Extraction Ratio

The extraction ratio is a measure of the organ efficiency in eliminating the drug during a single pass through the organ.

Cpa

Elimination organ

Cpv

Drug elimination

E =

Cpa - Cpv

Cpa

If the drug is not eliminated by the organ, the drug conc in the venous blood (Cpv) will be equal to the drug conc in the arterial blood (Cpa). The extraction ratio will be equal to 0.

If the drug is completely eliminated by the organ, the drug conc in the venous blood (Cpv) will be equal to zero and the extraction ratio will be equal to 1.

So, the extraction ratio can take values from 0 to 1. Drugs are classified as low extraction ratio drugs if E <0.3, and as high extraction ratio drugs if E > 0.7 .

It is important to note that E is the elimination efficiency during a single pass through the organ and is different from the fraction of the dose eliminated by metabolism. There are examples of drugs that are completely metabolized and have low E and drugs that have high E but not completely metabolized.

The extraction ratio is a function of the intrinsic ability of the organ to eliminate the drug (CLint) and the organ blood flow (Q).

E =

CLint

Q + CLint
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