First-Pass Metabolism: Difference between revisions

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First-pass metabolism (also known as presystemic [[Metabolism|metabolism]]) refers to the action of metabolic [[Enzyme|enzymes]], in the [[Liver|liver and]]&nbsp;gut wall, on drugs&nbsp;<ref>Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc.</ref>.&nbsp;These enzymes metabolise drugs before they enter the [[Systemic Circulation|systemic circulation]], often rendering a fraction of the drug inactive&nbsp;<ref name="null">Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc.</ref>. This lowers the proportion of an ingested drug that is&nbsp;acquired by the systemic circulation in its active form (its [[Bioavailability|bioavailability]]).<ref>Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc</ref>  
First-pass metabolism (also known as presystemic [[Metabolism|metabolism]]) refers to the action of metabolic [[Enzyme|enzymes]], in the [[Liver|liver]] and&nbsp;gut wall, on drugs&nbsp;<ref>Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc.</ref>.&nbsp;These enzymes metabolise drugs before they enter the [[Systemic Circulation|systemic circulation]], often rendering a fraction of the drug inactive&nbsp;<ref name="null">Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc.</ref>. This lowers the proportion of an ingested drug that is&nbsp;acquired by the systemic circulation in its active form (its [[Bioavailability|bioavailability]]).<ref>Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc</ref>  


This form of metabolism is therapeutically relevant as...  
This form of metabolism is therapeutically relevant as...  

Revision as of 17:59, 14 November 2011

First-pass metabolism (also known as presystemic metabolism) refers to the action of metabolic enzymes, in the liver and gut wall, on drugs [1]. These enzymes metabolise drugs before they enter the systemic circulation, often rendering a fraction of the drug inactive [2]. This lowers the proportion of an ingested drug that is acquired by the systemic circulation in its active form (its bioavailability).[3]

This form of metabolism is therapeutically relevant as...

  1. It implies that the efficacy of a drug is lower when its route of administration is oral rather than intravenous. [2]This frequently means that a higher dose is used when a drug is administered orally [2]. First-pass metabolism can reduce the bioavailability of some drugs to the extent that it renders them completely ineffective and makes oral administration unsuitable (insulin is an example of this) [4]
  2. First-Pass Metabolism differs between people [5].

References

  1. Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc.
  2. 2.0 2.1 2.2 Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc. Cite error: Invalid <ref> tag; name "null" defined multiple times with different content
  3. Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc
  4. Grahame-Smith D, Aronson J. (2002) Oxford Textbook of Clinical Pharmacology and Drug Therapy, 3rd Edition, Hong Kong: Oxford University Press.
  5. Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc.