Drug distribution 2026-11-05
Drug distribution is movement of a drug between blood and other body compartments. Perfusion, membrane permeability, tissue binding and plasma-protein binding jointly affect it. The apparent distribution volume iswhere is the amount in the body and the plasma concentration. If mg and mg/L, L. [ref]
Population Pharmacokinetics Guidance for Industry by the FDA. 2022, pharmacokinetic parameters and concentration-time models
The result is a proportionality quantity, not an anatomical cavity that must contain that many litres. Extensive tissue binding can lower and make large. A rapid fall in plasma concentration immediately after administration can therefore reflect distribution as well as drug elimination; distinguishing them requires a model and a suitable sampling schedule.
Drug elimination 2026-11-05
Drug elimination removes a parent drug from the body's measured parent-drug pool through drug metabolism or excretion. Redistribution from blood to a tissue changes plasma concentration but does not by itself eliminate the drug from the body. A mass balance separates input, output and transfers between compartments. [ref]
Population Pharmacokinetics Guidance for Industry by the FDA. 2022, pharmacokinetic model development and concentration-time analysis
For a one-compartment model with no input and first-order elimination, gives . Equal fractions disappear in equal time intervals. By contrast, a saturated elimination route can approach removal of equal amounts per interval. The latter produces a different concentration-time curve and cannot be assumed to have a concentration-independent half-life.
Drug withdrawal 2026-11-05
Drug withdrawal is a physiological or behavioural response to reducing or stopping exposure after adaptation to a drug. It differs from simple elimination of the substance: its manifestations reflect the adapted system functioning under changed exposure. It also differs from recurrence of the original condition, although both can occur together. [ref]
FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. 2020 safety communication, physical dependence and withdrawal definitions
For example, a system that has compensated for a persistent inhibitory influence may show excessive activity when that influence is removed. The timescale of adaptation can differ from the drug elimination timescale, so a response can continue after concentrations have fallen. Physical dependence, drug tolerance and compulsive use describe different phenomena; the presence of one alone does not establish all the others.