Intervalle posologique et voie d’administration : méthodes de détermination

The dosing interval (τ) is calculated using the ratio of maximum to minimum drug concentrations, the elimination rate constant (k), and pharmacokinetic principles. For example, an antibiotic with a three-hour half-life targeting 5 to 15 µg/mL requires a dosing interval of 4.76 hours to maintain therapeutic levels. This calculation ensures the drug concentration stays within the therapeutic window.

When establishing an antibiotic dosage interval, consider the drug's half-life, target concentration range in the bloodstream, and the patient's volume of distribution. These parameters determine how frequently doses must be administered to maintain therapeutic drug levels while avoiding toxicity and ensuring efficacy throughout treatment.

The route of administration affects the drug's bioavailability, rate of absorption, and onset of action—all critical for achieving optimal therapeutic outcomes. Different routes influence how quickly and efficiently a drug reaches the bloodstream, directly impacting whether therapeutic concentrations are achieved and maintained at the desired level.

Intravenous routes are ideal for drugs requiring rapid action or those unstable in the gastrointestinal tract. In contrast, oral or intramuscular routes suit drugs requiring slower absorption or sustained-release formulations. Intravenous administration provides immediate drug availability in the bloodstream, bypassing absorption barriers.

Drugs undergoing extensive first-pass metabolism in the liver are better administered through non-oral routes like intravenous injections, which provide immediate drug availability and bypass hepatic metabolism. This ensures the full therapeutic dose reaches systemic circulation rather than being metabolized before producing its intended effect.

Insulin is administered subcutaneously because it degrades in the gastrointestinal tract and cannot be absorbed effectively through the oral route. Subcutaneous administration ensures the hormone reaches the bloodstream intact, allowing it to exert its therapeutic effect on glucose metabolism and maintain proper physiological function.

Drug bioavailability determines how much of an administered dose reaches systemic circulation and is available to produce therapeutic effects. By understanding a drug's bioavailability through different routes, healthcare providers can calculate appropriate doses and intervals to maintain therapeutic concentrations while minimizing adverse effects.