22:
114:
124:
1454:
340:. Clearance is therefore expressed as the plasma volume totally free of the drug per unit of time, and it is measured in units of volume per units of time. Clearance can be determined on an overall, organism level («systemic clearance») or at an organ level (hepatic clearance, renal clearance etc.). The equation that describes this concept is:
258:, non-ionised acids and weak bases are reabsorbed both actively and passively. Weak acids are excreted when the tubular fluid becomes too alkaline and this reduces passive reabsorption. The opposite occurs with weak bases. Poisoning treatments use this effect to increase elimination, by alkalizing the urine causing
294:
Pharmacokinetics studies the manner and speed with which drugs and their metabolites are eliminated by the various excretory organs. This elimination will be proportional to the drug's plasmatic concentrations. In order to model these processes a working definition is required for some of the
273:
On other occasions drugs combine with bile juices and enter the intestines. In the intestines the drug will join with the unabsorbed fraction of the administered dose and be eliminated with the faeces or it may undergo a new process of absorption to eventually be eliminated by the kidney.
574:
is reached when the drug's supply to the blood plasma is the same as the rate of elimination from the plasma. It is necessary to calculate this concentration in order to decide the period between doses and the amount of drug supplied with each dose in prolonged treatments.
277:
The other elimination pathways are less important in the elimination of drugs, except in very specific cases, such as the respiratory tract for alcohol or anaesthetic gases. The case of mother's milk is of special importance. The liver and kidneys of newly born
327:
The difference in a drug's concentration in arterial blood (before it has circulated around the body) and venous blood (after it has passed through the body's organs) represents the amount of the drug that the body has eliminated or
250:. Glomerular filtration will only remove those drugs or metabolites that are not bound to proteins present in blood plasma (free fraction) and many other types of drugs (such as the organic acids) are actively secreted. In the
424:
313:
is the time required to eliminate 50% of the absorbed dose of a drug from an organism. Or put another way, the time that it takes for the plasma concentration to fall by half from its maximum levels.
599:
For elimination via bile please see: Estimation of
Biliary Excretion of Foreign Compounds Using Properties of Molecular Structure. 2014. Sharifi M., Ghafourian T. AAPS J. 16(1) 65–78.
535:
Each organ will have its own specific clearance conditions, which will relate to its mode of action. The «renal clearance» rate will be determined by factors such as the degree of
456:
510:
483:
530:
286:. For this reason it is important to know if a drug is likely to be eliminated from a woman's body if she is breast feeding in order to avoid this situation.
554:
As «hepatic clearance» is an active process it is therefore determined by factors that alter an organism's metabolism such as the number of functioning
32:
93:
270:
back into the blood stream and instead gets excreted with the urine. Acidifying the urine has the same effect for weakly basic drugs.
65:
345:
72:
636:
543:
of the transporters (active secretion depends on transporter proteins that can become saturated) or the number of functioning
242:
following the same steps and mechanisms as the products of intermediate metabolism. Therefore, drugs that are filtered by the
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693:
79:
1422:
61:
976:
51:
1412:
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845:
1407:
1103:
1014:
880:
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957:
608:
885:
1075:
1444:
810:
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251:
149:
of a drug is understood to be any one of a number of processes by which a drug is eliminated (that is,
86:
1484:
1474:
1322:
1070:
1064:
40:
157:) from an organism either in an unaltered form (unbound molecules) or modified as a metabolite. The
47:
1387:
1089:
255:
213:
150:
1138:
900:
895:
805:
723:
332:. Although clearance may also involve other organs than the kidney, it is almost synonymous with
235:
185:. These organs or structures use specific routes to expel a drug from the body, these are termed
36:
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1010:
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which promotes excretion of a weak acid, rather than it getting reabsorbed. As the acid is
8:
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as the drug will only be filtered out if it is in the unbound free form, the degree of
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1266:
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645:
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138:
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1307:
1239:
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50:
if you can. Unsourced or poorly sourced material may be challenged and
1085:
282:
are relatively undeveloped and they are highly sensitive to a drug's
154:
132:
1207:
1179:
1166:
855:
668:
544:
263:
614:
279:
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158:
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is the main excretory organ although others exist such as the
198:
193:
174:
170:
162:
419:{\displaystyle CL_{o}=Q\cdot {\frac {(C_{A}-C_{V})}{C_{A}}}}
289:
123:
1060:
953:
949:
751:
228:
218:
166:
1126:
1400:
1202:
1360:
512:
is the drug's plasma concentration in venous blood and
822:
485:
is the drug's plasma concentration in arterial blood,
1442:
518:
491:
464:
434:
348:
784:
524:
504:
477:
450:
418:
127:Diagram illustrating renal flow along the nephron
1466:
583:Other parameters of interest include a drug's
46:Please review the contents of the article and
1265:
630:
246:are also subject to the process of passive
637:
623:
1238:
706:
661:
547:(hence the importance of factors such as
290:Pharmacokinetic parameters of elimination
122:
1165:
873:
1467:
998:
928:
234:Drugs are excreted from the kidney by
618:
1053:
15:
578:
13:
1423:Minimum bactericidal concentration
14:
1501:
602:
1452:
1413:Minimum inhibitory concentration
644:
112:
20:
1353:WHO list of essential medicines
846:Non-specific effect of vaccines
589:apparent volume of distribution
565:
458:is the organ's clearance rate,
295:concepts related to excretion.
62:"Elimination" pharmacology
1408:Antimicrobial pharmacodynamics
562:has such clinical importance.
400:
374:
48:add the appropriate references
1:
1333:Functional analog (chemistry)
594:
266:, it cannot pass through the
886:Hill equation (biochemistry)
316:
298:
7:
33:reliable medical references
10:
1506:
1401:Antimicrobial pharmacology
881:Dose–response relationship
811:Desensitization (medicine)
558:, this is the reason that
320:
302:
130:
1323:Coinduction (anesthetics)
1316:
1117:
989:
775:
652:
256:distal convoluted tubules
39:or relies too heavily on
1388:Multiple drug resistance
1361:Tolerance and resistance
729:Physiological antagonist
611:, Animation of excretion
311:half life of elimination
309:The plasma half-life or
177:structures, such as the
1139:Neuropsychopharmacology
901:Cheng-Prussoff Equation
896:Del Castillo Katz model
823:Other effects of ligand
806:Receptor (biochemistry)
724:Irreversible antagonist
532:an organ's blood flow.
1275:Classical pharmacology
1036:Plasma protein binding
1011:Volume of distribution
719:Competitive antagonist
537:plasma protein binding
526:
506:
479:
452:
451:{\displaystyle CL_{o}}
420:
338:renal plasma clearance
128:
1383:Antibiotic resistance
1175:Clinical pharmacology
694:Physiological agonist
654:Ligand (biochemistry)
527:
507:
505:{\displaystyle C_{V}}
480:
478:{\displaystyle C_{A}}
453:
421:
236:glomerular filtration
126:
1280:Reverse pharmacology
1190:Pharmacoepidemiology
1031:Biological half-life
911:Ligand binding assay
785:Activity at receptor
679:Irreversible agonist
572:stable concentration
570:The steady state or
516:
489:
462:
432:
346:
323:Clearance (medicine)
305:Biological half-life
248:tubular reabsorption
187:elimination pathways
1328:Combination therapy
1216:Pharmacoinformatics
1185:Medicinal chemistry
791:Mechanism of action
1298:Immunopharmacology
1248:Pharmacotoxicology
1149:Psychopharmacology
941:Intrinsic activity
841:Pleiotropy (drugs)
762:Agonist-antagonist
674:Endogenous agonist
522:
502:
475:
448:
416:
129:
1440:
1439:
1436:
1435:
1396:
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1293:Photopharmacology
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1287:
1261:
1260:
1234:
1233:
1198:
1197:
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1160:
1154:Electrophysiology
1144:Neuropharmacology
1099:
1098:
1049:
1048:
985:
984:
972:Therapeutic index
924:
923:
869:
868:
818:
817:
747:
746:
702:
701:
525:{\displaystyle Q}
414:
240:tubular secretion
121:
120:
97:
1497:
1485:Pharmacokinetics
1475:Digestive system
1457:
1456:
1455:
1448:
1398:
1397:
1358:
1357:
1338:Polypharmacology
1263:
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1226:Pharmacogenomics
1221:Pharmacogenetics
1200:
1199:
1163:
1162:
1124:
1123:
1051:
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1021:Rate of infusion
996:
995:
991:Pharmacokinetics
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925:
871:
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820:
819:
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777:Pharmacodynamics
757:Neurotransmitter
739:Enzyme inhibitor
704:
703:
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639:
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579:Other parameters
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1378:Drug resistance
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1312:
1284:
1257:
1253:Neurotoxicology
1230:
1194:
1157:
1119:
1113:
1095:
1045:
1041:Bioavailability
1026:Onset of action
981:
920:
865:
814:
771:
743:
734:Inverse agonist
698:
684:Partial agonist
648:
643:
605:
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585:bioavailability
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568:
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408:
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394:
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334:renal clearance
325:
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268:plasma membrane
260:forced diuresis
183:lacrimal glands
179:salivary glands
135:
117:
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108:
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99:
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41:primary sources
25:
21:
12:
11:
5:
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1418:Bacteriostatic
1415:
1410:
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1391:
1390:
1385:
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1368:Drug tolerance
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1348:Lists of drugs
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1267:Drug discovery
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1109:Bioequivalence
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549:kidney failure
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1373:Tachyphylaxis
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860:Neurotoxicity
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832:
829:Selectivity (
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767:Pharmacophore
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560:liver failure
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103:December 2023
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74:
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67:
64: –
63:
59:
58:Find sources:
53:
49:
43:
42:
38:
34:
29:This article
27:
18:
17:
1343:Chemotherapy
1303:Cell biology
1204:Biochemistry
1128:Neuroscience
1076:Distribution
1006:Loading dose
689:Superagonist
646:Pharmacology
598:
588:
582:
571:
569:
566:Steady state
553:
534:
427:
337:
333:
329:
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310:
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233:
204:Perspiration
186:
146:
142:
139:pharmacology
136:
100:
90:
83:
76:
69:
57:
37:verification
30:
1428:Bactericide
1104:Compartment
915:Patch clamp
891:Schild plot
609:UAlberta.ca
556:hepatocytes
214:Respiration
143:elimination
31:needs more
1469:Categories
1308:Physiology
1240:Toxicology
1132:psychology
1081:Metabolism
1071:Absorption
1065:Liberation
907:Organ bath
835:Functional
714:Antagonist
707:Inhibitory
662:Excitatory
595:References
541:saturation
244:glomerulus
73:newspapers
1480:Excretion
1090:Clearance
1086:Excretion
905:Methods (
388:−
369:⋅
317:Clearance
299:Half life
175:glandular
147:excretion
133:Excretion
1490:Pharmacy
1459:Medicine
1208:genetics
1180:Pharmacy
1167:Medicine
977:Affinity
936:Efficacy
874:Analysis
856:Toxicity
587:and the
545:nephrons
252:proximal
181:and the
155:excreted
1118:Related
1061:(L)ADME
1015:Initial
999:Metrics
946:Potency
929:Metrics
831:Binding
801:Binding
669:Agonist
428:Where:
330:cleared
280:infants
264:ionised
151:cleared
87:scholar
52:removed
1445:Portal
1120:fields
224:Faeces
209:Saliva
169:, the
165:, the
159:kidney
141:, the
89:
82:
75:
68:
60:
1317:Other
1054:LADME
254:and
199:Tears
194:Urine
171:lungs
163:liver
94:JSTOR
80:books
1206:and
1130:and
966:TD50
962:LD50
958:ED50
954:IC50
950:EC50
752:Drug
229:Bile
219:Milk
167:skin
153:and
66:news
35:for
1063:: (
551:).
336:or
173:or
145:or
137:In
1471::
964:,
960:,
956:,
952:,
913:,
909:,
833:,
591:.
189::
54:.
1447::
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638:e
631:t
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520:Q
498:V
494:C
471:A
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444:o
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396:V
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383:A
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375:(
366:Q
363:=
358:o
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105:)
101:(
91:·
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77:·
70:·
44:.
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