1

MOTTO AND
VISION 2
To impart evidence based
research oriented
medical education
To provide best possible
patient care
To inculcate the values of
mutual respect and
ethical practice of
medicine
 VERTICAL INTEGRATION

MEDICINE (14% )
Clinical Subjects
Prof. Umar’s Clinically Oriented Integration Model
For Basic Sciences Interactive Lectures

1st Year Pharmacology LGIS (14

slides)
&
rch 7%) Re
s
a Bi ear
se ics(
Re eth oe ch
th &
Bi
o ics Core Subject– 9 slides (65%)

Horizontal Integration
(anatomy/physiology)– (2 slides)
HORIZONTAL
CORE 14 %
INTEGRATION SUBJECT
3.55
Vertical • (Medicine) –2
ANATOMY
PHARMACOLOGY
/PHYSIOLOGY integration slides (14%)
( 14% ) (65%)
(Clinical
Subjects)
cs B
Research & Bioethics 1 slide (7
Re ioe
thi h & se th
oe c ar ics
Bi sear
Re
ch
& %)
 Distribution of Drugs
4

DR UZMA UMAR
APWMO Pharmacology
22nd February 2024

SOURCE :
Bertram G. Katzung Basic & Clinical
Pharmacology 15th Edition
Google for images & research article
 LEARNING OBJECTIVES
5

By the end of lecture you should be able to

 Define distribution of drugs
 Discuss factors affecting distribution of drugs
 Define volume of distribution
 Clinical significance of distribution of drugs in
body
Horizontal

6
Horizontal

7
Core subject

8
DISTRIBUTION?
Where do drugs go?
Core subject
DISTRIBUTION
9

“The process by which a drug reversibly moves from

blood stream to and enters the extracellular fluid
and/or cells of tissues.”
Core subject

10
Core subject
Volume of Distribution
(Vd)
11

Relates the amount of drug in the body to the

concentration of drug (C) in blood or plasma

Vd=amount of drug in body/C
C = Cb, Cp, Cu

 Vd often exceeds any physical volume in the

body.

continue to next…
Core subject

12
Core subject

13
Core subject
Factors Affecting Distribution
Of Drugs 14

A. Blood flow
B. Tissue permeability of the drug
C. Binding of drugs to tissue proteins
D. Binding of drugs to plasma proteins
Core subject

15
A. Blood Flow
 kidneys, brain, liver
 Intestine ,adipose tissue

B. Tissue Permeability Of The Drug

 Molecular size
 Lipid solubility

 Degree of ionization

 Tissue specific transporters

 Blood Brain Barrier

 Passage across Placenta

Core subject

16

C. Binding of drug to plasma protein

 Albumin
 Alpha-acid
glycoprotein
D. Binding Of Drug Component With Tissue &
Extra Vascular Component:
 Bones & teeth : Tetracycline, phenytoin
 Kidney: vestibular apparatus : gentamicin
Vertical
Clinical Significance
17

Drugs with large Vd

Prediction of effectiveness of dialysis

continue to next..
Vertical

18
Further reading
Bioethics and research article &
artificial intelligence
19

 Physician should keep in mind pharmacokinetic parameters of

the prescribing drugs so as to achieve maximal clinical benefits

 Holt K, Nagar S, Korzekwa K. Methods to predict volume of

distribution. Current pharmacology reports. 2019 Oct;5:391-9.

 Yuan Y, Chang S, Zhang Z, Li Z, Li S, Xie P, Yau WP, Lin H, Cai

W, Zhang Y, Xiang X. A novel strategy for prediction of human
plasma protein binding using machine learning techniques.
Chemometrics and Intelligent Laboratory Systems. 2020 Apr
15;199:103962.
EOLA

20
EOLA

21

Calculate volume of
distribution for the three
compartments
 How To Access Digital Library
22

 Go to the website of HEC National Digital Library.

 On Home Page, click on the INSTITUTES.
 A page will appear showing the universities from Public and
Private Sector and other Institutes which have access to HEC
National Digital Library HNDL.
 Select your desired Institute.
 A page will appear showing the resources of the institution
 Journals and Researches will appear
 You can find a Journal by clicking on JOURNALS AND DATABASE
and enter a keyword to search for your desired journal.