation, and metastasis. Understanding these stages helps in cancer prevention, early detection, and targeted therapies.
Routes of administration
oral, IV, inhalation
Common types of target molecules for toxic chemicals
Nucleic acids (DNA)
proteins
membranes
Different types of disrepair
tissue necrosis: tissue cell death, injury overwhelms/ disables repair mechanisms
Fibrosis: extracellular matrix deposition with abnormal composition
Carcinogenesis: failure to repair DNA, Failure to apoptosis failure to terminate cell proliferation
How ionization affects crossing cell membrane
un-ionized form of a drug is usually lipid soluble and can readily cross the cell membrane
ionized = low lipid solubility and cant cross the cell membrane
when pH is = to pKa then un-ionized drug = 50:50 or in other words pKa is the pH where drug is 50% ionized and passes membranes
Genotoxic
carcinogens that interact with DNA resulting in mutation
indirect = require biotransformation; not directly binding to DNA
direct = directly interacting with DNA causing direct damage
non-genotoxic
carcinogens that modify gene expression but don't damage DNA
Stages of carcinogens
1) Initiation: Damage DNA then initiate cell (= potential cancer)
2) promotion: stimulate growth, no DNA damage in this step
3) progression: initiated cells accumulate additional genetic alterations
interesting history fact
Catherin de Medici (1519-1589): tested toxic concentrations on subjects, took note of how rapid they were intoxicated, their degree of response, the effectiveness of the toxin, ect.
Quantal dose curves
all or none. An individual in a population of organisms is classified as either a responder or a non-responder. Shows % of responders at different dosages. CAan show ED50
Individual dose curves
focused on graded response of an individual to varying dosages of a drug. Continues relationships. Represent effect of different doses on individual, measured on a grade scale such as blood pressure, pain relief, enzyme activity. X axis = dose y axis = graded response
How ethanol consumption can lead to liver steatosis
Primary pathway for ethanol breakdown is through ADH (alcohol dehydrogenase) ADH oxidizes NADH to NAD+ while reducing acetaldehyde to ethanol. NADH leads to steatosis by signaling a down regulation of fatty acid breakdown and up regulating fatty acid synthesis.
The route of blood flow through the glomerulus and describe the effect of NSAIDS and ACE-inhibitors on that flow
The blood flow through the glomerulus first goes through afferent arteriole then will get filtered and goes out the efferent arteriole. NSAIDs will cause constriction of afferent arteriole causing increased blood pressure in the glomerulus (stops production of prostaglandins). ACE inhibitors block conversion of angiotensin 1 to angiotensin 2 which inhibits efferent arteriolar vasoconstriction. If taken together no blood flow to the glomerulus will occur going either in or out causes kidneys to die.
How the route of exposure impacts bioavailability (IV and oral)
Route of exposure impacts bioavailability due to the process it has to go through specially the filtration process. When it is ingested orally it must go through the intestinal tract that absorbs and filters before putting things into the blood stream. This bioavailability is much less in comparison to IV because when administered intravenously it goes directly into the blood without a filtering process first which could take some of the medication or toxin out first so essentially the bioavailability in IV is 100% and the oral way of consumption's bioavailability would be less then 100%
Fun fact about batrachotoxin
found in birds, frogs, beetles
binds irreversible to the sodium channels in the body leaving them open
no known antidote at this time
indigenous people have used frogs with poison on darts to hunt
it was discovered in 1963
Takashi T. solved the steroidal structure using x-ray diffraction