Pathophysiological Influences on Pharmacokinetics and Pharmacodynamics

A special issue of Pharmaceutics (ISSN 1999-4923). This special issue belongs to the section "Pharmacokinetics and Pharmacodynamics".

Deadline for manuscript submissions: 31 March 2025 | Viewed by 321

Special Issue Editors


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Guest Editor
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
Interests: placental pharmacokinetic; pregnancy; high-risk pregnancy; infection in obstetrics

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Guest Editor
Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, RJ, Brazil
Interests: clinical pharmacokinetics; pharmacometrics; PBPK; in vitro drug metabolism

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Guest Editor
School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
Interests: clinical pharmacology; model-informed precision dosing; pharmacokinetics; drug-disease interactions

Special Issue Information

Dear Colleagues,

Pharmaceutics is excited to announce a Special Issue on "Pathophysiological Influences on Pharmacokinetics and Pharmacodynamics". This Special Issue aims to explore the latest advancements in PK and PD research across a diverse range of pathophysiological conditions.

Understanding how both diseases and physiological changes alter drug disposition is essential for tailoring pharmacological treatments to individual patients. Such insights are crucial to ensuring that therapies are both safe and effective. Disease states—such as infections, inflammatory states, and acute and chronic diseases—can significantly impact drug absorption, distribution, metabolism, and excretion, leading to variability in drug response that may result in adverse effects or therapeutic failure.

A key objective of clinical pharmacology is to promote individualized pharmacotherapy by identifying the factors that contribute to variability in drug response, with a particular focus on PK and PD. Many conditions, including bacterial, viral, fungal, and protozoal infections; chronic diseases like type 2 diabetes; neoplasms; autoimmune disorders; and physiological states such as pregnancy, are known to influence drug disposition. However, there remains a notable gap in the literature regarding the characterization of drug-metabolizing enzymes and transporters in both disease states and physiological conditions, particularly by in vivo activity markers.

This Special Issue seeks to address these gaps by highlighting recent progress in understanding the impact of both pathophysiological and physiological factors on drug kinetics and dynamics. Potential topics of interest include, but are not limited to, the following:

  • Characterization of drug kinetic disposition in patients with specific pathophysiological or physiological conditions;
  • Comparisons of PK and/or PD between healthy individuals and those with diseases or altered physiological states;
  • Exploration of how disease states and physiological conditions can modify drug absorption, distribution, metabolism, and excretion;
  • Impact of comorbidities and physiological changes on pharmacotherapy outcomes;
  • Optimization of drug therapy in patients with altered physiological states, including pregnancy;
  • Advances in PBPK modeling that account for pathophysiological and physiological influences.

We invite researchers from academia, government agencies, and industry to submit their work to this Special Issue. Each submission will undergo rigorous peer review and be edited by leading experts in the field to ensure the highest standards of quality and relevance. If you are interested in further discussion, please feel free to contact the Guest Editors.

Dr. Geraldo Duarte
Dr. Fernanda de Lima Moreira
Dr. Jhohann Richard de Lima Benzi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmaceutics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • drug–disease interactions
  • pharmacokinetics
  • pharmacodynamics
  • pharmacotherapy

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Published Papers (1 paper)

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Research

14 pages, 1069 KiB  
Article
Gestational Diabetes Mellitus Does Not Change the Pharmacokinetics and Transplacental Distribution of Fluoxetine and Norfluoxetine Enantiomers
by Daniela Miarelli Carvalho, Glauco Henrique Balthazar Nardotto, Gabriela Campos de Oliveira Filgueira, Geraldo Duarte, Ricardo Carvalho Cavalli, Vera Lucia Lanchote and Elaine Christine Dantas Moisés
Pharmaceutics 2025, 17(1), 35; https://doi.org/10.3390/pharmaceutics17010035 (registering DOI) - 30 Dec 2024
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Abstract
Background/Objectives: Fluoxetine (FLX) is the inhibitor of serotonin reuptake most prescribed in pregnant women with depression. This study evaluates the influence of gestational diabetes mellitus (GDM) on the enantioselective pharmacokinetics and transplacental distribution of FLX and its metabolite norfluoxetine (norFLX). Methods: [...] Read more.
Background/Objectives: Fluoxetine (FLX) is the inhibitor of serotonin reuptake most prescribed in pregnant women with depression. This study evaluates the influence of gestational diabetes mellitus (GDM) on the enantioselective pharmacokinetics and transplacental distribution of FLX and its metabolite norfluoxetine (norFLX). Methods: Ten pregnant women diagnosed with GDM (GDM group) were investigated in the third trimester of gestation after they achieved good glycemic control. They received a single oral dose of 20 mg FLX, and blood samples were collected from 0 to 672 h. On the day of delivery, after another single oral dose of 20 mg FLX, blood samples of maternal vein, umbilical vessels and intervillous space were collected at birth. The pharmacokinetics parameters obtained for pregnant women diagnosed with GDM were compared with a group of healthy pregnant women (n = 9) previously investigated using Kruskal–Wallis’s rank-sum test with the Dunn–Bonferroni post hoc test. Results: The area under the plasma over time curve (AUC0–∞) were 197.93 and 109.62 ng∙h/mL for FLX and 600.39 and 960.83 ng∙h/mL for norFLX, respectively, for their R-(+)- and S-(-)- enantiomers. The umbilical vein/maternal vein ratio for FLX and norFLX enantiomers was nearly 0.3, inferring low placental transfer. The umbilical artery/umbilical vein ratios were nearly 0.7 for both FLX and norFLX enantiomers, indicating absence or small fetal metabolism. Conclusions: The GDM did not alter the pharmacokinetics of FLX and norFLX enantiomers in patients with good glycemic control evaluated in the third trimester of gestation. Full article
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