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Recently, I have come across a situation involving nonlinear clearance
of a drug in which the volume of distribution is not well defined. Any
clarification will be greatly appreciated.
The rate of elimination for a drug eliminated by only one
capacity-limited process is given by:
dCp/dt = VmaxCp
Km + Cp
or dXe/dt = Vmax.V
Cp Km + Cp
It is apparent from this relationship that the Cls of a drug is
dependent on V. The question then is: What is the definition of V ? Is
it the volume of distribution in the central compartment, volume of
distribution during the terminal phase or some other combination of
terms especially if multicompartment processess are involved ?
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> The rate of elimination for a drug eliminated by only one
> capacity-limited process is given by:
>
> dCp/dt = VmaxCp
> Km + Cp
>
> or dXe/dt = Vmax.V
> Cp Km + Cp
>
> It is apparent from this relationship that the Cls of a drug is
> dependent on V.
If you choose this parameterisation the volume you want is the central
compartment volume. Most people who have used this kind of model in
PK have preferred to define Vmax in units of mass/time rather than
conc/time as you have done.
If you define X as the amt of drug in the central
compartment and Vmax in mass/time units then:
dX Vmax x Cp
--- = (RateIn - ----------- )
dt Km + Cp
then define Cp as X/V you can write:
dCp Vmax x Cp
--- = (RateIn - ----------- )/V
dt Km + Cp
In this case it is obvious that V must refer to the central compartment
volume because the DE is describing the central compartment rates.
--
Nick Holford, Dept Pharmacology & Clinical Pharmacology
University of Auckland, Private Bag 92019, Auckland, New Zealand
email:n.holford.-at-.auckland.ac.nz tel:+64(9)373-7599x6730 fax:373-7556
http://www.phm.auckland.ac.nz/Staff/NHolford/nholford.html
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Responding to the message of
from PharmPK.at.pharm.cpb.uokhsc.edu:
>
> PharmPK - Discussions about Pharmacokinetics
> Pharmacodynamics and related topics
>
> Recently, I have come across a situation involving nonlinear clearance
> of a drug in which the volume of distribution is not well defined. Any
> clarification will be greatly appreciated.
I have tried to clarify this problem on a recent paper: "Clearance, Turnover
Time, and Volume of Distribution" published by Pharmacological Research,
Volume
35, pages 189-193, 1997. If you want to discuss it further, please write me at
resci001.aaa.maroon.tc.umn.edu.
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In reply to Roseline Pardue-
Your post reminds me of a productive debate that I had with Nick Holford in
a thread that is still available on the BIS Computational Biology Forum at
http://www.BioInformaticsServices.com/rphair/bis/resources/forum.
The thread is called " Compartmental model parameterisation" and deals
primarily with the relative merits of Clearances and rate constants for
characterization of PK systems. You might find it informative. I know I
learned a lot from Nick in the course of that discussion.
To answer your question, though, appears to require only that you think
about the source of the V in your equation. You start with dCp/dt on the
left hand side, where Cp is the plasma concentration of the drug. You set
this equal to the Michaelis-Menten capacity-limited elimination,
VmCp/(Km+Cp).
You do not give a definition for Xe, and I think you might find a clear
answer to your question by being precise in your definitions. One way to
approach this is to recognize that mass is conserved, so Vp(dCp/dt) elimination flux (units of , say, umole/hour), where Vp is the plasma
volume. The elimination clearance, Cle, is then the ratio of this flux to
the plasma concentration:
Cle = (elimination flux)/Cp
Your post implies that the left hand side of your second equation
represents the Cle, so
(dXe/dt)/Cp = Cle = (elimination flux)/Cp = Vp(dCp/dt)/Cp = VpVm/(Km+Cp)
Consequently, the V in your equations appears to be equal to Vp, the plasma
volume.
Regards,
Bob
----------
Robert D. Phair, Ph.D. rphair.-at-.bioinformaticsservices.com
BioInformatics Services http://www.bioinformaticsservices.com
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Copyright 1995-2010 David W. A. Bourne (david@boomer.org)