- Drugs with lower clearance are eliminated at slower rate (if Vd is similar). Administration of the same dose will achieve higher steady state drug conc for drugs with lower clearance.
- The metabolite formation rate at steady state will be similar after administration of the same dose of the parent drugs if the fraction of the drug converted to the metabolite (fm) is constant.
- Since the metabolite parameters are similar and the metabolite formation rate is similar, the metabolite steady state concentration will not change regardless of the parent drug steady state conc.
The total body clearance is the volume of the plasma or blood which is completely cleared from the drug per unit time. It has units of volume/time.
The CLT for a drug is constant within a patient (dose and concentration independent) when the elimination processes follow first-order kinetics.
The total body clearance is a measure of the efficiency of all eliminating organs in eliminating the drug and it is the sum of all organ clearances (i.e. CLT is the sum of the renal clearance, hepatic clearance and all other organ clearances).
The elimination rate constant and the half life (the dependent pharmacokinetic parameters) are dependent on (is determined from) the total body clearance and the volume of distribution (the independent pharmacokinetic parameters).
CLT
Vd = k andCLT
Vd =0.693
t 1/2