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1 One Compartment Open Model IV bolus Dr Mohammad Issa

1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Page 1: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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One Compartment Open ModelIV bolus

Dr Mohammad Issa

Page 2: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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One compartment

Page 3: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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More than one compartment

Page 4: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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One compartment open model

The one-compartment open model offers the simplest way to describe the process of drug distribution and elimination in the body.

This model assumes that the drug can enter or leave the body (ie, the model is "open"), and the body acts like a single, uniform compartment.

The simplest route of drug administration from a modeling perspective is a rapid intravenous injection (IV bolus).

Page 5: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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One compartment open model

The simplest kinetic model that describes drug disposition in the body is to consider that the drug is injected all at once into a box, or compartment, and that the drug distributes instantaneously and homogenously throughout the compartment.

Drug elimination also occurs from the compartment immediately after injection.

Page 6: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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One compartment:

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Properties of a Pharmacokinetic Compartment1. Kinetic homogeneity. A compartment contains tissues that can

be grouped according to similar kinetic properties to the drug allowing for rapid distribution between tissues

2. Although tissues within a compartment are kinetically homogeneous, drug concentrations within a compartment may have different concentrations of drug depending on the partitioning and binding properties of the drug.

3. Within each compartment, distribution is immediate and rapidly reversible.

4. Compartments are interconnected by first-order rate constants. Input rate constants may be zero order

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One compartment:

Drug amount in the Body (X)

IV bolus administration

(dose = X0)

Elimination process

Elimination rate constant (K)

Based on the assumption of first order elimination process:

XK raten eliminatio

Page 9: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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C= concentration

D= dose

Vd: Volume of distribution

K: elimination rate constant

t: time

One compartment open modelD

rug

Co

nc

(C)

Time

tKeVd

DC

Page 10: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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How to distinguish one comp?lo

g (

C)

Time

Plotting log(C) vs. time yields a straight line

Page 11: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Fundamental parameters in one compartment Apparent Volume of Distribution (Vd) Elimination rate constant (K) Elimination half life (t1/2) Clearance (Cl)

Page 12: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Apparent Volume of Distribution (Vd)

100 mg

C= 10 mg/L C= 1 mg/L

Vd= 10 L Vd= 100 L

Page 13: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Apparent Volume of Distribution (Vd) In general, drug equilibrates rapidly in the body. When plasma

or any other biologic compartment is sampled and analyzed for drug content, the results are usually reported in units of concentration instead of amount

Each individual tissue in the body may contain a different concentration of drug due to differences in drug affinity for that tissue. Therefore, the amount of drug in a given location can be related to its concentration by a proportionality constant that reflects the volume of fluid the drug is dissolved in

The volume of distribution represents a volume that must be considered in estimating the amount of drug in the body from the concentration of drug found in the sampling compartment

Page 14: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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The real Volume of Distribution has physiological meaning and is related to body water

Plasma

Interstitial fluid

Total body water 42 L

Intracellular fluid

Plasma volume 4 L

Interstitial fluid volume 10 L

Intracellular fluid volume 28 L

Page 15: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Apparent Volume of Distribution

Drugs which binds selectively to plasma proteins, e.g. Warfarin have apparent volume of distribution smaller than their real volume of distribution

Drugs which binds selectively to extravascular tissues, e.g. Chloroquines have apparent volume of distribution larger than their real volume of distribution. The Vd of such drugs is always greater than 42 L (Total body water)

Page 16: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Apparent Volume of Distribution

Lipid solubility of drug Degree of plasma protein binding Affinity for different tissue proteins Fat : lean body mass Disease like Congestive Heart Failure

(CHF), uremia, cirrhosis

Page 17: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Apparent Volume of Distribution

In general, drug equilibrates rapidly in the body. When plasma or any other biologic compartment is sampled and analyzed for drug content, the results are usually reported in units of concentration instead of amount

Each individual tissue in the body may contain a different concentration of drug due to differences in drug affinity for that tissue. Therefore, the amount of drug in a given location can be related to its concentration by a proportionality constant that reflects the volume of fluid the drug is dissolved in

The volume of distribution represents a volume that must be considered in estimating the amount of drug in the body from the concentration of drug found in the sampling compartment

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Apparent Volume of Distribution: Mathematics In order to determine the apparent volume of distribution

of a drug, it is necessary to have plasma/serum concentration versus time data

0

0

C

X

conc. initial

doseVd

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Apparent volume of distribution estimation1. Plot log(C) vs. time

2. Plot the best-fit line

3. Extrapolate to the Y-axis intercept (to estimate initial concentration, C0)

4. Estimate Vd:

0

0

C

X

conc. initial

doseVd

Page 20: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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1- Plot log(C) vs. time

5.8

6

6.2

6.4

6.6

6.8

7

0 1 2 3 4 5 6

Lo

g (

Co

nc)

Time

Page 21: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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2- Plot the best-fit line

5.8

6

6.2

6.4

6.6

6.8

7

0 1 2 3 4 5 6

Lo

g (

Co

nc)

Time

Page 22: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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3-Extrapolate to the Y-axis intercept (to estimate C0)

5.8

6

6.2

6.4

6.6

6.8

7

0 1 2 3 4 5 6

Lo

g (

Co

nc)

Time

C0

Page 23: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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4-Estimate Vd

5.8

6

6.2

6.4

6.6

6.8

7

0 1 2 3 4 5 6

Lo

g (

Co

nc)

Time

Log(C0)

0

0

C

X

conc. initial

doseVd

Page 24: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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The Extent of Distribution and Vd in a 70 kg Normal Man

Vd, L% Body Weight

Extent of Distribution

5 7 Only in plasma

5-20 7-28 In extracellular fluids

20-40 28-56 In total body fluids.

>40 >56In deep tissues; bound to peripheral tissues

Page 25: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Elimination rate constant (K)

Elimination rate constant represents the fraction of drug removed per unit of time

K has a unit of reciprocal of time (e.g. minute-1, hour-1, and day-1)

With first-order elimination, the rate of elimination is directly proportional to the serum drug concentration

Page 26: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Elimination rate constant estimation

1. Plot log(C) vs. time

2. Plot the best-fit line

3. Calculate the slope using two points on the best-fit line

4. Estimate K: 303.2 SlopeK

Page 27: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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1- Plot log(C) vs. time

6

6.1

6.2

6.3

6.4

6.5

6.6

6.7

6.8

0 1 2 3 4 5 6

Lo

g (

Co

nc)

Time

Page 28: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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2- Plot the best-fit line

6

6.1

6.2

6.3

6.4

6.5

6.6

6.7

6.8

0 1 2 3 4 5 6

Lo

g (

Co

nc)

Time

Page 29: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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3- Calculate the slope using two points on the best-fit lin

6

6.1

6.2

6.3

6.4

6.5

6.6

6.7

6.8

0 1 2 3 4 5 6

Lo

g (

Co

nc)

Time

(Log(C1), t1)

(Log(C2), t2)

21

21 )log()log(

tt

CCSlope

Page 30: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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4- Estimate K

6

6.1

6.2

6.3

6.4

6.5

6.6

6.7

6.8

0 1 2 3 4 5 6

Lo

g (

Co

nc)

Time

303.2 SlopeK

Page 31: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Elimination half life (t1/2)

The elimination half life is sometimes called ‘‘biological half-life’’ of a drug

The elimination half life is defined as the time (h, min, day, etc.) at which the mass (or amount) of unchanged drug becomes half (or 50%) of the initial mass of drug

Page 32: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Elimination half life (t1/2) estimation

Two methods:From the value of K:

Directly from Conc vs. time plot Select a concentration on the best fit line (C1) Look for the time that is needed to get to 50% of

C1 half-life

Kt

693.02/1

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Clearance (Cl)

Clearance is a measure of the removal of drug from the body

Plasma drug concentrations are affected by the rate at which drug is administered, the volume in which it distributes, and its clearance

A drug’s clearance and the volume of distribution determine its half life

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Clearance (Cl) Clearance (expressed as volume/time) describes the removal of

drug from a volume of plasma in a given unit of time (drug loss from the body)

Clearance does not indicate the amount of drug being removed. It indicates the volume of plasma (or blood) from which the drug is completely removed, or cleared, in a given time period.

Figures in the following two slides represent two ways of thinking about drug clearance: In the first Figure, the amount of drug (the number of dots)

decreases but fills the same volume, resulting in a lower concentration

Another way of viewing the same decrease would be to calculate the volume that would be drug-free if the concentration were held constant as resented in the second Figure

Page 35: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Clearance (Cl)

the amount of drug (the number of dots) decreases but fills the same volume, resulting in a lower concentration

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Clearance (Cl)

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Clearance (Cl)

The most general definition of clearance is that it is ‘‘a proportionality constant describing the relationship between a substance’s rate of elimination (amount per unit time) at a given time and its corresponding concentration in an appropriate fluid at that time.’’

Clearance can also be defined as ‘‘the hypothetical volume of blood (plasma or serum) or other biological fluids from which the drug is totally and irreversibly removed per unit time.’’

Page 38: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Clearance (Cl) estimation

For ALL LINEAR pharmacokinetics (including one compartment) , clearance is calculated using:

where AUC is the area under the concentration curve (it will be discussed later)

AUC

doseCl

Page 39: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Clearance (Cl) estimation

For One compartment pharmacokinetics , clearance is calculated using:

VdKCl

Page 40: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Clearance (Cl)

Drugs can be cleared from the body by different pathways, or organs, including hepatic biotransformation and renal and biliary excretion. Total body clearance of a drug is the sum of all the clearances by various mechanisms.

Cl) hepatic and renal,total,Cl and Cl,(Cl

ClClClCl

hrt

otherhrt

Page 41: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Elimination rate

The elimination rate at any time can be calculated using: Elimination rate = K*X(t)OR Elimination rate = Cl*C(t)

where X(t) is the amount of drug in the body at time t, C(t) is the concntration of drug at time t

Page 42: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Area Under the Conc. Time Curve(AUC) calculation Two methods:

Model dependent: can be used only for one compartment IV bolus

Model independent: Can be used for any drug with any route of administration

Page 43: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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AUC calculation: Model dependent

With one compartment model, first-order elimination, and intravenous drug administration, the AUC can be calculated using:

K

C

VdK

DoseAUC 0

Page 44: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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0

200

400

600

800

1000

1200

0 2 4 6 8 10 12

AUC calculation: Model independent

Page 45: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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0

200

400

600

800

1000

1200

0 2 4 6 8 10 12

AUC calculation: Model independent

1

23

4 5

1- Divide the area into different parts based on the observed concentration points (parts 1-5)

Page 46: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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0

200

400

600

800

1000

1200

0 2 4 6 8 10 12

AUC calculation: Model independent

1

23

4 5

2- Calculate the area for each part of the parts 1,2,3 and 4 (until the last observed concentration) using trapezoidal rule

Page 47: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Trapezoidal rule(Trapezoid = المنحرف (شبه

C1

C2

t1 t2

)(2

C area 12

12 ttC

where C = concentration

t = time

Page 48: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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AUC calculation: Model independent

3- For part 5 (area between the last observed concentration and infinity) use the following equation:

C*K

C area

*

Page 49: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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0

200

400

600

800

1000

1200

0 2 4 6 8 10 12

AUC calculation: Model independent

1

23

4 5

4- The total AUC (from zero to infinity) is the sum of the areas of parts: 1,2,3,4, and 5

543210 AUCAUCAUCAUCAUC AUC

Page 50: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Fraction of the dose remaining

Fraction of dose remainig (F = X(t)/X0) is given by the following equation:

since t1/2= 0.693/k, the equation can be represented as:

tKtK

ee

0

0

X

X

dose

tat timeAmount F

2/12/1

2

1F

693.0 t

t

t

t

e

Page 51: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Time to get to certain conc.

Time to get to certain concentration (C*) is given by:

tKeC 0C **

C 0

Ce tK

*

Cln 0

CtK

KCt

*C

ln

0

Page 52: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Applications of one compartment model Case 1: Predicting Plasma Concentrations

Case 2: Duration of Action

Case 3:Value of a Dose to Give a Desired Initial Plasma Concentration

Page 53: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Case 1: Predicting Plasma Concentrations A 20-mg dose of a drug was

administered as an intravenous bolus injection. The drug has the following pharmacokinetic parameters: k = 0.1 h−1 and Vd = 20 L

1. Calculate the initial concentration (C0 )

2. Calculate the plasma concentration at 3 h

Page 54: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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1. Calculate the initial concentration (C0 )

2. Calculate the plasma conc. at 3 h

Case 1: Predicting Plasma Concentrations

mg/L 1L 20

mg 20

Vd

dose C0

mg/L 0.74e1 eC C (3)-(0.1)tK0

Page 55: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Case 2: Duration of Action

The duration of action of a drug may be considered to be the length of time the plasma concentration spends above the MEC. Its determination is best illustrated by example 2.

Page 56: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Case 2: Duration of Action

Continuing with the drug used in Example 1, if the therapeutic range is between 5 and 0.3 mg/L, how long are the plasma concentrations in the therapeutic range?

Page 57: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Case 2: Duration of Action

As indicated in the diagram (previous slide) C0 =1 mg/L. Thus, at time zero the plasma concentration is in the therapeutic range. The plasma concentration will remain therapeutic until it falls to the MEC (0.3 mg/L). At what time does this occur?

hr 0.121.0/3.0

1ln*

Cln

0

KCt

Page 58: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Case 3: Value of a Dose to Give a Desired Initial Plasma Concentration

Continuing with the drug used in Examples 1 and 2, If the initial Cp of 1 mg/L is unsatisfactory, Calculate a dose to provide an initial plasma concentration of 5 mg/L.

Vd

dose C0 Vd 0C dose

mg 100 L 20L

mg 5 dose

Page 59: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Examples

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Example 1

Ten mg metoclopramide was administered intravenously to a 72 kg patient. The minimum plasma concentration required to cause significant enhancement of gastric emptying is 50 ng/mL. The following plasma concentrations were observed after analysis of the specimen.

Page 61: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 1

Time (hr) Conc. (ng/ml)

1 90.0

2 68.0

4 40.0

6 21.5

8 12.0

10 7.0

Page 62: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 1

Calculate the biological half-life of the drug elimination (t½), the overall elimination rate constant (K), the volume (Vd), the coefficient of distribution and the duration of action (td)

Page 63: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 1

y = -0.1243x + 2.0832

R2 = 0.9995

0

0.5

1

1.5

2

2.5

0 2 4 6 8 10 12

time (hr)

log

(C

on

c)

Page 64: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 1

The elimination rate constant can be obtained from the slope:

Another way to calculate the slope is using:

1hr 0.286(2.303)(0.1243)

2.303SlopeK

t2-t1

log(C2)-log(C1) Slope

Page 65: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 1

Another way to calculate the slope (if you do not have the ability to do regression) is using:

where (C1,t1) and (C2,t2) are two different conc. time points

It is important to note that the first method for calculating the slope is more accurate

t2-t1

log(C2)-log(C1) Slope

Page 66: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 1

Calculating the slope using the second method:

Note that the value of the slope is similar to the

value estimated using the first method (-0.1243)

-0.134816-4

log(21.5)-log(40) Slope

Page 67: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 1

the biological half-life of the drug elimination (t½):

The volume of distribution (Vd):

hr 2.420.286

0.693

K

0.693t0.5

L 83ml10

L

mg

ng10

ng/ml

mg 0.083

121.12

10

10

10

C

doseVd

3

6

2.08320

Page 68: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 1

y = -0.1243x + 2.0832

R2 = 0.9995

y = -0.1243x + 2.0832

R2 = 0.9995

0

0.5

1

1.5

2

2.5

0 2 4 6 8 10 12

time (hr)

log

(C

on

c)

Intercept = log (C0)

C0= 10intecept

Page 69: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 1

the coefficient of distribution = Vd/wt=83 L/ 72 kg= 1.15 L/kg

the duration of action (td). td is the time needed for the conc. To get to 50 ng/ml :

hrKCt 1.3286.0

50121.12

ln *

Cln

0

Page 70: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 2

An adult male patient was given the first dose of an antibiotic at 6:00 AM. At 12:00 noon the plasma level of the drug was measured and reported as 5 µg/ml. The drug is known to follow the one compartment model with a half-life of 6 hours. The recommended dosage regimen of this drug is 250 mg q.i.d. the minimum inhibitory concentration is 3 µg/ml. Calculate the following: Apparent volume of distribution Expected plasma concentration at 10 AM. Duration of action of the first dose Total body clearance Fraction of the dose in the body 5 hours after the injection Total amount in the body 5 hours after the injection Cumulative amount eliminated 5 hours after the injection Total amount in the body immediately after injection of a second dose at 12:00 noon Duration of action of first dose only if dose administered at 6:00 AM was 500 mg.

Page 71: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 2

Elimination rate constant:

Initial concentration: The conc. at 12:00 noon (6 hrs after the

first dose) is 5 µg/ml:

1

0.5hr 0.1166

0.693t

0.693K

ug/ml 105)5(

)5(

6116.00

0

ee

tCC

eCtC

tk

tk

Page 72: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 2

Apparent volume of distribution: C(t=6hrs)= 5 ug/ml. Since the half life is 6 hrs, C0

= 10 ug/ml.

Expected plasma concentration at 10 AM

L 25ml 25000

μg

mg10

ml

μg 10

mg 250

C

XV

3-0

0D

150 11550669306930 -. hr././t.K

μg/ml 6.3 eC4)C(t tK0

Page 73: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 2

Duration of action of the first dose

Total body clearance

Fraction of the dose in the body 5 hours after the injection

hr 42.101155.03

10ln *

Cln

0

KCt

L/hr 89.2 DVKCl

56.02

1F

6

5

Page 74: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 2

Total amount in the body 5 hours after the injection = (0.56)(250 mg) = 140 mg

Cumulative amount eliminated 5 hours after the injection = dose – amount in the body = 250 – 140 = 110 mg

Total amount in the body immediately after injection of a second dose at 12:00 noon

Total amount = amount from the first dose + amount from the second dose = 125 + 250 = 375 mg

Page 75: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 2

Duration of action of first dose only if dose administered at 6:00 AM was 500 mg

Note that 6 hrs (one t0.5) is needed for the amount in the body to decline from 500 mg to 250 mg

hrs 16.42 hr 6 hr 42.10 dt

Page 76: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 3

The therapeutic range of a drug is 20-200 mg/L. After an intravenous bolus injection of 1.0 gm followed by regression analysis of the concentration of the drug in plasma (in units of mg/L) versus time (in hours), the following linear equation was obtained

Calculate the following Duration of action Total body clearance Rate of elimination at 2 hours

tCp 1.02log

Page 77: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

77

Example 3

From the equation:

The following were estimated:

tslopeCtCp )log(1.02log 0

mg/L 1001020 C

1hr 0.23(2.303)(0.1) 2.303SlopeK

L 10mg/L 100

mg 1000

C

XV

0

0D

Page 78: 1 One Compartment Open Model IV bolus Dr Mohammad Issa

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Example 3

Duration of action:

Total body clearance= K∙Vd=(0.23)(10) =2.3 L/hr Rate of elimination at 2 hours: Elimination rate = Cl*C(t=2) = 2.3*63 =145 mg/hr

hr 723.020

100ln *

Cln

0

KCtd

mg/L 63102)Cp(t

1.8(0.1)(2)22))log(Cp(t1.8

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