8.11
For drugs that follow nonlinear pharmacokinetics, the absorption, distribution, and elimination processes may potentially saturate.
A saturable pathway can lead to dose-dependent changes in the bioavailability of a drug.
The extent of bioavailability is generally estimated using
, which can be affected by saturation-limited absorption in the gastrointestinal tract, or concentration-dependent AUC, which can be affected by the enzymes involved in drug elimination.
Nonlinear pharmacokinetics can also stem from drug-protein binding. Protein-bound drugs exhibit longer elimination half-lives and slower elimination rates than free drugs.
High levels of protein binding result in reduced free drug available for glomerular filtration during renal excretion.
The concentration of the free drug, Cf, can be determined using an equation.
For protein-bound drugs, the free drug concentration is invariably lower than the total drug concentration.
Valproic acid is an example of a drug that shows nonlinear pharmacokinetics, partially due to nonlinear protein binding.
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