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Flip–flop kinetics

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Flip–flop kinetics can create difficulties in the determination and interpretation of pharmacokinetic parameters if not recognized.
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is smaller than when the drug is administered intravenously or by immediate-release formulation. Depot injections such as
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Jann MW, Ereshefsky L, Saklad SR (1985). "Clinical pharmacokinetics of the depot antipsychotics".
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Spanarello S, La Ferla T (2014). "The pharmacokinetics of long-acting antipsychotic medications".
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The term "flip–flop" indicates that the downward slope more closely represents
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Toutain PL, Bousquet-Mélou A (December 2004). "Plasma terminal half-life".
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Yáñez JA, Remsberg CM, Sayre CL, Forrest ML, Davies NM (May 2011).
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Journal of Veterinary Pharmacology and Therapeutics
258: 1226: 121:are examples of drugs with flip–flop kinetics. 208: 206: 156: 154: 1209: 987: 352: 252: 203: 151: 1216: 1202: 359: 345: 287: 960: 428: 383: 248:Determination of Absorption Rate Constant 186: 887: 595: 1227: 720: 650: 340: 23:, describes an atypical situation in 1168: 775: 64:These circumstances can occur with 31:or the rate at which it enters the 13: 1145:Minimum bactericidal concentration 14: 1251: 1172: 1135:Minimum inhibitory concentration 366: 308:10.2165/00003088-198510040-00003 227:10.1111/j.1365-2885.2004.00600.x 1075:WHO list of essential medicines 568:Non-specific effect of vaccines 1130:Antimicrobial pharmacodynamics 241: 1: 1055:Functional analog (chemistry) 144: 1188:. You can help Knowledge by 608:Hill equation (biochemistry) 273:10.2174/15748847113089990051 7: 119:medroxyprogesterone acetate 105:and long-acting injectable 10: 1256: 1167: 1123:Antimicrobial pharmacology 603:Dose–response relationship 533:Desensitization (medicine) 21:flip–flop pharmacokinetics 1045:Coinduction (anesthetics) 1038: 839: 711: 497: 374: 1110:Multiple drug resistance 1083:Tolerance and resistance 451:Physiological antagonist 39:rate. That is, when the 861:Neuropsychopharmacology 623:Cheng-Prussoff Equation 618:Del Castillo Katz model 545:Other effects of ligand 528:Receptor (biochemistry) 446:Irreversible antagonist 27:where a drug's rate of 1184:-related article is a 997:Classical pharmacology 758:Plasma protein binding 733:Volume of distribution 441:Competitive antagonist 115:testosterone enanthate 78:intradermal injections 1105:Antibiotic resistance 897:Clinical pharmacology 416:Physiological agonist 376:Ligand (biochemistry) 87:is determined by the 1002:Reverse pharmacology 912:Pharmacoepidemiology 753:Biological half-life 633:Ligand binding assay 507:Activity at receptor 401:Irreversible agonist 103:depot antipsychotics 59:elimination constant 1050:Combination therapy 938:Pharmacoinformatics 907:Medicinal chemistry 513:Mechanism of action 261:Curr Clin Pharmacol 94:, and the apparent 48:absorption constant 35:is slower than its 1240:Pharmacology stubs 1020:Immunopharmacology 970:Pharmacotoxicology 871:Psychopharmacology 663:Intrinsic activity 563:Pleiotropy (drugs) 484:Agonist-antagonist 396:Endogenous agonist 296:Clin Pharmacokinet 111:estradiol valerate 17:Flip–flop kinetics 1197: 1196: 1162: 1161: 1158: 1157: 1118: 1117: 1015:Photopharmacology 1010: 1009: 983: 982: 956: 955: 920: 919: 883: 882: 876:Electrophysiology 866:Neuropharmacology 821: 820: 771: 770: 707: 706: 694:Therapeutic index 646: 645: 591: 590: 540: 539: 469: 468: 424: 423: 179:10.4155/tde.11.19 109:medications like 66:sustained-release 50:) is slower than 1247: 1235:Pharmacokinetics 1218: 1211: 1204: 1176: 1169: 1120: 1119: 1080: 1079: 1060:Polypharmacology 985: 984: 958: 957: 948:Pharmacogenomics 943:Pharmacogenetics 922: 921: 885: 884: 846: 845: 773: 772: 743:Rate of infusion 718: 717: 713:Pharmacokinetics 648: 647: 593: 592: 542: 541: 504: 503: 499:Pharmacodynamics 479:Neurotransmitter 461:Enzyme inhibitor 426: 425: 381: 380: 361: 354: 347: 338: 337: 328: 327: 291: 285: 284: 256: 250: 245: 239: 238: 210: 201: 200: 190: 158: 70:depot injections 25:pharmacokinetics 1255: 1254: 1250: 1249: 1248: 1246: 1245: 1244: 1225: 1224: 1223: 1222: 1165: 1163: 1154: 1114: 1100:Drug resistance 1078: 1034: 1006: 979: 975:Neurotoxicology 952: 916: 879: 841: 835: 817: 767: 763:Bioavailability 748:Onset of action 703: 642: 587: 536: 493: 465: 456:Inverse agonist 420: 406:Partial agonist 370: 365: 334: 332: 331: 292: 288: 257: 253: 246: 242: 211: 204: 159: 152: 147: 137: 130: 107:steroid hormone 100: 93: 86: 56: 45: 12: 11: 5: 1253: 1243: 1242: 1237: 1221: 1220: 1213: 1206: 1198: 1195: 1194: 1177: 1160: 1159: 1156: 1155: 1153: 1152: 1147: 1142: 1140:Bacteriostatic 1137: 1132: 1126: 1124: 1116: 1115: 1113: 1112: 1107: 1102: 1097: 1092: 1090:Drug tolerance 1086: 1084: 1077: 1072: 1070:Lists of drugs 1067: 1062: 1057: 1052: 1047: 1042: 1040: 1036: 1035: 1033: 1032: 1027: 1022: 1017: 1011: 1008: 1007: 1005: 1004: 999: 993: 991: 989:Drug discovery 981: 980: 978: 977: 972: 966: 964: 954: 953: 951: 950: 945: 940: 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1133: 1131: 1128: 1127: 1125: 1121: 1111: 1108: 1106: 1103: 1101: 1098: 1096: 1095:Tachyphylaxis 1093: 1091: 1088: 1087: 1085: 1081: 1076: 1073: 1071: 1068: 1066: 1063: 1061: 1058: 1056: 1053: 1051: 1048: 1046: 1043: 1041: 1037: 1031: 1028: 1026: 1023: 1021: 1018: 1016: 1013: 1012: 1003: 1000: 998: 995: 994: 992: 990: 986: 976: 973: 971: 968: 967: 965: 963: 959: 949: 946: 944: 941: 939: 936: 935: 933: 931: 927: 923: 913: 910: 908: 905: 903: 900: 898: 895: 894: 892: 890: 886: 877: 874: 872: 869: 867: 864: 862: 859: 857: 855: 851: 847: 844: 838: 832: 829: 827: 824: 823: 813: 809: 806: 804: 801: 799: 796: 794: 791: 788: 784: 781: 780: 778: 774: 764: 761: 759: 756: 754: 751: 749: 746: 744: 741: 738: 734: 731: 729: 726: 725: 723: 719: 716: 714: 710: 700: 697: 695: 692: 689: 685: 681: 677: 673: 669: 666: 664: 661: 659: 656: 655: 653: 649: 638: 634: 630: 626: 624: 621: 619: 616: 614: 611: 609: 606: 604: 601: 600: 598: 594: 583: 582:Neurotoxicity 579: 576: 574: 571: 569: 566: 564: 561: 558: 554: 551:Selectivity ( 550: 549: 547: 543: 534: 531: 529: 526: 524: 521: 519: 516: 514: 511: 509: 505: 502: 500: 496: 490: 489:Pharmacophore 487: 485: 482: 480: 477: 475: 472: 471: 462: 459: 457: 454: 452: 449: 447: 444: 442: 439: 437: 434: 433: 431: 427: 417: 414: 412: 409: 407: 404: 402: 399: 397: 394: 392: 389: 388: 386: 382: 379: 377: 373: 369: 362: 357: 355: 350: 348: 343: 342: 339: 335: 325: 321: 317: 313: 309: 305: 302:(4): 315–33. 301: 297: 290: 282: 278: 274: 270: 266: 262: 255: 249: 244: 236: 232: 228: 224: 221:(6): 427–39. 220: 216: 209: 207: 198: 194: 189: 184: 180: 176: 173:(5): 643–72. 172: 168: 164: 157: 155: 150: 142: 139: 134: 127: 122: 120: 116: 112: 108: 104: 97: 90: 83: 79: 75: 71: 67: 62: 60: 53: 49: 42: 38: 34: 30: 26: 22: 18: 1190:expanding it 1182:pharmacology 1179: 1164: 1065:Chemotherapy 1025:Cell biology 926:Biochemistry 850:Neuroscience 798:Distribution 728:Loading dose 411:Superagonist 368:Pharmacology 333: 299: 295: 289: 267:(3): 310–7. 264: 260: 254: 243: 218: 214: 170: 166: 140: 132: 131:rather than 125: 123: 95: 88: 81: 74:subcutaneous 63: 51: 40: 20: 16: 15: 1150:Bactericide 826:Compartment 637:Patch clamp 613:Schild plot 72:, and some 37:elimination 33:bloodstream 1229:Categories 1030:Physiology 962:Toxicology 854:psychology 803:Metabolism 793:Absorption 787:Liberation 629:Organ bath 557:Functional 436:Antagonist 429:Inhibitory 384:Excitatory 167:Ther Deliv 145:References 29:absorption 812:Clearance 808:Excretion 627:Methods ( 930:genetics 902:Pharmacy 889:Medicine 699:Affinity 658:Efficacy 596:Analysis 578:Toxicity 324:12848774 281:23343447 235:15601438 197:21837267 840:Related 783:(L)ADME 737:Initial 721:Metrics 668:Potency 651:Metrics 553:Binding 523:Binding 391:Agonist 316:2864156 188:3152312 842:fields 322:  314:  279:  233:  195:  185:  117:, and 1180:This 1039:Other 776:LADME 320:S2CID 19:, or 1186:stub 928:and 852:and 688:TD50 684:LD50 680:ED50 676:IC50 672:EC50 474:Drug 312:PMID 277:PMID 231:PMID 193:PMID 785:: ( 304:doi 269:doi 223:doi 183:PMC 175:doi 76:or 61:). 1231:: 686:, 682:, 678:, 674:, 635:, 631:, 555:, 318:. 310:. 300:10 298:. 275:. 263:. 229:. 219:27 217:. 205:^ 191:. 181:. 169:. 165:. 153:^ 138:. 113:, 1217:e 1210:t 1203:v 1192:. 814:) 810:( 789:) 739:) 735:( 690:) 670:( 639:) 584:) 580:( 559:) 360:e 353:t 346:v 326:. 306:: 283:. 271:: 265:9 237:. 225:: 199:. 177:: 171:2 136:e 133:k 129:a 126:k 99:e 96:k 92:a 89:k 85:e 82:k 57:( 55:e 52:k 46:( 44:a 41:k

Index

pharmacokinetics
absorption
bloodstream
elimination
absorption constant
elimination constant
sustained-release
depot injections
subcutaneous
intradermal injections
depot antipsychotics
steroid hormone
estradiol valerate
testosterone enanthate
medroxyprogesterone acetate


"Flip-flop pharmacokinetics--delivering a reversal of disposition: challenges and opportunities during drug development"
doi
10.4155/tde.11.19
PMC
3152312
PMID
21837267


doi
10.1111/j.1365-2885.2004.00600.x
PMID
15601438

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