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High Extraction Ratio Drugs
kinetics depends on blood flow
  • slower the Q, higher the extraction
  • higher the Q, the lower the extraction
Excretion
  • Elimination of drug by excretion unchanged in body fluid or breath
  • Urine: nonvolatile & metabolites. Rate: GFR (drug not bound to plasma proteins), prox. tubular active secretion, passive reabsorption
  • Bile: drugs actively transported by hepatocyte; once in SI, lipophillic are reabsorbed & cleared again by liver (enterohepatic circulation), more polar are biotransformed, unabsorbed & metabolites-->feces
  • Minor routes: sweat, tears, fluids, milk; pH-dependent passive diffusion of lipophilic drugs (Can expose infants to drugs in mother's milk)
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