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-:PRESENTED BY:-
           Sujit R. Patel
    Department of Pharmaceutics,
Maratha Mandal’s College Of Pharmacy,
             Belgaum.                   #
CONTENTS

Introduction

Linear & Nonlinearity Pharmacokinetics

Detection of non-linearity in pharmacokinetics

Causes of nonlinearity

Michaelis – Menten equation

Estimation of Km and Vmax

Estimation of Km and Vmax at steady-state concentration
                                                           #
LINEAR PHARMACOKINETICS

» At therapeutic doses, the change in the amount of drug in
the body or the change in its plasma concentration due to
absorption, distribution, binding, metabolism or excretion, is
proportional to its dose, whether administered as a single dose
or as multiple doses.

» In such situation the rate processes are said to follw first
order or linear kinetics and all semilog plots of C Vs t for
different doses when collected for dose administered, are
superimposable.


                                                              #
» The important pharmacokinetic parameters viz. F, Ka, KE, Vd, ClR,
  ClH which describes the time course of a drug in the body
  remain unaffected by the dose.

» Pharmacokinetics is dose independent.




                                                             #
NONLINEAR PHARMACOKINETICS

 » The rate process of drug’s ADME are depend upon carrier
or enzymes that are substrate specific, have definite
capacities and are susceptible to saturation at a high drug
concentration.

 » In such cases, an essentially first-order kinetics transform
into a mixture of first-order and zero-order rate processes and
the pharmacokinetic parameters are changed with the size of
the administered dose.

 » Pharmacokinetics of such drugs are said to be dose-
dependent. Terms synonymous with it are mixed-order,
nonlinear and capacity-limited kinetics.
                                                            #
DETECTION OF NON-LINEARITY IN
         PHARMACOKINETICS
•    There are several tests to detect non –linearity in
     pharmacokinetics but the simplest ones are:

1) First test:- Determination of steady state plasma
   concentration at different doses.

2) Second test:- Determination of some important
   pharmacokinetic parameters such as fraction
   bioavailability, elimination half life or total systemic
   clearance at different doses of drug. Any change in these
   parameters is indicative to non-linearity which are
   usually constant.
                                                           #
CAUSES OF NON-LINEARITY
                       Drug absorption
• Three causes:- I) Solubility / dissolution of drug is rate-limited;
                    Griseofulvin - at high concentration in intestine.

                  II) Carrier - mediated transport system; Ascorbic
                      acid - saturation of transport system.

                 III) Presystemic gut wall / hepatic metabolism
                      attains saturation; Propranolol.

• These parameters affected F, Ka, Cmax and AUC.

• A decrease in these parameters is observed in former two causes
  and an increase in latter cause.
                                                               #
Drug distribution
  At high doses non-linearity due to
• Two causes:- I) Binding sites on plasma proteins get
                  saturated; Phenylbutazone.

                 II) Tissue binding sites get saturated.

• In both cases there is increase in plasma drug
  concentration.

• Increase in Vd only in (I)

• Clearance with high ER get increased due to saturation of
  binding sites.                                              #
Drug metabolism
• Non-linearity occurs due to capacity limited metabolism, small
  changes in dose administration - large variations in plasma
  concentration at steady state - large intersubject variability.

• Two imp causes:- I) Capacity - limited metabolism - enzyme &/
                      cofactor saturation; Phenytoin, Alcohol.

                      II) Enzyme induction - decrease in plasma
                          concentration; Carbamazepine.

•   Autoinduction in dose dependent concentration.
•   Saturation of enzymes - decrease in ClH - increase in Css.
•   In case of enzyme induction reverse condition.
•   Other reasons includes saturation of binding sites, inhibitory
                                                                     #
    effects of the metabolites on the action of enzymes.
Drug excretion
• Two active processes which are saturable,
          I) Active tubular secretion - Penicillin G
         II) Active tubular reabsorption - Water soluble
             vitamins & Glucose.

• Saturation of carrier systems - decrease in renal clearance in
  case of I & increase in II. Half life also increases.
• Other reasons like forced diuresis, change in urine pH,
  nephrotoxicity & saturation of binding sites.
• In case of biliary excretion non - linearity due to saturation -
  Tetracycline & Indomethacin.


                                                                     #
Examples of drugs showing nonlinear pharmacokinetics
               Causes                             Drugs
GI absorption:-
Saturable transport in gut wall    Riboflavin, Gabapentin
Saturable GI decomposition         Penicillin G, Omeprazole
Intestinal metabolism              Propranolol, Salicylamide
Distribution:-
Saturable plasma protein binding   Phenylbutazone, Lidocaine
Tissue binding                     Imipramine
Metabolism:-
Saturable metabolism               Phenytion, Salicylic acid
Enzyme induction                   Carbamazepine
Metabolite inhibition              Diazepam
Renal elimination:-
Active secretion                   Para- aminohippuric acid
Tubular reabsorption               Ascorbic acid, Riboflavin
Change in urine pH                 Salicylic acid, Dextroamphetamine
                                                                  #
MICHAELIS MENTEN ENZYME
           KINETICS

   It is also called as Capacity-limited metabolism or Mixed
    order kinetics.

    E+D           ED        E + M

   Enzymes usually react with the substrate to form enzyme
    substrate complexes; then the product is formed. The
    enzyme can go back to react with another substrate to
    form another molecule of the product.



                                                            #
MICHAELIS MENTEN EQUATION
•    The kinetics of capacity limited or saturable processes is best described by
     Michaelis-Menten equation.


                          dC       Vmax . C     ……………….. I
                               =
                          dt        KM+ C
                           Where ,
                                -dC/dt = rate of decline of drug conc. with time
                                   Vmax = theoretical maximum rate of the
                                            process
                                    KM = Michaelis constant

•    Three situation can now be considered depending upon the value of K m and
     C.

1)   when KM = C:
•    under this situation , eq I reduces to,
•    -dC/dt = Vmax/2 ...................II
•                                                                                   #
     The rate of process is equal to half of its maximum rate.
2)   If a drug at low conc. undergoes a saturable biotransformation
     then KM>>C:

•    here , KM +C =KM and eq. I reduces to,

      -dC/dt =Vmax C /KM………………III

•    above eq. is identical to the one that describe first order elimination of
     drug, where Vmax/KM= KE.

3)   When KM<<C:
•    Under this condition ,KM +C= C and eq. I will become,
     -dC/dt =Vmax …………….IV

     above eq. is identical to the one that describe a zero order process i.e.
     the rate process occurs at constant rate V max and is independent of
     drug conc.
     E.g. metabolism of ethanol                                                #
Zero order rate at high doses
          Mixed order rate at
          intermediated doses
Dc         First order rate at low doses

dt
                C


     Figure 1
     A plot of MME

                                           #
ESTIMATION OF Vmax & Km

In enzymatic kinetic work, the classic Michaelis-Menten
equation:
   V = Vmax . C        ………..(1)
         KM + C
                where, V= reaction rate,
                       C= substrate conc. both are
                           used to determine Vmax
                           & Km.
The velocity of the reaction(V) at various concentration levels of
drug(C) are determined either by in-vitro experiments or in-vivo
experiments at constant enzyme levels.

                                                              #
Method 1
By reciprocating equation (1), we get :
           1 Km . 1           1    ……..(2)
              =           +
           V Vmax . C Vmax

When 1/V is plotted against 1/C, a straight line is
obtained with a slope of Km/Vmax and an Intercept of
1/Vmax.
E.g. : A plot of 1/ V vs 1/ C (shown in the fig. 2)
gave an intercept of 0.33µmol and a slope of 1.65, Now,
calculate Vmax and KM.

                                                    #
Km/Vmax




                   1/ Vmax

   -1/ Km




                         Figure 2
            Plot of 1/V vs 1/C for determining Km & Vmax

Now, Intercept= 1/ Vmax = 0.33 µ mol.
   Vmax = 3 µ mol/ml min
   Slope = Km/ Vmax So, 1.65 = Km/ Vmax
   Km = 1.65 Х 3 = 4.95µmol/ ml
                                                           #
   X-axis intercept= -1/ Km
Method 2

 Multiplying eq. 2 by C, we get :

 C        Km                C
      =              +                    ………..... (3)
V         Vmax            Vmax


A plot of C /V vs C gives a straight line with 1 / Vmax as the slope and
Km / Vmax as the intercept (shown in the fig. 3).




                                                                           #
ax




            ax




             Figure 3.
Plot of C/V vs C for determining Km & Vmax
                                             #
Method 3

The equation can also be written
as :

 V = - Km V + Vmax                           …………(4)
          C
A plot of V vs V / C gives a straight line with a slope of –Km & an Intercept
of Vmax. (shown in the fig. 4)




                                                                        #
Figure 4
Plot of V vs V / C for determining Km & Vmax
                                               #
CALCULATION OF KM & VMAX
   STEADY- STATE CONCENTRATION
• If drug is administered for constant rate IV infusion/ in a multiple
  dosage regimen, the steady-state conc. is given in terms of
  dosing rate (DR):
          DR = Css ClT       ……………….. (1)

• If the steady-state is reached, then the dosing rate = the rate of
  decline in plasma drug conc. & if the decline occurs due to a
  single capacity-limited process then eq. I become as:
                  Vmax Css
         DR   =                 ……………….. (2)
                   KM+ Css



• From a plot of Css vs. DR, a typical curve having a shape of
  hocky-stick is obtained which is shown in fig. 5.
                                                                  #
Curve for a drug following nonlinear kinetics
By plotting the steady-state concentration against dosing rates




            Css
                   Km

                                Vmax / 2        Vmax

                     DR (in mg/hr or mg/day )


                         Figure 5
                                                              #
METHODS USED TO
DETERMINE THE
    KM & VMAX AT
   STEADY-STATE


                   #
•    There are three methods which are used to define the KM
     & Vmax at steady-state with appreciable accuracy:
1)   Lineweaver-Burk Plot:- the reciprocal of eq. (2) we get
       1          KM             1
              =              +              ……………….. (3)
       DR         Vmax Css       Vmax

•    If 1/DR is plotted against 1/Css a straight line is obtained
     having slope KM/Vmax & y-intercept 1/Vmax.


2)   Direct linear plot:-
•    Plotting a pair of Css, i.e.Css1,&Css2 against corresponding
     dosing rates DR1 & DR2 we get following fig. 6 which
     gives values KM &Vmax
                                                                    #
Direct linear plot for estimation of KM & Vmax
  at steady-state conc. Of a drug, when it is
    administered at different dosing rates


                  DR
                                    Vmax



                          DR1


                                    DR2



    Css 1         Css 2                         KM


            Css                 0          KM
                                                     #
                           Figure 6
3)   Graphical method:-




DR




             DR/Css




                      Figure 7
      Plot of DR vs DR/Css for determining Km & Vmax
                                                       #
3)   Graphical method:-
•    In this method by rearranging eq. (2) we get
                     KM DR       ……………….. (4)
      DR = Vmax -
                       Css

•    In graph DR is plotted against DR/Css, a straight line is
     obtained with slope –KM & y - intercept Vmax.
•    KM & Vmax can be estimated by simultaneous eq. as

       DR1   =   Vmax - KMDR1          …………….…...(5)
                         Css1
                        KM DR2          ……………….. (6)
       DR2   =   Vmax -
                         Css2
                                                                 #
• On solving above eq. 5 & 6 we get,

              DR2- DR1
     KM =                      ……………….. (7)
              DR1 DR2
                    -
              Css 1   Css 2



• By substituting values of DR1, DR2, Css1 & Css2 we get value of
  KM & from KM we can found value of Vmax at steady-state
  concentration.
• From experimental observations, it shows that KM is much
  less variable than Vmax.
                                                               #
QUESTIONS

1. Explain the non-linear pharmacokinetics of a drug given through
   I.V. bolus injection. (‘07)

2. Write Michaelis-Menten equation. How is Vmax and KM estimated.
   (Sep’05)

3. Discuss Michaelis-Menten equation. (‘06)




                                                            #
REFERENCE

1. Biopharmaceutics and Pharmacokinetics a treatise by
   Brahmankar DM, Jaiswal SB.

2. http://google.co.in

3. Biopharmaceutics & pharmacokinetics by Dr. Shobha Rani
   R. Hiremath.




                                                         #
#

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Non linear kinetics

  • 1. -:PRESENTED BY:- Sujit R. Patel Department of Pharmaceutics, Maratha Mandal’s College Of Pharmacy, Belgaum. #
  • 2. CONTENTS Introduction Linear & Nonlinearity Pharmacokinetics Detection of non-linearity in pharmacokinetics Causes of nonlinearity Michaelis – Menten equation Estimation of Km and Vmax Estimation of Km and Vmax at steady-state concentration #
  • 3. LINEAR PHARMACOKINETICS » At therapeutic doses, the change in the amount of drug in the body or the change in its plasma concentration due to absorption, distribution, binding, metabolism or excretion, is proportional to its dose, whether administered as a single dose or as multiple doses. » In such situation the rate processes are said to follw first order or linear kinetics and all semilog plots of C Vs t for different doses when collected for dose administered, are superimposable. #
  • 4. » The important pharmacokinetic parameters viz. F, Ka, KE, Vd, ClR, ClH which describes the time course of a drug in the body remain unaffected by the dose. » Pharmacokinetics is dose independent. #
  • 5. NONLINEAR PHARMACOKINETICS » The rate process of drug’s ADME are depend upon carrier or enzymes that are substrate specific, have definite capacities and are susceptible to saturation at a high drug concentration. » In such cases, an essentially first-order kinetics transform into a mixture of first-order and zero-order rate processes and the pharmacokinetic parameters are changed with the size of the administered dose. » Pharmacokinetics of such drugs are said to be dose- dependent. Terms synonymous with it are mixed-order, nonlinear and capacity-limited kinetics. #
  • 6. DETECTION OF NON-LINEARITY IN PHARMACOKINETICS • There are several tests to detect non –linearity in pharmacokinetics but the simplest ones are: 1) First test:- Determination of steady state plasma concentration at different doses. 2) Second test:- Determination of some important pharmacokinetic parameters such as fraction bioavailability, elimination half life or total systemic clearance at different doses of drug. Any change in these parameters is indicative to non-linearity which are usually constant. #
  • 7. CAUSES OF NON-LINEARITY Drug absorption • Three causes:- I) Solubility / dissolution of drug is rate-limited; Griseofulvin - at high concentration in intestine. II) Carrier - mediated transport system; Ascorbic acid - saturation of transport system. III) Presystemic gut wall / hepatic metabolism attains saturation; Propranolol. • These parameters affected F, Ka, Cmax and AUC. • A decrease in these parameters is observed in former two causes and an increase in latter cause. #
  • 8. Drug distribution At high doses non-linearity due to • Two causes:- I) Binding sites on plasma proteins get saturated; Phenylbutazone. II) Tissue binding sites get saturated. • In both cases there is increase in plasma drug concentration. • Increase in Vd only in (I) • Clearance with high ER get increased due to saturation of binding sites. #
  • 9. Drug metabolism • Non-linearity occurs due to capacity limited metabolism, small changes in dose administration - large variations in plasma concentration at steady state - large intersubject variability. • Two imp causes:- I) Capacity - limited metabolism - enzyme &/ cofactor saturation; Phenytoin, Alcohol. II) Enzyme induction - decrease in plasma concentration; Carbamazepine. • Autoinduction in dose dependent concentration. • Saturation of enzymes - decrease in ClH - increase in Css. • In case of enzyme induction reverse condition. • Other reasons includes saturation of binding sites, inhibitory # effects of the metabolites on the action of enzymes.
  • 10. Drug excretion • Two active processes which are saturable, I) Active tubular secretion - Penicillin G II) Active tubular reabsorption - Water soluble vitamins & Glucose. • Saturation of carrier systems - decrease in renal clearance in case of I & increase in II. Half life also increases. • Other reasons like forced diuresis, change in urine pH, nephrotoxicity & saturation of binding sites. • In case of biliary excretion non - linearity due to saturation - Tetracycline & Indomethacin. #
  • 11. Examples of drugs showing nonlinear pharmacokinetics Causes Drugs GI absorption:- Saturable transport in gut wall Riboflavin, Gabapentin Saturable GI decomposition Penicillin G, Omeprazole Intestinal metabolism Propranolol, Salicylamide Distribution:- Saturable plasma protein binding Phenylbutazone, Lidocaine Tissue binding Imipramine Metabolism:- Saturable metabolism Phenytion, Salicylic acid Enzyme induction Carbamazepine Metabolite inhibition Diazepam Renal elimination:- Active secretion Para- aminohippuric acid Tubular reabsorption Ascorbic acid, Riboflavin Change in urine pH Salicylic acid, Dextroamphetamine #
  • 12. MICHAELIS MENTEN ENZYME KINETICS  It is also called as Capacity-limited metabolism or Mixed order kinetics. E+D ED E + M  Enzymes usually react with the substrate to form enzyme substrate complexes; then the product is formed. The enzyme can go back to react with another substrate to form another molecule of the product. #
  • 13. MICHAELIS MENTEN EQUATION • The kinetics of capacity limited or saturable processes is best described by Michaelis-Menten equation. dC Vmax . C ……………….. I = dt KM+ C Where , -dC/dt = rate of decline of drug conc. with time Vmax = theoretical maximum rate of the process KM = Michaelis constant • Three situation can now be considered depending upon the value of K m and C. 1) when KM = C: • under this situation , eq I reduces to, • -dC/dt = Vmax/2 ...................II • # The rate of process is equal to half of its maximum rate.
  • 14. 2) If a drug at low conc. undergoes a saturable biotransformation then KM>>C: • here , KM +C =KM and eq. I reduces to, -dC/dt =Vmax C /KM………………III • above eq. is identical to the one that describe first order elimination of drug, where Vmax/KM= KE. 3) When KM<<C: • Under this condition ,KM +C= C and eq. I will become, -dC/dt =Vmax …………….IV above eq. is identical to the one that describe a zero order process i.e. the rate process occurs at constant rate V max and is independent of drug conc. E.g. metabolism of ethanol #
  • 15. Zero order rate at high doses Mixed order rate at intermediated doses Dc First order rate at low doses dt C Figure 1 A plot of MME #
  • 16. ESTIMATION OF Vmax & Km In enzymatic kinetic work, the classic Michaelis-Menten equation: V = Vmax . C ………..(1) KM + C where, V= reaction rate, C= substrate conc. both are used to determine Vmax & Km. The velocity of the reaction(V) at various concentration levels of drug(C) are determined either by in-vitro experiments or in-vivo experiments at constant enzyme levels. #
  • 17. Method 1 By reciprocating equation (1), we get : 1 Km . 1 1 ……..(2) = + V Vmax . C Vmax When 1/V is plotted against 1/C, a straight line is obtained with a slope of Km/Vmax and an Intercept of 1/Vmax. E.g. : A plot of 1/ V vs 1/ C (shown in the fig. 2) gave an intercept of 0.33µmol and a slope of 1.65, Now, calculate Vmax and KM. #
  • 18. Km/Vmax 1/ Vmax -1/ Km Figure 2 Plot of 1/V vs 1/C for determining Km & Vmax Now, Intercept= 1/ Vmax = 0.33 µ mol. Vmax = 3 µ mol/ml min Slope = Km/ Vmax So, 1.65 = Km/ Vmax Km = 1.65 Х 3 = 4.95µmol/ ml # X-axis intercept= -1/ Km
  • 19. Method 2 Multiplying eq. 2 by C, we get : C Km C = + ………..... (3) V Vmax Vmax A plot of C /V vs C gives a straight line with 1 / Vmax as the slope and Km / Vmax as the intercept (shown in the fig. 3). #
  • 20. ax ax Figure 3. Plot of C/V vs C for determining Km & Vmax #
  • 21. Method 3 The equation can also be written as : V = - Km V + Vmax …………(4) C A plot of V vs V / C gives a straight line with a slope of –Km & an Intercept of Vmax. (shown in the fig. 4) #
  • 22. Figure 4 Plot of V vs V / C for determining Km & Vmax #
  • 23. CALCULATION OF KM & VMAX STEADY- STATE CONCENTRATION • If drug is administered for constant rate IV infusion/ in a multiple dosage regimen, the steady-state conc. is given in terms of dosing rate (DR): DR = Css ClT ……………….. (1) • If the steady-state is reached, then the dosing rate = the rate of decline in plasma drug conc. & if the decline occurs due to a single capacity-limited process then eq. I become as: Vmax Css DR = ……………….. (2) KM+ Css • From a plot of Css vs. DR, a typical curve having a shape of hocky-stick is obtained which is shown in fig. 5. #
  • 24. Curve for a drug following nonlinear kinetics By plotting the steady-state concentration against dosing rates Css Km Vmax / 2 Vmax DR (in mg/hr or mg/day ) Figure 5 #
  • 25. METHODS USED TO DETERMINE THE KM & VMAX AT STEADY-STATE #
  • 26. There are three methods which are used to define the KM & Vmax at steady-state with appreciable accuracy: 1) Lineweaver-Burk Plot:- the reciprocal of eq. (2) we get 1 KM 1 = + ……………….. (3) DR Vmax Css Vmax • If 1/DR is plotted against 1/Css a straight line is obtained having slope KM/Vmax & y-intercept 1/Vmax. 2) Direct linear plot:- • Plotting a pair of Css, i.e.Css1,&Css2 against corresponding dosing rates DR1 & DR2 we get following fig. 6 which gives values KM &Vmax #
  • 27. Direct linear plot for estimation of KM & Vmax at steady-state conc. Of a drug, when it is administered at different dosing rates DR Vmax DR1 DR2 Css 1 Css 2 KM Css 0 KM # Figure 6
  • 28. 3) Graphical method:- DR DR/Css Figure 7 Plot of DR vs DR/Css for determining Km & Vmax #
  • 29. 3) Graphical method:- • In this method by rearranging eq. (2) we get KM DR ……………….. (4) DR = Vmax - Css • In graph DR is plotted against DR/Css, a straight line is obtained with slope –KM & y - intercept Vmax. • KM & Vmax can be estimated by simultaneous eq. as DR1 = Vmax - KMDR1 …………….…...(5) Css1 KM DR2 ……………….. (6) DR2 = Vmax - Css2 #
  • 30. • On solving above eq. 5 & 6 we get, DR2- DR1 KM = ……………….. (7) DR1 DR2 - Css 1 Css 2 • By substituting values of DR1, DR2, Css1 & Css2 we get value of KM & from KM we can found value of Vmax at steady-state concentration. • From experimental observations, it shows that KM is much less variable than Vmax. #
  • 31. QUESTIONS 1. Explain the non-linear pharmacokinetics of a drug given through I.V. bolus injection. (‘07) 2. Write Michaelis-Menten equation. How is Vmax and KM estimated. (Sep’05) 3. Discuss Michaelis-Menten equation. (‘06) #
  • 32. REFERENCE 1. Biopharmaceutics and Pharmacokinetics a treatise by Brahmankar DM, Jaiswal SB. 2. http://google.co.in 3. Biopharmaceutics & pharmacokinetics by Dr. Shobha Rani R. Hiremath. #
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Editor's Notes

  1. February 11, 2013 Dept. of Pharmaceutics