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___ in a drug transporters may result in changes in drug pharmacokinetics leading to reduced drug efficacy and increased risk for drug-induced toxicity; may cause sensitivity to certain drugs.
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Genetic polymorphisms (mutations)
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In the liver, ABC transporters facilitate drug clearance of unmodified drugs or their metabolites by ___ them into the ___.
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Efflucxing; bile
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Oral meds are absorbed in the ___
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GI tract
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___ takes meds from GI tract to the liver to be metabolized into a hydrophilic molecule (from a lipophilic molecule); it is then pumped into the ___ or ___.
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Hepatic Portal vein; urine or bile duct
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Protein enzymes in ___ metabolize drugs to be circulated - concentration does down (way to eliminate from system)
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Liver
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Functional unit of kidney
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Nephron
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Blood is filtered from the kidneys into the ___
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Glomerulus
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Drugs in the blood will typically end up in the ___ (if small enough to be filtered through the glomerulus)
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Lumen
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____ will be lower for drugs with a substrate that will be pushed back by efflux pumps, so absorption will be lower.
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Oral bioavailability
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In the intestine, ABC transporters are expressed right on the edge of ___
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Epithelial cells (by the lumen)
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Expression of transporters with major roles in drug efficacy or toxicity in ___, ___, ___, and ____.
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Human intestinal epithelia, kidney proximal tubule epithelia, hepatocytes, and brain capillary endothelial cells
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It is often the case that a drug will be a substrate for more than one ___
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Transporter
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Transmembrane proteins; single proteins, heterodimers, and homodimers
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ABC transporters
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Transport rate =
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[(Tmax)(S)] / [Km + S](S = concentration of drug; Km = maximum affinity of molecule for a transporter; Tmax = maximum transport)
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Depends on number of protein molecules expressed on cell surface
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Tmax
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