RLO: Clinical impact of changes in drug clearance

Introduction

The clinical impact of a drug is influenced by the total body clearance of the drug, which is itself affected by several factors.

The rate at which a drug is cleared from the body is important clinically as it impacts on how long the active drug is present in the patient's system. A decrease in drug clearance will mean that more active drug is present in the body for longer, which could lead to the patient developing side effects. This is particularly true for drugs which have a narrow therapeutic index, such as theophylline. On the other hand, an increase in drug clearance results in the active drug being present in the patient's system for a shorter period of time and might result in a decrease in therapeutic effect.

The rate of total body drug clearance is influenced by a number of factors including age, disease, genetic influences, environmental influences and drug-drug interactions, some of which will be discussed here.

 

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