9.1
Biodisponibilidad: Visión general
La biodisponibilidad se refiere a la proporción de un fármaco administrado que alcanza la circulación sistémica en su forma activa e inalterada. Const…
La biodisponibilidad indica la fracción de la dosis total administrada que llega a la circulación sistémica como un fármaco intacto.
Las diferentes vías de administración dan como resultado una biodisponibilidad variable. Por ejemplo, el fármaco entra directamente en el torrente sanguíneo a través de una inyección intravenosa, lo que proporciona una biodisponibilidad del 100%.
Sin embargo, los medicamentos administrados por vía oral pasan a través del tracto gastrointestinal, se absorben y se metabolizan en el hígado, lo que resulta en una dosis menor del medicamento que llega a la circulación sistémica.
La biodisponibilidad de un fármaco oral depende de la actividad enzimática en la pared intestinal o el hígado, el pH gástrico y la motilidad intestinal. Es la relación entre la cantidad de fármaco que llega a la circulación sistémica y la cantidad de fármaco administrada.
Algunos medicamentos, como la lidocaína, se someten a un extenso metabolismo de primer paso, lo que reduce significativamente su biodisponibilidad y descarta su uso oral.
Los estudios de biodisponibilidad de un fármaco nuevo o existente indican su utilidad terapéutica, eficiencia de absorción, formulación adecuada y vía de administración eficaz.
View the full transcript and gain access to JoVE Core videos
Q1: Why does intravenous injection result in 100% bioavailability while oral administration does not?
Intravenous injection delivers the drug directly into the bloodstream, bypassing absorption barriers and metabolism, achieving 100% bioavailability. Oral drugs must traverse the gastrointestinal tract, where they undergo absorption and hepatic metabolism before reaching systemic circulation, resulting in lower bioavailability due to first-pass metabolism and other absorption factors.
Q2: What role does first-pass metabolism play in determining oral drug bioavailability?
First-pass metabolism occurs when drugs are metabolized by enzymes in the intestinal wall or liver before reaching systemic circulation. Drugs like lidocaine undergo extensive first-pass metabolism, significantly reducing their bioavailability and making oral administration ineffective. This process is a major determinant of whether a drug can be given orally or requires alternative administration routes.
Q3: How do gastric pH and intestinal motility affect drug bioavailability?
Gastric pH influences drug solubility and absorption; weakly acidic drugs absorb better in the stomach, while weakly basic drugs absorb in the intestines. Intestinal motility alters the drug's residence time in absorption sites, either enhancing or impeding uptake. Together, these factors significantly impact the fraction of drug reaching systemic circulation.
Q4: What is the relationship between enzyme activity in the gut wall and oral drug bioavailability?
Enzyme activity in the gut wall and liver metabolizes drugs before they reach systemic circulation, directly reducing bioavailability. Drugs with high enzyme susceptibility experience significant metabolism during this phase. Understanding enzyme activity is essential for predicting oral bioavailability and determining whether conceptual approaches overcoming bioavailability problems are needed.
Q5: How do bioavailability studies help in drug development and formulation optimization?
Bioavailability studies evaluate the fraction of administered drug reaching systemic circulation and its absorption efficiency. These studies determine therapeutic utility, identify suitable administration routes, and optimize formulations to improve absorption and systemic delivery. Insights guide the design and approval of new and improved drug formulations, ensuring safety and efficacy.
Q6: What factors determine whether a drug can be administered orally versus intravenously?
Oral administration viability depends on enzyme activity, gastric pH, and intestinal motility. Drugs undergoing extensive first-pass metabolism, like lidocaine, cannot be given orally because insufficient drug reaches systemic circulation. Intravenous administration bypasses these barriers, making it suitable for drugs with poor oral bioavailability or when rapid systemic delivery is required.
Q7: Why is bioavailability considered a crucial pharmacokinetic parameter in drug therapy?
Bioavailability determines the proportion of administered drug reaching systemic circulation in active form, directly affecting therapeutic effectiveness. It indicates whether a drug will achieve intended therapeutic outcomes at a given dose. Bioavailability assessment guides dosing decisions, formulation selection, and administration route choice, ensuring optimal drug efficacy and patient safety.