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The first-pass hepatic metabolism of a number of important therapeutic agents is inconsistent with traditional models that assume that the hepatic extraction ratio of a drug is constant in each individual (independent of the concentration of drug in the hepatic sinusoidal blood and also independent of the history of exposure to the drug). In this review, the authors examine the first-pass metabolism of five "problematic drugs" (propranolol, lidocaine, propafenone, verapamil, and nitroglycerin). Each of these compounds has unique facets to its hepatic clearance and pharmacokinetics as well as striking similarities. Selected aspects of first-pass metabolism are reviewed, and a theory that may explain some of the unusual behavior of the four lipophilic bases (propranolol, lidocaine, propafenone, and verapamil) is presented. Finally, the unusual and variable clearance of nitroglycerin is discussed. D Lalka, RK Griffith, and CL Cronenberger

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15y ago
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11y ago

First pass metabolism is when some substance (usually a drug) is altered before it can reach its site of action.

Often, drugs that are taken orally are brought by the digestive system into the hepatic portal vein into the liver, which does lots of metabolism. If the same drug could have been administered intravenously (that is, through an injection or line), it would not undergo first pass metabolism because it has bypassed the liver to get into circulation. Eventually, the drug will probably be completely metabolized either way, it's just that the oral route reaches circulation more metabolized than something injected.


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11y ago

the effect after 1st pass effect which is undergone by beta glucoronidase enzyme in small intestine .

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13y ago

If the liver biotransforms the drug extensively into an inactive form, its availability in bioactive form would be greatly reduced before it reaches its site of action

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12y ago

It means the phase of Pharmacokinetic in whic drug has to passed to liver where it is biotranformed or Metabolized and concentration of drug reduced to its orignal concentration.

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Q: What is first pass metabolism?
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What is the difference between first pass and phase one of drug metabolism?

First pass metabolism refers to the metabolism of a drug that occurs in the liver after it is absorbed from the gastrointestinal tract, before it enters systemic circulation. Phase 1 metabolism is the initial biotransformation of a drug, primarily carried out by enzymes such as cytochrome P450, to make the drug more polar and easier to eliminate from the body.


What is first-pass metabolism?

First pass metabolism is when some substance (usually a drug) is altered before it can reach its site of action.Often, drugs that are taken orally are brought by the digestive system into the hepatic portal vein into the liver, which does lots of metabolism. If the same drug could have been administered intravenously (that is, through an injection or line), it would not undergo first pass metabolism because it has bypassed the liver to get into circulation. Eventually, the drug will probably be completely metabolized either way, it's just that the oral route reaches circulation more metabolized than something injected.


What will happen to the drug after first pass elimination when taken orallyWill the concentration of the drug decrease?

Depending on the drug, first pass can have a major influence on it's fraction reaching systemic circulation. F = fa x fg x fh Essentially the fraction reaching the systemic circulation or bioavailability (F) is influenced by fa - absorption from intestine, fg = fraction escaping metabolism in the gut, and fh = fraction escaping the first pass (metabolism) by the liver carried via the portal vein. The amount of drug reaching the systemic circulation (bioavailable) can be drastically reduced by first pass. When talking concentration, we can only measure the blood, so the amount reaching could be less.


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What is the medical term meaning liver's function of filtering newly introduced drugs or toxins before the blood is returned to the rest of the body?

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What is 'first pass mechanism' in pharmacology?

In pharmacology, the first-pass mechanism refers to the initial metabolism of a drug in the liver before it reaches systemic circulation. This process can significantly reduce the bioavailability of the drug, meaning less of the drug reaches its target site in the body. It is an important consideration when determining drug dosage and route of administration.


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The effect of decreased albumin concentration on drug absorption is that it may cause first-pass metabolism. This may increase gastric pH levels as well.Ê


How route of administration drug can control bioavailability drug?

The route of administration of a drug can affect its bioavailability by influencing factors such as first-pass metabolism, absorption rate, and drug stability. For example, intravenous administration bypasses the first-pass metabolism, leading to higher bioavailability compared to oral administration where the drug may be metabolized before reaching the systemic circulation. Additionally, different routes can also affect the onset of action and duration of drug effects.


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