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04 GIT anatomy and phyisiology new.pptx

Aug 07, 2018

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  • 8/20/2019 04 GIT anatomy and phyisiology new.pptx

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    BIOPHARMACEUTICS

    &PHARMACOKINETICS

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    GIT: Anatomy andPhysiology The enteral system consists of the

    alimentary canal from the mouth tothe anus.

     Th ma!o" #hysiologi$ #"o$sss thato$$%" in th GI systm a":

    ' s$"tion(' digstion

    )' a*so"#tion

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    ' S$"tion

    Secretion + in$l%ds th t"ans#o"t o,-%id.

    l$t"olyts. ##tids and #"otins intoth l%mn

    o, th alimnta"y $anal'

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    ' S$"tion

    En/yms in sali0a and #an$"ati$s$"tions a" in0ol0d in thdigstion o, $a"*ohyd"ats and

    #"otins' Oth" s$"tions s%$h as m%$%s.

    #"ot$t th linings o, th l%mn o, th

    GIT'

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    (' 1igstion

    Digestion + *"a2do3n o, ,ood$onstit%nts into

    small" st"%$t%"s in #"#a"ation ,o"

    a*so"#tion'

    Food constituents are mostly

    absorbed in the proximal area(duodenum) of the small intestine.

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    )' A*so"#tion

    Absorption + nt"y o, $onstit%nts ,"omth l%mn o, th g%t into th *ody4 may* $onsid"d as th nt "s%lt o, *oth

    l%mn5to5*lood and *lood5to5l%mnt"ans#o"t mo0mnts'

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    Im#o"tant:

    1"%gs administ"d o"ally #ass th"o%gh0a"io%s #a"ts o, th nt"al $analin$l%ding th o"al $a0ity. so#hag%s. and

    0a"io%s #a"ts o, th GIT' Rsid%s0nt%ally 6it th *ody th"o%gh than%s'

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    Im#o"tant:

     Th total t"ansit tim. in$l%ding gast"i$m#tying. small intstinal t"ansit and$oloni$ t"ansit "angs ,"om 7'8 to 9 days

    Ki"3an & Smith ;

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    Im#o"tant:

    Small intstin t"ansit tim SITT="angs ,"om 3 to 4 ho%"s ,o" mosthalthy s%*!$ts' I, a*so"#tion is not

    $om#ltd *y th tim a d"%g la0sth small intstin. a*so"#tion may *""ati$ and in$om#lt +ABSORPTION>IN1O>

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    Im#o"tant:

     Th small intstin is no"mally ?lld 3ithdigsti0 !%i$s and li@%ids. 2#ing thl%mn $ontnts -%id'

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    Im#o"tant:

    In $ont"ast. th -%id in th $olon is"a*so"*d. and th l%minal $ontntin th $olon is ith" smisolid o"

    solid. ma2ing ,%"th" d"%g dissol%tion""ati$ and di$%lt'

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    Im#o"tant:

     Th la$2 o, th sol%*ili/ing $t o,th $him and digsti0 -%id$ont"i*%ts to a lss ,a0o"a*l

    n0i"onmnt ,o" d"%g a*so"#tion'

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     Th no"mal #hysiologi$ #"o$sss o, thalimnta"y $anal may * a$td *y:

    ' dit

    (' $ontnts o, th GIT

    )' Ho"mons

    8' 0is$"al n"0o%s systm

    9' 1isas dia""ha. in-ammato"y *o3ldisas=

    ' 1"%gs anti$holin"gi$s=

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    Im#o"tant:

     Th%s d"%gs gi0n *y th nt"al "o%t,o" systmi$ a*so"#tion may *a$td *y th anatomy. #hysiologi$

    ,%n$tions and $ontnts o, thalimnta"y t"a$t'

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    Im#o"tant:

    Mo"o0". th #hysi$al. $hmi$al and

    #ha"ma$ologi$ #"o#"tis o, th d"%gitsl, 3ill also a$t its o3n a*so"#tion,"om th alimnta"y $anal'

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    Rasons 3hy GIT o"s an $inta*so"#tion systmD

    ' $o#io%s *lood s%##ly

    (' nti" lngth o, GIT is lind 3ithm%$o%s mm*"an

    m%$o%s mm*"an is "i$h in *lood0ssls and 3ill ,a$ilitat a*so"#tion o,d"%g4 it s$"ts m%$in 3hi$h is a highm3 #olysa$$ha"id that may *ind d"%gs

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    Rasons 3hy GIT o"s an $inta*so"#tion systmD

    )' th" a" a"o%nd F57 lit"s o,-%idday

    #"od%$d *y o" s$"td into th GIT4

    and5( lit"s $om ,"om th ,ood and

    -%id

    inta2'8' GIT is #",%sd *y $a#illa"y nt3o"2that

    allo3s $int a*so"#tion and

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    Bio#ha"ma$%ti$al 1ata o, thGast"ointstinal T"a$t

    Part pH Remarks

    Oral Cavity 7Has an average length of 15-20cm and its main secretion issaliva 1!500ml"day# $hichcontain ptyalin! a salivaryamylase and can digeststarches% &t also secretes m'cin$hich is a glycoprotein that mayinteract $ith dr'gs% (illi isa)sent%

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    Bio#ha"ma$%ti$al 1ata o, thGast"ointstinal T"a$t

    Part pH Remarks

    *tomach 2-+1%5-2

    ,asting

    Presence of food

    *ecretion histamine H2# gastrin

    .astrin reg'lated )y stomach

    distention presence ofpeptides and amino acids

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    Bio#ha"ma$%ti$al 1ata o, thGast"ointstinal T"a$t

    Part pH Remarks

    *tomach/asic dr'gs are sol')iliedrapidly )y stomach acid

    mptying is inf'enced )y foodcontent and osmolality

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    Bio#ha"ma$%ti$al 1ata o, thGast"ointstinal T"a$t

    Part pH Remarks

    'oden'm +-+%5

    Presence of )icar)onate

    3rypsin! chymotrypsin car)o4ypeptidase proteins toamino acids

     mylase CHO

    Pancreatic lipase

     fats to fattyacids

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    Bio#ha"ma$%ti$al 1ata o, thGast"ointstinal T"a$t

    Part pH Remarks

    'oden'mComple4 fl'id medi'm helpsdissolve dr'gs $ith limiteda6'eo's sol')ility

    ster prodr'g are hydrolyed

    Protein dr'gs are 'nsta)le d'e

    to proteolytic enymes

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    Bio#ha"ma$%ti$al 1ata o, thGast"ointstinal T"a$t

    Part pH Remarks

    &le'm 7  cid dr'gs $ill dissolve d'e to)icar)onate secretion

    ,ats and hydropho)ic dr'gs aredissolved )y )ile secretion

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    Bio#ha"ma$%ti$al 1ata o, thGast"ointstinal T"a$t

    Part pH Remarks

    Colon 5%5-7

    ack microvilli

    (ery limited dr'g a)sorption d'eto visco's and semisolid nat'reof l'men contents

    8'cin l')ricant and

    protectant

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    Bio#ha"ma$%ti$al 1ata o, thGast"ointstinal T"a$t

    Part pH Remarks

    Colon3heophylline metoprolol area)sor)ed

     )sor)ed at this region are goodcandidates for s'stained releasedosage forms

     ero)ic aero)icmicroorganisms $hichmeta)olies dr'gs -dopa andlact'lose#

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    Bio#ha"ma$%ti$al 1ata o, thGast"ointstinal T"a$t

    Part pH Remarks

    Rect'm 7 *'perior hemorrhoidal vein

    8iddle hemorrhoidal vein

    &nferior hemorrhoidal vein

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    T it ti , 1 i th

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     T"ansit tim o, 1"%g in thGI T"a$t Pha"ma$ologi$ #"o#"tis o, th d"%g

     Ty# o, dosag ,o"m #hysi$o$hmi$al#"o#"tis=

    Physiologi$ ,a$to"s + 3ith ,ooddigsti0,d stat= o" ,astdint"digsti0 stat=

    Mi ti M t C l

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    Mig"ating Moto" Com#l6MMC= Alt"nating $y$ls o, #"o#%lsi0

    mo0mnt that m#tis th %##" GIt"a$t to th $$%m

    Mi ti M t C l

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    Mig"ating Moto" Com#l6MMC=

    & && &&&&( ,eeding

    90-+0 20-:0 10-200-5

    &nterdigestive fasted# state igestive fed# state

    Mi ti M t C l

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    Mig"ating Moto" Com#l6MMC= Bil s$"tion *gins at #has II

    Onst o, #a"ti$l & m%$%s dis$ha"g mayo$$%" d%"ing th latt" #a"t o, #has II

    M%$%s & #a"ti$l dis$ha"g $ontin%s at#has III

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    %n$tions o, Gast"i$ Motility

     To allo3 th stoma$h to s"0 as a"s"0oi" ,o" th la"g 0ol%m o, ,oodthat may * ingstd at a singl mal

     To ,"agmnt ,ood into small" #a"ti$ls tomi6 $hym 3ith gast"i$ s$"tion so thatdigstion $an *gin

    Em#ty gast"i$ $ontnts into thd%odn%m at a $ont"olld "at gast"i$m#tying tim=

    a$to"s that a$t gast"i$

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    a$to"s that a$t gast"i$m#tying ol%m + la"g 0ol%m. g"at" initial

    ,ollo3d *y slo3 m#tying

    atty a$ids + %nsat%"atd J sat%"atd.

    8C $hain o" mo" J sho"t & mdi%m$hain  D emulsifed by bile acid &lecithin in bile

    Ca"*ohyd"ats + hy#"osmola"

     D P"otins + hy#"osmola"  D

    a$to"s that a$t gast"i$

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    a$to"s that a$t gast"i$m#tying Osmoti$ #"ss%" + "at o, m#yting

    may in$"as at lo3" $on$' thnd$"as at high" $on$'

    Physi$al stat o, gast"i$ $ontnts +small" #a"ti$ls  D

    A$ids D 5 lo3 M> J high M>  

    neutralized by pancreatic & duodenalsecretions 

    a$to"s that a$t gast"i$

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    a$to"s that a$t gast"i$m#tying Al2ali + in$"asd at lo3 $on$' =.

    d$"asd at high $on$' 9=

    1"%gs5 anti$holin"gi$ D. na"$oti$

    analgsi$ mo"#hin= D.mto$lo#"amid D. thanol D

    Body #osition + lying on th l,t sid D

    is$osity + mo" 0is$o%s

     D

    a$to"s that a$t gast"i$

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    a$to"s that a$t gast"i$m#tying Emotional stats + agg"ssi0st"ss,%l

    stat D. d#"ssionD

    Bil salts 5 D

    E6"$is 5 D 1isas stats + hy#othy"oidism 0s

    hy#"thy"oidism D. dia*ti$s D

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    Slo3 in gast"i$ m#tying  dlay int"ansit to th d%odn%m  delay inabsorption  delay onset of action

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    Intstinal Motility

    1"%gs m%st ha0 a s%$int tim"sidn$ tim= at th sit ,o" o#tim%ma*so"#tion

    1ia""ha  a*so"#tion o, a d"%gD Small intstin t"ansit tim SITT=  

    d"%g 3ill ta2 a*o%t 4! hours ,astd

    stat= & !"# hours ,d stat= to #assth"o%gh th stoma$h & SI

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    Intstinal Motility

    Mo%th5to5an%s t"ansit tim L $3.3 ho%"s

    Man $olon t"ansit tim L 3$ ho%"s

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    P",%sion o, GI t"a$t

    Im#o"tant in $a""ying th d"%g intosystmi$ $i"$%lation

    S#lan$hni$ $i"$%lation "$i0s a*o%t

    (F o, th $a"dia$ o%t#%t and isin$"asd a,t" mals

    Som d"%gs 'g' *lomy$in #"#a"d in

    $hylomi$"ons= $an * a*so"*d inlym#hati$ $i"$%lation and *y#ass ?"st5#ass $t

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    E$t o, ood on GI d"%g a*so"#tion

    1lay in gast"i$ m#tying

    Stim%lation o, *il -o3

    Chang in #H o, th GI t"a$t

    An in$"as in th s#lan$hni$ *lood -o3

    Chang in th l%minal mta*olism o,d"%g s%*stan$

    Physi$al o" $hmi$al int"a$tion o, thmal 3ith th d"%g #"od%$t

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    Rd%$d a*so"#tion 3ith ,ood

     Tt"a$y$lin

    Pni$illin G

    Isonia/id

    Amo6i$illin

    As#i"in

    Ri,am#in

    %"osmid

    Phna$tin

    1layd a*so"#tion 3ith

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    1layd a*so"#tion 3ith,ood As#i"in

    A$tamino#hn

    Nit"o,%"antoin

    1igo6in

    S%l?so6a/ol

    C#h"adin

    C,a$lo"

    S%l,adia/in

    In$"asd a*so"#tion 3ith

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    In$"asd a*so"#tion 3ith,ood 1i$o%ma"ol

    G"iso,%l0in

    Phnytoin

    Mto#"olol

    O6a/#am

    P"o#"anolol

    Hyd"ala/in

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    Not a$td 3ith ,ood

     Tho#hyllin

    P"dnison

    Chlo"#"o#"amid

    Mt"onida/ol

    P"o#ylthio%"a$il

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    E$t o, ,ood on GI d"%g a*so"#tion

    Ca%s

    Calo"i$ $ontnt

    Mal 0ol%m

    Mal tm#"at%" E$t 1"%g #"od%$t t"ansit tim %minal dissol%tion

    1"%g #"ma*ility

    Systmi$ a0aila*ility

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    1A R$ommndation

    High5$alo"i and high5,at mals  $to, ,ood on th *ioa0aila*ility and*io@%i0aln$ o, d"%g #"od%$ts

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    E$t o, ood on GI d"%g a*so"#tion

    Pni$illin. tt"a$y$lin and $"tainhyd"o#hili$ d"%gs ha0 d$"asda*so"#tion 3ith ,ood

    G"iso,%l0in a" a*so"*d *tt" 3ith,ood $ontaining high ,at $ontnt

    Bil in$"as a*so"#tion o, ,at sol%*ld"%gs th"o%gh mi$ll ,o"mation

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    E$t o, ood on GI d"%g a*so"#tion

    Som *asi$ d"%gs $inna"i/in= 3ithlimitd a@%o%s sol%*ility $an %nd"go"a#id dissol%tion and *tt" a*so"#tion

    in th #"sn$ o, ,ood

     a$id s$"tion#H

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    E$t o, ood on GI d"%g a*so"#tion

    Gn"ally. *ioa0aila*ility o, d"%g is*tt" in a ,astd stat and 3ith a la"g"0ol%m o, 3at"

    1"%gs "yth"omy$in. i"on salts. as#i"in &NSAI1s= a" gi0n 3ith ,ood to "d%$gast"i$ i""itaion  a*so"#tion "at is"d%$d *%t th 6tnt & $a$y is th

    sam Una*so"*d anti*ioti$ in th GI t"a$t  D

    D

    S%staind5"las ta*lt and dia""ha

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    E$t o, ood on GI d"%g a*so"#tion

    Ent"i$5$oatd ta*lt 0s nt"i$5$oatd*adsmi$"o#a"ti$ls in th #"sn$ o,,ood  D D d"%g a*so"#tion

    ood $an a$t th intg"ity o, thdosag ,o"m  tho#hyllin $ont"olld5"las ta*lt= *ioa0aila*ility mo" "a#idin th ,d5stat than ,astd5stat  dos

    d%m#ing G"an%ls 5( mm in si/= and ta*lts

    that asily disintg"ats in th #"sn$

    o, ,ood

     D D

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    E$t o, ,ood on GI d"%g

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    E$t o, ,ood on GI d"%ga*so"#tion

     Timing o, ta2ing th mds in "lation tomals  H(5 *lo$2"s

    atty ,oods 3hi$h may dlay stoma$h

    m#tying

     D D timing o, d"%gs that a"snsiti0 to a$id

    #H in "lation to d"%g dissol%tion  tt"a$y$lin and sodi%m *i$a"*onat

    ood may nhan$ a*so"#tion o, d"%gs*yond ( ho%"s a,t" mals 'g'$,#odo6im #"o6til=

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     Timing o, d"%g inta2 in "lation to ,ood

     Th"a#%ti$ goal

    Physi$o$hmi$al #"o#"tis o, th d"%g#2a. sol%*ility. #a"ti$l si/. sta*ility in

    gast"i$ #H= 1osag ,o"m s%staind5"las ta*lt.

    sol%tion. nt"i$5$oatd ta*lt=

    Cha"a$t" o, th d"%g gast"i$ i""itant= 1"%g int"a$tionin$om#ati*ilitis 'g'

    tt"a$y$lin anta$ids=

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    1o%*l5#a2 #hnomnon

    Us%ally sn in administ"d singl doso, ,astd #atints

    a"ia*ility o, stoma$h m#tying

    a"ia*ility in intstinal motility P"sn$ o, ,ood

    Ent"oh#ati$ "$y$ling

    ail%" o, a ta*lt dosag ,o"m

    *l 2 h

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    1o%*l5#a2 #hnomnon