GasGasGas - The FRCA Primary Exam Podcast Gas Gas Gas - Hepatic Clearance
Sep 10, 2024
Dive into the fascinating world of drug clearance as it explores how the liver clears substances at a kinetic level. Discover the difference between flow-limited and capacity-limited clearance with engaging examples. Learn about the impact of hepatic blood flow on drug accumulation in various clinical states. The episode clarifies the concepts of clearance versus elimination and introduces the nuances of enterohepatic recycling, affecting everything from medications to oral contraceptives. It's a thrilling ride through pharmacology!
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Clearance Is Not The Same As Offset
- Clearance measures how many mLs of blood are completely cleared of a substance per minute and is distinct from drug offset time.
- Volume of distribution and site of action often determine clinical offset more than clearance alone.
Intrinsic Clearance Is Liver Capacity
- Intrinsic clearance is the liver's maximal capacity to metabolise a drug if unconstrained by flow or binding.
- Think of intrinsic clearance as how many 'passengers' the liver station can process per unit time before bottlenecking.
Railway Station Analogy For Clearance
- Dr Gas uses a railway station analogy to visualise intrinsic clearance and saturation.
- The station processes passengers until it bottlenecks, illustrating enzyme capacity limits.