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Volume of Distribution (V d ) Volume of distribution ( V d ) relates amount of drug in body to plasma concentration V d = (amount of drug in the body) / (plasma drug concentration) V d is changed in disease states that decrease plasma proteins a decrease in plasma proteins decreases binding of drug to plasma proteins e.g., liver disease e.g., kidney disease V d increased in disease states that increase total body water ascites, pulmonary edema, heart failure can lower plasma concentration of water soluble drugs V d predicts drug distribution in body low V d drugs medium V d drugs high V d drugs Clearance (CL) CL = (rate of elimination of drug) / (plasma drug concentration) = V d * K e K e = elimination constant CL relates the rate of elimination to the plasma concentration Half-Life (t 1/2 ) t 1/2 = (0.7 * V d )/CL half-life is time required for amount of drug to fall to 50% of an earlier measurement during elimination or during constant infusion a drug infused at a constant rate reaches about 94% of steady state after 4 half lives for drugs eliminated by first-order kinetics, half-life is constant regardless of concentration Bioavailability (F) bioavailability is the fraction of administered dose that reaches systemic circulation bioavailability is defined as unity, or 100%, in case of IV administration bioavailability of drug administered by other routes is generally reduced by incomplete absorption, first-pass metabolism, and any distribution into other tissues that occurs before the drug enters systemic circulation e.g., orally, F = percent that is absorbed and survives first-pass metabolism in liver Calculation of bioavailabillity (F) = 100% * (AUC-oral * Dose-IV) / (AUC-IV * Dose-oral), where AUC is the area under the curve of a pharmacokinetic plasma concentration versus time plot delayed release formulations will have slower rise and lower peak compared with rapid release formulations

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10.1016/s0022-3476(95)70178-8 J Pediatr

Tumor-related fungi and crosstalk with gut fungi in the tumor microenvironment