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The amount of blood perfusing the liver that is cleared of the medication per unit of time is known as hepatic drug clearance.

Many medications are metabolized in the liver, sometimes to the point that only a little quantity of active substance makes it to the remainder of the circulatory system.

Results of this first trip through the liver, the drug's bioavailability may be considerably reduced.

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Oral Bioavailability on First Pass Effect

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Oral Bioavailability on First Pass Effect

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Methodologist experimental for assessing factors affecting oral bioavailability in vivo

Individual contributions due to absorption and gut lumen losses appear to be estimated using an integrated set of approaches.

Assumed treatment of linear pK and constant clearance

This determine metabolite bioavailability

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Drug taken orally, pass via liver before going systemic circulation, removed by metabolism or hepatobiliary secretion.

Factors - plasma protein concentration, enzymatic activity, gastriontestinal motility.

The drugs bioavailability may be considerably reduced.

First pass metabolism-

Swallowed drug→Digestive system→Hepatic portal system→Liver→Rest of the body

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Oral dose of drugs having higher first pass impact than others

There is significant individual variation in the oral dose

For this bioavailability raised in patients with impaired liver function

It keeps serum drug concentrations stay within patient’s therapeutic ranges

This maximises patients safety and therapy efficacy

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Bioavailability for drugs with a high first-pass effect using oral clearance

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Bioavailability for drugs with a high first-pass effect using oral clearance

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A straight line with an intercept of unity and a slope of reciprocal of hepatic blood flow results from charting the reciprocal of bioavailability vs Oral clearance

Lignocaine and verapamil : shows strong and good predictability Propranolol: shows poor predictability

Useful in terms of detection of a drug's limited bioavailability