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Related Concept Videos

Drug Distribution: Volume of Distribution01:25

Drug Distribution: Volume of Distribution

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The volume of distribution refers to the theoretical volume necessary to contain the entire amount of an administered drug at the same concentration observed in the blood plasma. The body's intracellular fluid compartment, which makes up two-thirds of the total body water, is contrasted with the extracellular fluid compartment—comprising plasma and interstitial fluid—that accounts for one-third. The volume of distribution can vary depending on the characteristics of the drug.
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Drug Distribution: Overview01:11

Drug Distribution: Overview

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Drug distribution within the body is a dynamic process involving the movement of a drug in two directions across various compartments: from the bloodstream into tissues (tissue uptake) and from tissues back into the bloodstream (tissue release or redistribution). This process is passive and primarily driven by two variables: the concentration gradient between the bloodstream and the extravascular tissues and the drug's ability to cross the cell membrane.
Initially, the free drug in the...
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Drug Distribution: Tissue Binding01:21

Drug Distribution: Tissue Binding

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Upon entering the systemic circulation, drugs can distribute into the interstitial and intracellular fluid of various tissue cells. This distribution is facilitated by the binding of drugs to different cellular components within tissues, which may lead to drug accumulation in specific areas. Drugs bound to tissue components serve as reservoirs that release free drugs back into the system, prolonging the drug's overall action. However, this accumulation can also result in local toxicity.
For...
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Drug Distribution as One-Compartment Model and Elimination by Nonlinear Pharmacokinetics: Overview01:25

Drug Distribution as One-Compartment Model and Elimination by Nonlinear Pharmacokinetics: Overview

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Drug administration can occur through various routes, each of which may result in a different process of elimination. This process is often mixed with nonlinear and linear processes. It's important to understand that a single drug can be metabolized into different metabolites through parallel processes.
For instance, consider the metabolism of sodium salicylate. This compound is metabolized into two distinct substances: a glucuronide and a glycine conjugate. The rate of conjugation depends...
381
Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions01:09

Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions

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Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
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Drug Distribution: Plasma Protein Binding01:29

Drug Distribution: Plasma Protein Binding

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Drugs predominantly attach to plasma proteins, with only a small percentage remaining unbound. The unbound portion can be calculated as one minus the bound fraction. Acidic drugs form large, inactive complexes by reversibly binding to plasma albumin, which prevents them from diffusing across biological barriers. These drug-protein complexes act as reservoirs for the drugs. As the concentration of unbound drugs decreases, these complexes quickly dissociate to release the free drug, maintaining...
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Analysis and Specification of Starch Granule Size Distributions
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Financial Effect of a Drug Distribution Model Change on a Health System.

Erin M Turingan1,2, Bijan C Mekoba1,2, Samuel M Eberwein1,2

  • 1University of North Carolina Medical Center, NC, USA.

Hospital Pharmacy
|December 26, 2017
PubMed
Summary

Manufacturer drug distribution changes increased health system costs. Shifting inpatient administrations to outpatient settings could offset these expenses, particularly for bevacizumab, rituximab, and trastuzumab.

Keywords:
drug formulariesdrug utilization reviewformulary committeehospital drug distribution systemshospital financial managementhospital formulary

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Area of Science:

  • Health economics
  • Pharmaceutical distribution
  • Oncology drug management

Background:

  • Drug manufacturers alter distribution models impacting medication access and health system finances.
  • Changes from open to limited distribution can significantly affect healthcare providers.

Purpose of the Study:

  • To quantify the financial impact of limited distribution for bevacizumab, rituximab, and trastuzumab on health systems.
  • To identify opportunities for shifting drug administration to outpatient settings.

Main Methods:

  • Financial impact assessed by applying cost minus discount to total drug expenditure over one year.
  • Opportunity analysis involved chart reviews of inpatient administrations to calculate opportunity cost.
  • Opportunity cost included inpatient administration costs and outpatient administration margins.

Main Results:

  • Total drug expenditure reached $26,427,263 during the study period.
  • The distribution model change resulted in a financial effect of $1,393,606.
  • 387 administrations were identified as shiftable to outpatient settings, with a total opportunity cost of $1,766,049.

Conclusions:

  • Drug distribution model changes led to increased health system expenditure due to lost cost-minus-discount.
  • Shifting inpatient administrations to outpatient settings can mitigate increased drug expenditure.
  • Restricting bevacizumab, rituximab, and trastuzumab to outpatient use is recommended where clinically appropriate.