PK/PD based design of antibacterial drugs can help in combatting Antimicrobial resistance (AMR)

The discharge of antibiotics into the environment such as excretion of intact antibiotic drugs from humans (during treatment of infections) and animals (growth promoters in meat animals, veterinary medicine, aquatic animals) can lead to significant antibiotic levels in sewage water, discharge, and agricultural fields. This in turn leads to accumulation of the antibiotics in grazing…

Systemic blood clearance of high extraction drugs is limited by organ perfusion (blood flow)

There are many drugs that are extensively metabolized by the liver by drug metabolizing enzymes (DME). In many cases a single DME is responsible for the metabolic clearance of a drug. For many drugs the intrinsic metabolic clearance by the liver far exceeds the liver blood flow of an animal species. In such cases the…

Pharmacokinetic Basis for Dose Fractionation in Anti-infective Pharmacology

Dose fractionation (DF) is an experimental method used to identify the pharmacokinetic/pharmacodynamic (PK/PD) index of an anti-bacterial molecule. Two non-compartmental PK parameters Cmax and AUC, in addition to time above a threshold concentration and in vitro potency (e.g.MIC) are the basis for determining the PK/PD index that best describes the pharmacodynamics of the molecule. PK/PD…

Pharmacokinetic basis for Loading dose and Maintenance dose in therapy

In critical care medicine, the goal is to deliver therapeutic drug concentrations rapidly in blood and then maintain therapeutic concentrations for extended durations for optimum therapeutic outcome.  Oral dosing has the disadvantage of not being able to rapidly achieve therapeutic concentrations in blood due to delay in absorption and bioavailability issues. IV infusion to reach…

Steady State Pharmacokinetics

Ramesh Jayaraman DoseQuartics Consulting Steady state concentrations and accumulation Selection of dosing regimen is as important as dose for designing pharmacology and toxicology studies. The objectives of the pharmacology/toxicology studies could be based on answering specific questions such as Time to achieve steady state is determined by Volume of distribution and clearance. Steady state concentrations…

Intravenous Infusion Dosing: Varying Concentrations at Constant Exposure

Ramesh Jayaraman DoseQuartics Consulting The Exposure (AUC) of a therapeutic when administered as infusions and bolus When a dose of a drug is administered as an intravenous bolus and as infusions of different durations, the exposures (AUC) will be the same in the dosing interval, under linear conditions. However, the peak concentrations achieved will decrease…