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    Renal Drug Excretion

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    Satwika Ekananda
    This document summarizes renal drug excretion. It discusses the processes of glomerular filtration and tubular secretion and reabsorption that influence renal excretion of drugs. Factors like plasma protein binding, renal function, and urine pH can impact the rate of renal excretion. Changing the urine pH through medications can alter the excretion of weak acids or bases by affecting their degree of ionization in the urine. Impaired renal function or controlling urine pH following intoxication can influence the dosage or renal clearance of drugs.

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    Renal Drug Excretion

    Uploaded by

    Satwika Ekananda
    39 views15 pages
    This document summarizes renal drug excretion. It discusses the processes of glomerular filtration and tubular secretion and reabsorption that influence renal excretion of drugs. Factors like plasma protein binding, renal function, and urine pH can impact the rate of renal excretion. Changing the urine pH through medications can alter the excretion of weak acids or bases by affecting their degree of ionization in the urine. Impaired renal function or controlling urine pH following intoxication can influence the dosage or renal clearance of drugs.

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    [9]Renal Drug Excretion

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    This document summarizes renal drug excretion. It discusses the processes of glomerular filtration and tubular secretion and reabsorption that influence renal excretion of drugs. Factors like plasma protein binding, renal function, and urine pH can impact the rate of renal excretion. Changing the urine pH through medications can alter the excretion of weak acids or bases by affecting their degree of ionization in the urine. Impaired renal function or controlling urine pH following intoxication can influence the dosage or renal clearance of drugs.

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    Download as PPT, PDF, TXT or read online from Scribd
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    Download as ppt, pdf, or txt
    39 views15 pages

    Renal Drug Excretion

    Uploaded by

    Satwika Ekananda
    This document summarizes renal drug excretion. It discusses the processes of glomerular filtration and tubular secretion and reabsorption that influence renal excretion of drugs. Factors like plasma protein binding, renal function, and urine pH can impact the rate of renal excretion. Changing the urine pH through medications can alter the excretion of weak acids or bases by affecting their degree of ionization in the urine. Impaired renal function or controlling urine pH following intoxication can influence the dosage or renal clearance of drugs.

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    of 15

    RENAL DRUG

    EXCRETION

    TOYA ARIAWAN
    ADME

    A bsorption
    D istribution
    Metabolism
    E xcretion
    Drug at
    absorption
    Asite
    Drug D
    in the
    Mbody

    Metaboli
    tes
    E
    Excreted Excreted
    drug metaboli
    tes
    DRUG EXCRETION

    1. Kidney
    2. Biliary system
    3. Saliva
    4. Lungs
    5. Breast milk
    RENAL EXCRETION
    = GLOMERULAR FILTRATION
    + TUBULAR SECRETION
    - TUBULAR
    REABSORPTION
    PLASMA DRUG
    CONCENTRATIO
    N
    FACTORS
    PLASMA
    THAT
    PROTEIN
    INFLUENCE
    BINDING
    RENAL
    EXCRETION
    RENAL
    FUNCTION
    GLOMERULAR FILTRATION
    Unbound drugs/metabolites
    Low molecular weight <
    60,000 Da

    TUBULAR SECRETION

    In the proximal tubule


    Carrier mediated
    Active process (energy dependent
    process)
    Have maximal ability (may become
    saturates)
    There are competition between
    ANION (ORGANIC ACID)
    SECRETORY SYSTEM
    Probenecid block the normally rapid
    tubular secretion of penicillin

    CATION (ORGANIC BASES) SECRETORY


    SYSTEM
    Cimetidine
    Ketoconazole
    Pramipexole
    Trimethopri BLOC Dofetilile
    m K
    Prochlorpera
    zine
    TUBULAR
    REABSORPTION
    Passive process (passive
    diffusion)
    Unionized form of
    drugs/metabolites tends to be
    reabsorbed readily because
    have lipophilic properties)
    Depending on the urine
    pH, a weak acid or base
    can be more or less
    ionized in the urine,
    therefore more or less
    reabsorbed
    Weak Weak
    acid base
    Acidificati Unionized Ionized
    excretio
    on of forms>> forms >>
    n
    urine

    Alkalinizat Ionized Unionized


    ion of forms>>> forms
    urine excretio
    n
    Alkalinization of urine enhanced the
    excretion of acetylsalicylic acid,
    phentobarbital
    Effect of pH urine alter the rate of drug
    elimination depend on - the molecule degree
    of ionization AND
    - contribution of renal route to total
    elimination
    DRUGS USED TO CHANGE
    URINE pH
    Alkalinization of urine
    sodium
    bicarbonate
    Acidification of urine
    vitamin C
    NH4Cl
    CLINICAL
    IMPLICATIONS
    1 Impairment of renal
    function
    Renal
    clearance
    Dosage regimen must be adapted
    (especially for drugs or their
    active
    metabolites that are
    predominantly cleared by
    the kidney (> 50%)
    2 Following intoxication
    Forced diuresis + urine
    pH control can be useful
    to increase the renal
    excretion of certain
    drugs and toxins

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