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By Craig C. R., Stitzel R. E.

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The lower renal plasma flow in the newborn also may decrease the glomerular filtration of drugs. 41 back-diffusion occurs primarily in the distal tubules and collecting ducts, where most of the urine acidification takes place. Since it is the un-ionized form of the drug that diffuses from the tubular fluid across the tubular cells into the blood, it follows that acidification increases reabsorption (or decreases elimination) of weak acids, such as salicylates, and decreases reabsorption (or promotes elimination) of weak bases, such as amphetamines.

Segal MB. The Barriers and Fluids of the Eye and Brain. Boca Raton, FL: CRC, 1989. Tillement J-P and Lindenlaub E (eds). Protein Binding and Drug Transport. New York: Liss, 1987. Zhang Y and Benet LZ. The gut as a barrier to drug absorption: combined role of cytochrome P4503A and p-glycoprotein. Clin Pharmacokinet 2001;40:159–168. 3 Drug Absorption and Distribution Case Study 33 Improving Drug Absorption A 47-year-old man recently received a heart transplant and is being discharged home with oral medications, including cyclosporine.

Thus, the efficient retention of proteins within the circulation is attributed to a combination of factors, including their globular structure, their large molecular size, and the magnitude of their negative charge. Factors that affect the glomerular filtration rate (GFR) also can influence the rate of drug clearance. For instance, inflammation of the glomerular capillaries may increase GFR and hence drug filtration. Most drugs are at least partially bound to plasma proteins, and therefore their actual filtration rates are less than the theoretical GFR.

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