First-Pass Metabolism
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...
- 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].
- First-Pass Metabolism differs between people [5].
References
- ↑ Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc.
- ↑ 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 - ↑ Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc
- ↑ Grahame-Smith D, Aronson J. (2002) Oxford Textbook of Clinical Pharmacology and Drug Therapy, 3rd Edition, Hong Kong: Oxford University Press.
- ↑ Rang H, Dale M, Ritter J, Flower R and Henderson G. (2012) Rang and Dale's Pharmacology, 7th Edition, Spain: Elsevier Inc.