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  2. First pass effect - Wikipedia

    en.wikipedia.org/wiki/First_pass_effect

    An example of a drug where first-pass metabolism is a complication and disadvantage is in the antiviral drug remdesivir. Remdesivir cannot be administered orally because the entire dose would be trapped in the liver with little achieving systemic circulation or reaching target organs and cells (for example, cells infected with SARS-CoV-2).

  3. Rectal administration - Wikipedia

    en.wikipedia.org/wiki/Rectal_administration

    In addition, the rectal route bypasses around two-thirds of the first-pass metabolism as the rectum's venous drainage is two-thirds systemic (middle and inferior rectal vein) and one-third hepatic portal system (superior rectal vein). This means the drug will reach the circulatory system with significantly less alteration and in greater ...

  4. Sublingual administration - Wikipedia

    en.wikipedia.org/wiki/Sublingual_administration

    Furthermore, after absorption from the gastrointestinal tract, such drugs must pass to the liver, where they may be extensively altered; this is known as the first pass effect of drug metabolism. Due to the digestive activity of the stomach and intestines, the oral route is unsuitable for certain substances, such as salvinorin A

  5. Route of administration - Wikipedia

    en.wikipedia.org/wiki/Route_of_administration

    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 of substances from the tissues and from the digestive tract can ...

  6. Bioavailability - Wikipedia

    en.wikipedia.org/wiki/Bioavailability

    Whether a drug is taken with or without food will also affect absorption, other drugs taken concurrently may alter absorption and first-pass metabolism, intestinal motility alters the dissolution of the drug and may affect the degree of chemical degradation of the drug by intestinal microflora.

  7. Enteral administration - Wikipedia

    en.wikipedia.org/wiki/Enteral_administration

    Drugs given by enteral administration may be subjected to significant first pass metabolism, and therefore, the amount of drug entering the systemic circulation following administration may vary significantly for different individuals and drugs. Rectal administration is not subject to extensive first pass metabolism.

  8. Pharmacokinetics of estradiol - Wikipedia

    en.wikipedia.org/wiki/Pharmacokinetics_of_estradiol

    The greater potency of vaginal estradiol relative to oral estradiol is due to the lack of the first pass associated with oral estradiol and due to low local metabolism of estradiol in the vagina. [10] Because of the high estradiol levels achieved, LH and FSH are more strongly suppressed with vaginal estradiol than with other routes. [72]

  9. Hepatic portal system - Wikipedia

    en.wikipedia.org/wiki/Hepatic_portal_system

    This is known as the first pass effect. As a consequence, certain drugs can only be taken via certain routes. As a consequence, certain drugs can only be taken via certain routes. For example, nitroglycerin cannot be swallowed because the liver would deactivate the medication, but it can be taken under the tongue or transdermally (through the ...