Clearance and metabolism factors

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Drug Choice

⁃Describe toxicities that are specific to:

⁃1) Drug Class

⁃2) Individual Drug

Drug Exposure Across Time (Dt)

⁃Factors that increase (Dt) will increase the risk of toxicity. These will include:

⁃1) Increased or Additive Dosing from the same class of drugs

⁃2) Duration and Frequency of Exposure

⁃3) Decreased Hepatic Clearance

⁃4) Decreased Renal Elimination

Patient Variabilities

⁃For drugs that require hepatic metabolism

⁃1) Neonates and patients with hepatic failure have decreased hepatic enzyme activity

⁃2) Elderly and patients with cardiac failure have decreased cardiac output and decreased hepatic blood flow

⁃For drugs that require renal elimination

⁃1) Neonates and patients with renal failure have decrease renal blood flow

⁃Pathological and Genetic factors may increase toxicity

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