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Beyne İlaç Taşınması ve Dağılımının Farmakokinetiği

Yıl 2017, Sayı: 2, 81 - 104, 01.06.2017

Öz

Merkezi Sinir Sistemi MSS hastalıklarının sıklığında son zamanlarda ciddi bir artış görülmesi, bu alanda daha etkili ve güvenli tedaviler geliştirilmesi gerekliliğine yol açmıştır. İlaç keşfi ve geliştirilmesi çalışmalarında karşılaşılan en büyük zorluklardan biri beyinde etkili ve güvenli konsantrasyon profilinin elde edilmesidir. Farmakolojik etkinin ortaya çıkabilmesi için MSS ilaçlarının kan beyin engelini KBE geçmesi, hedef bölgeye etkili konsantrasyonlarda ulaşması ve ilacın serbest fraksiyonunun hedef ile uygun bir şekilde etkileşmesi gerekir. Serebral kan akım hızı F , KBE’nin permeabilitesi influks klerensi , ilacın fizikokimyasal özellikleri, beyin dokusuna nonspesifik bağlanma derecesi ve efluks klerensi beyne ilaç taşınmasında etkili olan temel faktörlerdir. Aktif influks ve/veya efluks taşıyıcılar da ilaçların mutlak beyin konsantrasyonunu etkiler. İlacın kan-beyin arasındaki dengelenme hızı CLin, Kin , dengelenme derecesi Kp,uu,beyin ve beyin içi dağılımı Vu,beyin ; beyinde etkili konsantrasyonlara ulaşıp ulaşmadığını doğrulamak için tespit edilmesi gereken başlıca parametrelerdir. Bu parametrelerin belirlenmesi için in vitro, in vivo ve in siliko yöntemler kullanılmaktadır.

Kaynakça

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Pharmacokinetics of Brain Drug Delivery and Distribution

Yıl 2017, Sayı: 2, 81 - 104, 01.06.2017

Öz

Recently, significant increases in the frequency of central nervous system CNS diseases have led to the need to develop more effective and safe therapies. One of the biggest challenges in drug discovery and development studies is obtained the effective and safe concentration profile in the brain. In order for pharmacologic efficacy to occur, CNS drugs must cross the bloodbrain barrier BBB , reach effective concentrations at the target site, and the free fraction of the drug should interact appropriately with the target. Cerebral blood flow F , permeability of BBB influx clearance , physicochemical properties of the drug, nonspecific binding level to the brain tissue and efflux clearance are the main factors that are effective in drug delivery to the brain. Active influx and/or efflux carriers also affect the absolute brain concentration of the drugs. The drug equilibrium rate CLin, Kin and the drug equilibrium extent Kp,uu,brain between blood to brain and intracerebral distribution of the drug Vu,brain are the main parameters which should be determined in order to verify whether the drug has reached effective concentrations in the brain or not. In vivo, in vitro and in silico methods are being used for the determination of such parameters.

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  • Fr dén M, Ljungqv st H, M ddleton B, Bredberg U, Hammarlund-Udenaes M: Improved measurement of drug exposure n the bra n us ng drug-spec f c correct on for res dual blood. Journal of Cerebral Blood Flow & Metabol sm 2010, 30(1):150-161.
  • N cholson C, Ph ll ps JM: Ion d ffus on mod f ed by tortuos ty and volume fract on n the extracellular m croenv ronment of the rat cerebellum. The Journal of Phys ology 1981, 321(1):225-257.
  • N cholson C, Syková E: Extracellular space structure revealed by d ffus on analys s. Trends n Neurosc ences 1998, 21(5):207-215.
  • Becker S, L u X: Evaluat on of the ut l ty of bra n sl ce methods to study bra n penetrat on. Drug Metabol sm and D spos t on 2006, 34(5):855-861.
  • Loryan I, Hammarlund-Udenaes M. Drug D scovery Methods for Study ng Bra n Drug Del very and D str but on. In: Hammarlund-Udenaes M, de Lange ECM, Thorne RG (eds), Drug Del very to the Bra n. Spr nger, Berl n, Germany. 2014:271-316.
  • D L, Umland JP, Chang G, Huang Y, L n Z, Scott DO, et al: Spec es ndependence n bra n t ssue b nd ng us ng bra n homogenates. Drug Metabol sm and D spos t on 2011, 39(7):1270-1277.
  • L u X, Van Natta K, Yeo H, V lensk O, Weller PE, Worboys PD, et al: Unbound drug concentrat on n bra n homogenate and cerebral sp nal flu d at steady state as a surrogate for unbound concentrat on n bra n nterst t al flu d. Drug Metabol sm and D spos t on 2009, 37(4):787-793.
  • K elbasa W, Stratford RE: Exploratory translat onal model ng approach n drug development to pred ct human bra n pharmacok net cs and pharmacolog cally relevant cl n cal doses. Drug Metabol sm and D spos t on 2012, 40(5):877-883.
  • Ball K, Bouzom F, Scherrmann JM, Walther B, Declèves X: Development of a phys olog cally based pharmacok net c model for the rat central nervous system and determ nat on of an n v tro– n v vo scal ng methodology for the blood–bra n barr er permeab l ty of two transporter substrates, morph ne and oxycodone. Journal of Pharmaceut cal Sc ences 2012, 101(11):4277-4292.
Toplam 179 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Tuğba Çopur Bu kişi benim

Sibel Bozdağ Pehlivan Bu kişi benim

Levent Öner Bu kişi benim

Yayımlanma Tarihi 1 Haziran 2017
Yayımlandığı Sayı Yıl 2017 Sayı: 2

Kaynak Göster

Vancouver Çopur T, Pehlivan SB, Öner L. Beyne İlaç Taşınması ve Dağılımının Farmakokinetiği. HUJPHARM. 2017(2):81-104.