Drug Delivery to the Brain pp 233-268 | Cite as
PKPD Aspects of Brain Drug Delivery in a Translational Perspective
Abstract
The development and optimization of CNS drug is hampered by the inaccessibility of the human brain and the difficulty to quantify human CNS drug effects. The use of serial CSF sampling in animals and mathematical modeling of plasma pharmacokinetics, in conjunction with CNS effects, provided only useful information for drugs that distribute to the brain target site by simple diffusion and having direct and reversible CNS effects. Active transport processes across blood–brain barriers and brain cell membranes may be applicable for many drugs and should be taken into account. Also, context dependencies of the rates and extents of all transport processes should be included. This indicates the need for cross-compare designed preclinical experimental approaches and mathematical modeling to provide information on contributions of the (main) individual processes, in terms of rate and extent, as well as their interplay, to be able to predict human CNS drug effects.
Keywords
Intranasal Administration PKPD Model Target Occupancy Prolactin Plasma Concentration Total Brain ConcentrationAbbreviations
- AR
Agonist receptor complex density
- BBB
Blood–brain barrier
- BCSFB
Blood–cerebrospinal fluid barrier
- Ce
Concentration of the drug in the effect compartment
- CNS
Central nervous system
- CSF
Cerebrospinal fluid
- E
Effect
- E0
Effect in the absence of the agonist
- EC50
Concentration of agonist at half-maximal effect
- ECF
Extracellular fluid
- Em
Maximal effect in the biological system
- Emax
Maximal effect of the agonist
- KA
Agonist-receptor binding dissociation equilibrium constant
- Ke
Density of agonist receptor complex that elicits the half maximal effect
- K1e
First-order rate constant for influx K1e
- Keo
Rate constant for drug efflux from the hypothetical effect compartment
- P-gp
P-glycoprotein
- PD
Pharmacodynamics
- PK
Pharmacokinetics
- PKPD
Pharmacokinetic-pharmacodynamic
- RT
Total receptor density
- τ
Transducer constant (efficacy parameter)
- Ve,app
Apparent volume of distribution in the brain
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