Handbook
of
Basic
Pharmacokinetics
. . . including Clinical Applications
Sixth Edition
Wolfgang A. Ritschel
Ph.D., M.D., Mr. Pharm., F.A.S.A., F.C.P.
Professor Emeritus of Pharmacokinetics
and Biopharmaceutics
College of Pharmacy
Professor of Pharmacology
and Cell Biophysics
College of Medicine
University of Cincinnati
Cincinnati, Ohio
Gregory L. Kearns
Pharm.D., Ph.D., F.C.P.
Marion Merrell Dow/Missouri Chair in Pediatric Pharmacology
Professor of Pediatrics and Pharmacology
University of Missouri—Kansas City
Chief, Division of Pediatric Pharmacology and Medical Toxicology
Director, Pediatric Pharmacology Research Unit
Children's Mercy Hospitals and Clinics
Kansas City, Missouri
APhA
AMERICAN PHARMACISTS ASSOCIATION
WASHINGTON, D.C.
Contents
Preface ix
1. Definitions and Glossary 1
2. The LADMER System—Liberation, Absorption, Distribution, Metabolism,
Elimination, and Response 10
3. Organs, Tissues, Cells, and Organelles 13
4. Cell Membranes 20
5. Drug-Receptor Interactions 27
6. Absorption/Transport Mechanisms 31
7. pKa and Degree of Ionization 47
8. Lipid/Water Partition Coefficient 53
9. Physicochemical Factors Altering Biological Performance of Drugs 57
10. Biopharmaceutical Data of the Gastrointestinal Tract 66
11. Fluid Compartments and Circulatory System 79
12. Binding of Drugs to Biological Material 88
13. Drug Biotransformation 98
14. Compartment Models 115
15. Determination of Rate Constants 122
16. Volume of Distribution and Distribution Coefficient 131
17. Excretion and Clearance of Drugs 139
18. Urinary and Biliary Recycling 165
19. Cumulative Urinary Excretion 167
VII
VIII CONTENTS
20. Area Under the Blood Level-Time Curve 179
21. Pharmacokinetics of Single Dose Administration 188
22. Pharmacokinetics of Multiple Dosing 200
23. Compartment Model Independent Analysis 220
24. Pediatric Pharmacokinetics 227
25. Drug Dosage in Elderly Patients 241
26. Drug Dosage in Obese Patients 250
27. Drug Disposition in Pregnancy 255
28. Dosage Regimen Design 260
29. Drug Monitoring and Dose Adjustment 278
30. Physiological and Pathological Factors Influencing Drug Response 281
31. First Dose Size in Man 288
32. Forensic Pharmacokinetics 291
33. Nonlinear Pharmacokinetics 295
34. Curve Fitting 302
35. Correlation of Clinical Response with Drug Disposition 311
36. Bioavailability and Bioequivalence 318
37. Body Surface Areas 339
38. Extracorporeal Methods of Drug Removal 342
39. Pharmacogenetics and Pharmacogenomics 355
Appendix 367
Index 403