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Assignment
Course - Biopharmaceutics and Pharmacokinetics 1
Course code - PHR 304
Submitted by: Submitted to:
Md. Azamu Shahiullah Prottoy Zara Sheikh
ID – 11146018 Dept. of Pharmacy
Effect of protein-binding on apparent volume of
distribution
The extent of drug distribution into tissues depends on the degree of plasma protein and tissue binding.
Extensive plasma protein binding will cause more drugs to stay in the central blood compartment.
Therefore drugs which bind strongly to plasma protein tend to have lower volumes of distribution. Of
these plasma proteins, albumin, which comprises 50 % of the total proteins, binds the widest range of
drugs. Acidic drugs commonly bind to albumin, while basic drugs often bind to alpha1-acid
glycoprotein and lipoproteins. Many endogenous substances, steroids, vitamins, and metal ions are
bound to globulins. The higher the protein binding, lower the tissue distribution.
Proteins with Potential Binding Sites for Various Drugs
In the bloodstream, drugs are transported partly in solution as free (unbound) drug and partly
reversibly bound to blood components (e.g., plasma proteins, blood cells). Of the many plasma
proteins that can interact with drugs, the most important are albumin, α1-acid glycoprotein, and
lipoproteins. Acidic drugs are usually bound more extensively to albumin; basic drugs are usually
bound more extensively to α1-acid glycoprotein, lipoproteins, or both. Only unbound drug is available
for passive diffusion to extravascular or tissue sites where the pharmacologic effects of the drug occur.
Therefore, the unbound drug concentration in systemic circulation typically determines drug
concentration at the active site and thus efficacy. At high drug concentrations, the amount of bound
drug approaches an upper limit determined by the number of available binding sites. Saturation of
binding sites is the basis of displacement interactions among drugs (see Drug–Receptor Interactions).
Drugs bind to many substances other than proteins. Binding usually occurs when a drug associates
with a macromolecule in an aqueous environment but may occur when a drug is partitioned into body
fat. Because fat is poorly perfused, equilibration time is long, especially if the drug is highly lipophilic.
Accumulation of drugs in tissues or body compartments can prolong drug action because the tissues
release the accumulated drug as plasma drug concentration decreases. For example, thiopental is
highly lipid soluble, rapidly enters the brain after a single IV injection, and has a marked and rapid
anesthetic effect; the effect ends within a few minutes as the drug is redistributed to more slowly
perfuse fatty tissues. Thiopental is then slowly released from fat storage, maintaining subanesthetic
plasma levels. These levels may become significant if doses of thiopental are repeated, causing large
amounts to be stored in fat. Thus, storage in fat initially shortens the drug's effect but then prolongs it.
Some drugs accumulate within cells because they bind with proteins, phospholipids, or nucleic acids.
For example, chloroquine concentrations in WBCs and liver cells can be thousands of times higher
than those in plasma. Drug in cells is in equilibrium with drug in plasma and moves into plasma as the
drug is eliminated from the body.
Increases half-life of the drug
The drug/protein complex does not permeate phospholipid bilayers, including capillary membranes,
glomerular membranes in the nephrons, and the blood brain barrier. Bound drugs are also less
available to the enzymes involved in first-pass metabolism. After much of the free drug has been
cleared by the metabolic and excretory processes, the reversible drug/protein complex serves as a
depot to replenish the concentration in vivo. For these reasons, drugs with high protein binding activity
values tend to have a greater half-life compared to those with lower values. The prolonged activity
resulting from these factors may be desirable, or may promote the emergence of undesirable side
effects.
Effect of protein binding on elimination of drugs
Protein binding decreases the renal excretion of drugs and enhances the biological half-life. Only the
free drug can get excreted through filtration. For example, tetracycline is excreted mainly by filtration.
These drugs bind to proteins and results in decreased renal excretion. Interaction of tetracycline (TC)
derivatives viz. oxytetracycline, doxycycline, demeclocycline and chlorotetracycline with bovine
serum albumin (BSA) and concomitant changes in protein conformation were studied using
fluorescence quenching and circular dichroism measurements. Fluorescence data revealed the presence
of one to three binding sites on BSA for different TC derivatives. This binding study with the marker
ligands, warfarin and bilirubin, elucidated site-I as a primary binding site for TCs on albumin.
Scatchard analysis revealed the binding affinity (K(a)) and capacity (n) for these derivatives vary in
the range from 0.8 to 3.2 x 10(6) l/mole and 1.3-3.4, respectively. Significant reduction (60-45%) in
secondary structure (alpha-helical content) of BSA was noticed upon interaction with different TC
derivatives in presence of Cu (II) ions. High affinity binding of TCs with BSA signifies drug stability.
However, excessive binding at higher TC concentrations in combination with Cu (II) induces
conformational change in protein structure, which may exert detrimental effect on cellular protein.
The binding of drugs in extravascular organs decreases their concentration in blood and thereby slows
their elimination by the kidney, liver, or lungs. However, the binding of drugs to plasma proteins may
either hasten or retard the elimination of drugs, depending on the mechanism of elimination. For
example, the binding of drugs to plasma proteins lowers their unbound concentrations in blood and
thereby decreases their rate of elimination by glomerular filtration and by inefficient transport systems
in the kidney. Moreover, binding to plasma proteins would decrease the rate of elimination of lipid-
soluble drugs that diffuse rapidly from the glomerular filtrate back into blood, even though they are
rapidly transported by active transport systems. In addition, the binding of drugs to plasma proteins
would also decrease the rate of drug metabolism by relatively inactive enzyme systems in liver,
especially when the K,, of the enzyme is high. However, when drugs are metabolized rapidly by liver
enzymes and polar drugs are rapidly eliminated by transport systems in the kidney; their clearance by
an organ may approach the blood flow rate through the organ. Under these conditions, the binding to
plasma proteins and to blood cells may enhance the rate of elimination of drugs. Thus, the efficiency
of the mechanisms by which a drug is eliminated determines whether the binding of drugs to plasma
proteins should be considered as storage depots or as transport mechanisms. To illustrate the diverse
effects of binding to plasma proteins on drug elimination, the apparent rate constants of elimination
(rate/concentration) at various concentrations of two hypothetical drugs were calculated. One of the
drugs is completely cleared from plasma as it passes through the liver, and the other is eliminated so
slowly that only 1.0% of the unbound drug is extracted as it passes through the liver. In making of
these calculations, some assumptions were taken such as- 1. The distribution phases have been
completed; 2. The unbound forms of the drugs distribute with body water (50 liters); 3. The kinetic
volumes of distribution are the same as the equilibrium volumes of distribution, that is, the rate
constants for the transfer of drugs from the body compartment to the blood are large compared with
the apparent rate constants of elimination; the blood flow rate through the liver is 1.6 litedmin. When
the total concentrations of the drugs in plasma are infinitely greater than the concentrations of the
bound forms, the apparent volume of distribution of both drugs would be 50 liters, and thus the rate
constant of elimination for the rapidly eliminated drug would be 100 times that for the slowly
eliminated drug. However, as the plasma levels of the drugs decrease, the ratio of the total amounts of
the drugs in the body to their total concentrations in the plasma decreases, whereas the ratio of the total
amounts of the drugs in the body to their unbound concentrations in the plasma increases. Because the
apparent rate constant of elimination equals clearance/v, the apparent rate constant for the rapidly
eliminated drug increases as the plasma level of the drug declines, whereas the rate constant for the
slowly eliminated drug decreases.
Effect of protein binding on patients with kidney
diseases
Albumin is primarily responsible for the binding of acidic drugs whereas basic drugs appear to bind
preferentially to AAG. The low concentration of albumin and AAG in patients with liver disease
indicates the inability of the liver to synthesize these drug-binding proteins. Impaired binding of acidic
and basic drugs is well documented in patients with liver disease. The albumin concentrations in the
transplant patients were low despite stable biochemical liver tests. Because albumin is primarily
responsible for binding of acidic drugs, liver transplant patients would not be able to bind acidic drugs
as efficiently as the normal subjects. However, the AAG concentrations were elevated in all the
transplant patients studied. AAG is an acute-phase reactant and is primarily synthesized in the liver.
AAG concentrations are known to increase in plasma.
Effect of protein binding on patients with hepatic
disease
Protein binding affects distribution. The impaired liver is unable to synthesize plasma proteins
(albumin) adequately. Liver impairment causes accumulation of substances (bilirubin) that displace
drugs from protein-binding sites. A statistics on this case shows that liver disease patients with normal
conc. Of albumin and bilirubin have unbound percentages of frusemide similar to those in healthy
subjects. Defective binding of frusemide is linked to hypoalbuminaemia or hyperbilirubinaemia.
Albumin is an important determinant of the plasma protein binding of frusemide when bilirubin is
normal. Bilirubin binds to albumin strongly and thus reduces the binding reserve of albumin. A
correlation was found between the unbound percentage of frusemide and bilirubin concentration.
Patients with liver disease may have normal degree of frusemide if albumin concentrations are normal.
A bilirubin concentration less than 40mg/l has no effect on the binding of frusemide.
Reference
• Applied_biopharmaceutics and pharmacokinetics 5th
edition 2004 by
Leon_sh_argel_susanna_wu-pong_andrew
• http://ffarmasi.unand.ac.id/media/download/doc/256/raw
• http://www.merckmanuals.com/professional/clinical_pharmacology/pharmacokinetics/drug_di
stribution_to_tissues.html
• https://answers.yahoo.com/question/index?qid=20090812084237AAKzgN5
• http://www.ncbi.nlm.nih.gov/pubmed/12297231
• http://voices.yahoo.com/how-drug-distributed-metabolized-body-2488762.html
• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379901/?page=3
• http://www.slideshare.net/Mohammad-Hadi-Farjoo/drugs-pharmacology-in-liverdisease#
• http://onlinelibrary.wiley.com/store/10.1111/j.1749-6632.1973.tb20464.x/asset/j.1749-
6632.1973.tb20464.x.pdf?
v=1&t=hv1v2699&s=6c018643337aaeb6a34db064a0efb3612061d7b4
• http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/
ucm072123.pdf
• http://d-scholarship.pitt.edu/4205/1/31735062129709.pdf
• http://cid.oxfordjournals.org/content/40/1/174.full

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Effects of Protein Binding

  • 1. Assignment Course - Biopharmaceutics and Pharmacokinetics 1 Course code - PHR 304 Submitted by: Submitted to: Md. Azamu Shahiullah Prottoy Zara Sheikh ID – 11146018 Dept. of Pharmacy
  • 2. Effect of protein-binding on apparent volume of distribution The extent of drug distribution into tissues depends on the degree of plasma protein and tissue binding. Extensive plasma protein binding will cause more drugs to stay in the central blood compartment. Therefore drugs which bind strongly to plasma protein tend to have lower volumes of distribution. Of these plasma proteins, albumin, which comprises 50 % of the total proteins, binds the widest range of drugs. Acidic drugs commonly bind to albumin, while basic drugs often bind to alpha1-acid glycoprotein and lipoproteins. Many endogenous substances, steroids, vitamins, and metal ions are bound to globulins. The higher the protein binding, lower the tissue distribution. Proteins with Potential Binding Sites for Various Drugs In the bloodstream, drugs are transported partly in solution as free (unbound) drug and partly reversibly bound to blood components (e.g., plasma proteins, blood cells). Of the many plasma proteins that can interact with drugs, the most important are albumin, α1-acid glycoprotein, and lipoproteins. Acidic drugs are usually bound more extensively to albumin; basic drugs are usually bound more extensively to α1-acid glycoprotein, lipoproteins, or both. Only unbound drug is available
  • 3. for passive diffusion to extravascular or tissue sites where the pharmacologic effects of the drug occur. Therefore, the unbound drug concentration in systemic circulation typically determines drug concentration at the active site and thus efficacy. At high drug concentrations, the amount of bound drug approaches an upper limit determined by the number of available binding sites. Saturation of binding sites is the basis of displacement interactions among drugs (see Drug–Receptor Interactions). Drugs bind to many substances other than proteins. Binding usually occurs when a drug associates with a macromolecule in an aqueous environment but may occur when a drug is partitioned into body fat. Because fat is poorly perfused, equilibration time is long, especially if the drug is highly lipophilic. Accumulation of drugs in tissues or body compartments can prolong drug action because the tissues release the accumulated drug as plasma drug concentration decreases. For example, thiopental is highly lipid soluble, rapidly enters the brain after a single IV injection, and has a marked and rapid anesthetic effect; the effect ends within a few minutes as the drug is redistributed to more slowly perfuse fatty tissues. Thiopental is then slowly released from fat storage, maintaining subanesthetic plasma levels. These levels may become significant if doses of thiopental are repeated, causing large amounts to be stored in fat. Thus, storage in fat initially shortens the drug's effect but then prolongs it. Some drugs accumulate within cells because they bind with proteins, phospholipids, or nucleic acids. For example, chloroquine concentrations in WBCs and liver cells can be thousands of times higher than those in plasma. Drug in cells is in equilibrium with drug in plasma and moves into plasma as the drug is eliminated from the body. Increases half-life of the drug The drug/protein complex does not permeate phospholipid bilayers, including capillary membranes, glomerular membranes in the nephrons, and the blood brain barrier. Bound drugs are also less available to the enzymes involved in first-pass metabolism. After much of the free drug has been cleared by the metabolic and excretory processes, the reversible drug/protein complex serves as a depot to replenish the concentration in vivo. For these reasons, drugs with high protein binding activity values tend to have a greater half-life compared to those with lower values. The prolonged activity resulting from these factors may be desirable, or may promote the emergence of undesirable side effects.
  • 4. Effect of protein binding on elimination of drugs Protein binding decreases the renal excretion of drugs and enhances the biological half-life. Only the free drug can get excreted through filtration. For example, tetracycline is excreted mainly by filtration. These drugs bind to proteins and results in decreased renal excretion. Interaction of tetracycline (TC) derivatives viz. oxytetracycline, doxycycline, demeclocycline and chlorotetracycline with bovine serum albumin (BSA) and concomitant changes in protein conformation were studied using fluorescence quenching and circular dichroism measurements. Fluorescence data revealed the presence of one to three binding sites on BSA for different TC derivatives. This binding study with the marker ligands, warfarin and bilirubin, elucidated site-I as a primary binding site for TCs on albumin. Scatchard analysis revealed the binding affinity (K(a)) and capacity (n) for these derivatives vary in the range from 0.8 to 3.2 x 10(6) l/mole and 1.3-3.4, respectively. Significant reduction (60-45%) in secondary structure (alpha-helical content) of BSA was noticed upon interaction with different TC derivatives in presence of Cu (II) ions. High affinity binding of TCs with BSA signifies drug stability. However, excessive binding at higher TC concentrations in combination with Cu (II) induces conformational change in protein structure, which may exert detrimental effect on cellular protein. The binding of drugs in extravascular organs decreases their concentration in blood and thereby slows their elimination by the kidney, liver, or lungs. However, the binding of drugs to plasma proteins may either hasten or retard the elimination of drugs, depending on the mechanism of elimination. For example, the binding of drugs to plasma proteins lowers their unbound concentrations in blood and thereby decreases their rate of elimination by glomerular filtration and by inefficient transport systems in the kidney. Moreover, binding to plasma proteins would decrease the rate of elimination of lipid- soluble drugs that diffuse rapidly from the glomerular filtrate back into blood, even though they are rapidly transported by active transport systems. In addition, the binding of drugs to plasma proteins would also decrease the rate of drug metabolism by relatively inactive enzyme systems in liver, especially when the K,, of the enzyme is high. However, when drugs are metabolized rapidly by liver enzymes and polar drugs are rapidly eliminated by transport systems in the kidney; their clearance by an organ may approach the blood flow rate through the organ. Under these conditions, the binding to plasma proteins and to blood cells may enhance the rate of elimination of drugs. Thus, the efficiency of the mechanisms by which a drug is eliminated determines whether the binding of drugs to plasma
  • 5. proteins should be considered as storage depots or as transport mechanisms. To illustrate the diverse effects of binding to plasma proteins on drug elimination, the apparent rate constants of elimination (rate/concentration) at various concentrations of two hypothetical drugs were calculated. One of the drugs is completely cleared from plasma as it passes through the liver, and the other is eliminated so slowly that only 1.0% of the unbound drug is extracted as it passes through the liver. In making of these calculations, some assumptions were taken such as- 1. The distribution phases have been completed; 2. The unbound forms of the drugs distribute with body water (50 liters); 3. The kinetic volumes of distribution are the same as the equilibrium volumes of distribution, that is, the rate constants for the transfer of drugs from the body compartment to the blood are large compared with the apparent rate constants of elimination; the blood flow rate through the liver is 1.6 litedmin. When the total concentrations of the drugs in plasma are infinitely greater than the concentrations of the bound forms, the apparent volume of distribution of both drugs would be 50 liters, and thus the rate constant of elimination for the rapidly eliminated drug would be 100 times that for the slowly eliminated drug. However, as the plasma levels of the drugs decrease, the ratio of the total amounts of the drugs in the body to their total concentrations in the plasma decreases, whereas the ratio of the total amounts of the drugs in the body to their unbound concentrations in the plasma increases. Because the apparent rate constant of elimination equals clearance/v, the apparent rate constant for the rapidly eliminated drug increases as the plasma level of the drug declines, whereas the rate constant for the slowly eliminated drug decreases.
  • 6. Effect of protein binding on patients with kidney diseases Albumin is primarily responsible for the binding of acidic drugs whereas basic drugs appear to bind preferentially to AAG. The low concentration of albumin and AAG in patients with liver disease indicates the inability of the liver to synthesize these drug-binding proteins. Impaired binding of acidic and basic drugs is well documented in patients with liver disease. The albumin concentrations in the transplant patients were low despite stable biochemical liver tests. Because albumin is primarily responsible for binding of acidic drugs, liver transplant patients would not be able to bind acidic drugs as efficiently as the normal subjects. However, the AAG concentrations were elevated in all the transplant patients studied. AAG is an acute-phase reactant and is primarily synthesized in the liver. AAG concentrations are known to increase in plasma. Effect of protein binding on patients with hepatic disease Protein binding affects distribution. The impaired liver is unable to synthesize plasma proteins (albumin) adequately. Liver impairment causes accumulation of substances (bilirubin) that displace drugs from protein-binding sites. A statistics on this case shows that liver disease patients with normal conc. Of albumin and bilirubin have unbound percentages of frusemide similar to those in healthy subjects. Defective binding of frusemide is linked to hypoalbuminaemia or hyperbilirubinaemia. Albumin is an important determinant of the plasma protein binding of frusemide when bilirubin is normal. Bilirubin binds to albumin strongly and thus reduces the binding reserve of albumin. A correlation was found between the unbound percentage of frusemide and bilirubin concentration. Patients with liver disease may have normal degree of frusemide if albumin concentrations are normal. A bilirubin concentration less than 40mg/l has no effect on the binding of frusemide.
  • 7. Reference • Applied_biopharmaceutics and pharmacokinetics 5th edition 2004 by Leon_sh_argel_susanna_wu-pong_andrew • http://ffarmasi.unand.ac.id/media/download/doc/256/raw • http://www.merckmanuals.com/professional/clinical_pharmacology/pharmacokinetics/drug_di stribution_to_tissues.html • https://answers.yahoo.com/question/index?qid=20090812084237AAKzgN5 • http://www.ncbi.nlm.nih.gov/pubmed/12297231 • http://voices.yahoo.com/how-drug-distributed-metabolized-body-2488762.html • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379901/?page=3 • http://www.slideshare.net/Mohammad-Hadi-Farjoo/drugs-pharmacology-in-liverdisease# • http://onlinelibrary.wiley.com/store/10.1111/j.1749-6632.1973.tb20464.x/asset/j.1749- 6632.1973.tb20464.x.pdf? v=1&t=hv1v2699&s=6c018643337aaeb6a34db064a0efb3612061d7b4 • http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ ucm072123.pdf • http://d-scholarship.pitt.edu/4205/1/31735062129709.pdf • http://cid.oxfordjournals.org/content/40/1/174.full