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  2. First pass effect - Wikipedia

    en.wikipedia.org/wiki/First_pass_effect

    First-pass metabolism may occur in the liver (for propranolol, lidocaine, clomethiazole, and nitroglycerin) or in the gut (for benzylpenicillin and insulin). [4] The four primary systems that affect the first pass effect of a drug are the enzymes of the gastrointestinal lumen, [5] gastrointestinal wall enzymes, [6] [7] [8] bacterial enzymes [5] and hepatic enzymes.

  3. ADME - Wikipedia

    en.wikipedia.org/wiki/ADME

    Compounds begin to break down as soon as they enter the body. The majority of small-molecule drug metabolism is carried out in the liver by redox enzymes, termed cytochrome P450 enzymes. As metabolism occurs, the initial (parent) compound is converted to new compounds called metabolites. When metabolites are pharmacologically inert, metabolism ...

  4. Enterohepatic circulation - Wikipedia

    en.wikipedia.org/wiki/Enterohepatic_circulation

    Enterohepatic circulation of drugs. Enterohepatic circulation is the circulation of biliary acids, bilirubin, drugs or other substances from the liver to the bile, followed by entry into the small intestine, absorption by the enterocyte and transport back to the liver.

  5. Drug metabolism - Wikipedia

    en.wikipedia.org/wiki/Drug_metabolism

    Drug metabolism is the metabolic breakdown of drugs by living organisms, usually through specialized enzymatic systems. More generally, xenobiotic metabolism (from the Greek xenos "stranger" and biotic "related to living beings") is the set of metabolic pathways that modify the chemical structure of xenobiotics, which are compounds foreign to an organism's normal biochemistry, such as any drug ...

  6. Hepatic portal system - Wikipedia

    en.wikipedia.org/wiki/Hepatic_portal_system

    Many drugs that are absorbed through the GI tract are substantially metabolized by the liver before reaching general circulation. This is known as the first pass effect . As a consequence, certain drugs can only be taken via certain routes.

  7. Proteins produced and secreted by the liver - Wikipedia

    en.wikipedia.org/wiki/Proteins_produced_and...

    All plasma proteins except Gamma-globulins are synthesised in the liver. [1] Human serum albumin, osmolyte and carrier protein; α-fetoprotein, the fetal counterpart of serum albumin; Soluble plasma fibronectin, forming a blood clot that stops bleeding; C-reactive protein, opsonin on microbes, [2] acute phase protein; Various other globulins

  8. Plasma protein binding - Wikipedia

    en.wikipedia.org/wiki/Plasma_protein_binding

    Protein + drugProtein-drug complex. Notably, it is the unbound fraction which exhibits pharmacologic effects. It is also the fraction that may be metabolized and/or excreted. For example, the "fraction bound" of the anticoagulant warfarin is 97%. This means that out of the amount of warfarin in the blood, 97% is bound to plasma proteins.

  9. Route of administration - Wikipedia

    en.wikipedia.org/wiki/Route_of_administration

    Rate of extent of absorption of the drug from different routes. Effect of digestive juices and the first pass metabolism of drugs. Condition of the patient. In acute situations, in emergency medicine and intensive care medicine, drugs are most often given intravenously. This is the most reliable route, as in acutely ill patients the absorption ...