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Dear all,
i would be glad to know the answers of the following questions
1) What is the difference between AUCall and AUC0-infinity in non
compartmental analysis by WinNonlin?
2) How to calculate the fraction of dose converted into metabolite by
non-compartmental analysis in case of iv bolus ( oral also)?
3) How to find out MRT incase of iv infusion for a definite period of
time?
Thanks in advance.
*************************************
*SK.ABDUL MOHAMMED JAFAR SADIK BASHA*
*2002H108032 *
*Room No.: 230, Bhagirath Bhavan *
*BITS, Pilani *
*Rajasthan *
*************************************
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> 1) What is the difference between AUCall and AUC0-infinity in non
> compartmental analysis by WinNonlin?
AUCinf is the total AUC i.e. AUClast plus AUClast to inf (Clast/lambdaz)
AUCall is AUClast plus the area of the triangle assuming that the next
time point after Clast is zero.
> 2) How to calculate the fraction of dose converted into metabolite by
> non-compartmental analysis in case of iv bolus ( oral also)?
Fm = AUC'x/AUC', where AUC'x is the total area under the curve of
metabolite in plasma after IV drug and AUC' is the total area under the
curve of metabolite after an equimolar IV dose of metabolite.
> 3) How to find out MRT incase of iv infusion for a definite period of
> time?
MRTinfusion = MRT + (Infusion time/2)
Brian E. Davies
Clinical Director, PDMP
Hoffmann-La Roche, Nutley, NJ
* brian.davies.aaa.roche.com
* (973) 235-2053
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Abdul,
To make the correct calculation of MRT from in infusion of finite time
please see: Straughn, AB. "Model-independent steady-state volume of
distribution", J Pharm Sci 1982 May: 715):597-8. Note an original
paper
on this subject has an integration error in the proof and gives the
wrong
answer.
Art Straughn, Pharm.D.
Professor and Director
Drug Research Laboratory
University of Tennessee
874 Union Ave
Suite 5P
Memphis, TN 38163
E-mail: ASTRAUGHN.aaa.UTMEM.EDU
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I have attached a graph (both as .pdf and .jpg format) which clearly
describes differences between AUC (all) and AUC (inf). Hope this helps.
Aziz Karim
[As attachments aren't possible on the PharmPK list I have put the jpeg
image on the PharmPK website at
http://www.boomer.org/pkin/pk/AUCinf.jpg - db]
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Dear colleagues
In answer to the following question:
>> 3) How to find out MRT incase of iv infusion for a definite period of
>> time?
Brian Davies wrote:
> MRTinfusion = MRT + (Infusion time/2)
This is correct. However, it may be confusing. In non-compartmental
analysis, MRT is calculated as
MRT = AUMC/AUC
This value of MRT includes the term (Infusion time/2), and thus equals
the
MRTinfusion in your equation.
On the other hand, in compartmental analysis, MRT is usually calculated
as
MRT = Vss / CL
This value of MRT refers to a bolus dose administration.
So, if MRT is calculated from AUMC/AUC, addition of (Infusion time/2)
should
be omitted. The actual MRT is obtained by subtraction of (Infusion
time/2)
from MRTinfusion.
By the way, I do not know which MRT is provided by WinNonlin. Anyhow, it
should be made clear which value is reported. I would suggest to stick
to
the 'real' MRT, i.e. after a bolus dose administration. IMHO, the value
of
MRTinfusion does not make much sense.
Hans Proost
Johannes H. Proost
Dept. of Pharmacokinetics and Drug Delivery
University Centre for Pharmacy
Antonius Deusinglaan 1
9713 AV Groningen, The Netherlands
Email: j.h.proost.-a-.farm.rug.nl
[I'm not sure what real MRT means...MRT probably should always be
provided with a subscript... MRT(IV-Bolus), MRT(IV-Infusion), or
MRT(Oral) etc.
Thus, MRT(xxx) is 'always' = AUMC/AUC
and the calculations:
MRT(IV-infusion) - MRT(IV-bolus) = MIT (mean infusion time ;-) =
Duration/2 <- no new information
MRT(Oral) - MRT(IV-bolus) = MAT (mean absorption time) <- might be
useful
can/may be performed...do I have the right? - db]
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Dear Aziz,
a graph using the original scale might be a better demonstration
of the phenomenon, since AUC calculation is based on non-transformed
data.
In addition, you cannot display points with concentration zero in
log-scale.
Regards
Peter
Peter Wolna
Inst. f. Klin. Pharmakologie
D-67269 Gruenstadt
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Dear Aziz:
Congratulations. Perfect graph.
Dr. Ibrahim Wasfi
Forensic Science Laboratory
P O BOX 253, Abu Dhabi
United Arab Emirates
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Aziz,
The graph that you have supplied is misleading. Because you have
labelled
the y-axis as being a log scale this is not the graph that represents
the
AUC that is required. You cannot plot zero on a log scale and therefore
this
does not give the correct visual representation of the relevant areas.
Paul
Dr Paul S. Collier
School of Pharmacy
Queen's University, Belfast
97 Lisburn Road
Belfast BT9 7BL
N. Ireland, UK
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Hans
The MRT given by WinNonlin is always the 'real' MRT because the program
automatically adjusts for the infusion time.
regards
Brian
Brian E. Davies
Clinical Director, PDMP
Hoffmann-La Roche, Nutley, NJ
* brian.davies.-a-.roche.com
* (973) 235-2053
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>> MRTinfusion = MRT + (Infusion time/2)
>
> This is correct. However, it may be confusing. In non-compartmental
> analysis, MRT is calculated as
>
> MRT = AUMC/AUC
>
I think this is the most widespread actual use of MRT.
> By the way, I do not know which MRT is provided by WinNonlin. Anyhow,
> it
> should be made clear which value is reported. I would suggest to stick
> to
> the 'real' MRT, i.e. after a bolus dose administration. IMHO, the value
> of
> MRTinfusion does not make much sense.
I like to use the term Mean Disposition Time (MDT) to refer to Vss/CL
because it refers to the residence time attributable to disposition
(distribution and elimination) and excludes the input process which has
a Mean Input Time (MIT) (aka Mean Absorption Time MAT). They are simply
related like this:
MRT = MIT + MDT
The MDT is the same as MRT for a bolus input because MIT=0.
Nick
Nick Holford, Divn Pharmacology & Clinical Pharmacology
University of Auckland, 85 Park Rd, Private Bag 92019, Auckland, New
Zealand
email:n.holford.at.auckland.ac.nz
http://www.health.auckland.ac.nz/pharmacology/staff/nholford/
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Dear Paul:
You are absolutely right that you can not show zero value in the log
scale.
The graph was for illustrative purpose only. The problem with using the
linear scale would be that the terminal phase elimination phase would
not be
obvious because of the exponential decay. I should omit the zero value
from
the graph and just say value below lqc.
Again thanks for your comments.
Aziz
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Dear Hans,
You rather have an interesting opinion regarding
MRTinfusion. Would you please provide a little more
insight as to why do you think MRTinfusion does not
make much sense? What about slow release formulation?
Should do not be still meaningful/ useful if the
plasma concentration-time curve decline in a
mono-exponential manner?
Rostam
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Dear Rostam,
Thank you for your response.
> Would you please provide a little more
> insight as to why do you think MRTinfusion does not
> make much sense?
I would say: the advocates of MRTinfusion should indicate what is the
use of this value.
MRTinfusion is the average time that drug molecules reside in the body
AND in the syringe (starting at time zero). To me, this makes no sense
because the drug in the syringe is not in the patient. We have full
control over the drug administration.
I welcome the suggestion by Nick Holford about Mean Residence Time =
AUMC/AUC and Mean Disposition Time = Vss/CL. Please note, however, that
in case of infusions, this definition of MRT cannot be translated to
the 'mean residence time in the body'. So, the confusion is not yet
solved completely.
> What about slow release formulation?
In this case the situation is different. In case we would know that the
release of drug obeys perfect zero-order over a defined time interval,
the situation is almost similar to that of an infusion, but the drug is
in the body (albeit not in the
'pharmacokinetic system') and is out of control. In real life, slow
release formulation are generally far from perfect
zero-order over a defined time interval, so the concept of a Mean Input
Time or Mean Absorption Time (as mentioned by Nick Holford) may be
applied.
> Should do not be still meaningful/ useful if the
> plasma concentration-time curve decline in a
> mono-exponential manner?
In case of a mono-exponential plasma concentration-time decline MRT and
MRTinfusion may be useful, but also may be considered superfluous,
since clearance and volume of distribution (two independent
characteristics of the system) describe the system exactly. Half-life
is useful for choosing an
appropriate dosing interval, and indicates how fast steady state is
reached. IMHO, that's enough, and we do not really need more parameters.
Best regards,
Hans Proost
Johannes H. Proost
Dept. of Pharmacokinetics and Drug Delivery
University Centre for Pharmacy
Antonius Deusinglaan 1
9713 AV Groningen, The Netherlands
Email: j.h.proost.aaa.farm.rug.nl
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Some remarks to the recent discussion on the meaning and usefulness of
MRT:
In view of a clear terminology I have proposed the names "mean
disposition residence time" (MDRT) for disposition curves after a bolus
iv dose and "mean body residence time" (MBRT) or "mean total residence
time" (MTRT) after noninstantaneous input, i.e.
MTRT = MDRT + MIT, where MIT= mean input time
MIT = T/2 for infusion time T (i.e., useful to calculate MDRT from
numerically estimated MTRT).
MIT = MDT + MAT (mean dissolution time + mean absorption time) after
oral administration.
Since MDT (mean dissolution time) is an already established term in
pharmacy and very useful for in vitro-in vivo correlation, the use MDT
instead of MDRT, as proposed by Nick, is open to question.
Regarding the information given by MDRT on the disposition system, the
following holds for linear systems and only assumes that the
elimination rate is proportional to C(t), but is independent of a
specific compartmental model.
Besides the fundamental relationship MDRT= Vss/CL, MDRT determines
the degree of accumulation: Ass /FDm = MDRT/tau
(Dm maintenance dose, tau dosing interval)
More than 90% of a bolus dose is eliminated in t90% (washout) and
following infusion more than 90% of Css a reached in t90%, where
t90% = 3.7 MDRT
Note that t63.2% =MDRT only holds for a one compartment model
(monoexponential function) !
Upper and lower bounds to the washout curves can be predicted when the
variance of RT is known after bolus injection or for log-concave curves
after oral administration.
e.g. ., time required for 63% of the total administered dose to be
eliminated (Rostam's question):
MDRT(1-CV^2)/2 < t63% < MDRT (where CV^2 = VDRT/MDRT^2) (< means: <
or =)
The following inequality is general valid V0 < Vss < Vz. (< means: <
or =)
Weiss, M.: Generalizations in linear pharmacokinetics using properties
of certain classes of residence time distributions. I. Log-convex drug
disposition curves. J. Pharmacokin. Biopharm. 14:635-657 (1986)
Weiss, M.: Generalizations in linear pharmacokinetics using properties
of certain classes of residence time distributions. II. Log-concave
curves following oral administration.J. Pharmacokin. Biopharm. 15:57-74
(1987)
Weiss, M.: Washout time versus mean residence time. Pharmazie
43:126-127 (1988)
Weiss, M.: The relevance of residence time theory to pharmacokinetics.
Eur. J. Clin. Pharmacol. 43:571-579 (1992)
The theory of residence time distributions also offers a method to
define measures of kinetics of drug distribution in the body (i.e.,
which are not influenced by elimination as t1/2,alpha): Weiss, M, Pang
KS.: The dynamics of drug distribution. I. Role of the second and third
curve moment. J. Pharmacokinet. Biopharm. 20: 253-278 (1992)
Best regards,
Michael Weiss
Martin Luther Univ.
Dep of Pharmacology
Section of Pharmacokinetics
D-06097 Halle/Saale
Germany
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