Abstract
The utility of clearance (CL) as the parameter to relate rate of elimination to measured drug concentration is now well established in pharmacokinetics. The concept of clearance was first proposed by Möller et al. (1) to characterize the handling of urea by the kidney, and subsequently applied to quantitate the removal of substances by the liver, gastrointestinal tract and other eliminating organs. Today, clearance measurements are used to assess organ function, to predict steady-state concentrations following constant rate regimens, to predict the degree of hepatic first-pass loss of orally administered drug, and to assess the extent of drug absorption (2,3). The application of clearance concepts in pharmacokinetics has come with the measurement of concentrations of drug and metabolites in plasma and blood.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
E. Müller, J.J. Mcintosh and D. Van Slyke, Studies of urea excretion, J. Clin. Invest. 6: 427–446 (1929).
M. Rowland, L.Z. Benet and G.G. Graham, Clearance concepts in pharmacokinetics, J. Pharmacokin. Biopharm. 1: 123–126 (1973).
M. Rowland, Effect of some physiological factors on bioavailability of oral dosage forms, in: “Current Concepts in the Pharmaceutical Sciences: Dosage Form Design and Evaluation,” J. Swarbrick, ed., Lea and Febiger, Philadelphia (1973), pp. 182–230.
D. Cutler, A linear recirculatory model for drug disposition, J. Pharmacokin. Biopharm. 7: 101–116 (1979).
K. Cassidy and B. Houston,In vivoassessment of extrahepatic conjugative metabolism in first-pass effects using the model compound phenol, J. Pharm. Pharmacol. 32: 57–59 (1980).
J.A. Jansen, Influence of plasma protein binding kinetics on hepatic clearance assessed from a “tube” model and a “well-stirred” model, J. Pharmacokin. Biopharm. 9: 15–25 (1981).
T.N. Tozer, Concepts basic to pharmacokinetics, Pharmac. Therap. 12: 109–132 (1981).
R.W. Brauer, G.F. Leung, R.F. McElroy Jr. and R.H. Holloway, Circulatory pathways in the rat liver as revealed by P32 chromic phosphate colloid uptake in the isolated perfused liver preparation, Am. J. Physiol. 184: 593–598 (1956).
S. Keiding and P.B. Andreasen, Hepatic clearance measurements and pharmacokinetics, Pharmacology 19: 105–110 (1979).
K.B. Bischoff and R.L. Dedrick, Thiopental pharmacokinetics, J. Pharm. Sci. 57: 1346–1351 (1968).
K.S. Pang and M. Rowland, Hepatic clearance of drugs. I. Theoretical considerations of a “well-stirred” and a “parallel tube” model. Influence of hepatic blood flow, plasma and blood binding and hepatocellular enzyme activity on hepatic drug clearance, J. Pharmacokin. Biopharm. 5: 625–653 (1977).
G.R. Wilkinson and D.G. Shand, Commentary: A physiological approach to hepatic drug clearance, Clin. Pharmacol. Ther. 18: 377–390 (1975).
K.J. Himmelstein and R.J. Lutz, A review of the applications of physiologically based pharmacokinetic modeling, J. Pharmacokin. Biopharm. 7: 127–145 (1979).
K. Winkler, L. Bass, S. Keiding and N. Tygstrup, The effect of hepatic perfusion on assessment of kinetic constants, in: “Regulation of Hepatic Metabolism,” L. Lundquist and N. Tygstrup, eds., 6th Alfred Benzon Symposium, Munksgaard, Copenhagen (1974), pp. 797–807.
B. Mannervik, Design and analysis of kinetic experiments for discrimination between rival models, in: “Kinetic Data Analysis,” L. Endrenyi, ed., Plenum Press, New York (1981), pp. 235–270.
K.S. Pang and M. Rowland, Hepatic clearance of drugs. II. Experimental evidence for acceptance of the “well-stirred” model over the “parellel tube” model using lidocaine in the perfused rat liverin situpreparation, J. Pharmacokin. Biopharm. 5: 655–679 (1977).
D.G. Shand, D.M. Kornhauser and G.R. Wilkinson, Effects of route of administration and blood flow on hepatic elimination, J. Pharmacol. Exp. Ther. 195: 424–432 (1975).
A.B. Ahmad, Ph.D. thesis, University of Bath, England (1982).
S. Keiding and E. Chiarantini, Effect of sinusoidal perfusion on galactose elimination kinetics in perfused rat liver, J. Pharmacol. Exp. Ther. 205: 465–470 (1978).
T.W. Guentert and S. Øie, Effect of plasma protein binding on quinidine kinetics in the rabbit, J. Pharmacol. Exp. Ther. 215: 165–171 (1980).
A.B. Ahmad, P.N. Bennett and M. Rowland, The influence of varying arterial flow contributing to the perfused rat liver on systemic availability of lignocaine, Brit. J. Pharmacol. 74:244P–245P (1981).
R.H. Kardon and R.G. Kessel, Three-dimensional organization of the hepatic microcirculation in the rodent as observed by scanning electron microscopy of corrosion casts, Gastroenterology 79: 72–81 (1980).
K.S. Pang and J.A. Terrell, Retrograde perfusion to probe the heterogeneous distribution of hepatic drug metabolizing enzymes in rats, J. Pharmacol. Exp. Ther. 216: 339–346 (1981).
L. Bass, P. Robinson and A.J. Bracken, Hepatic elimination of flowing substances: the distributed model, J. Theoret. Biol. 72: 161–184 (1978).
F. Kiel, Dynamics of renal proximal tubular secretion, Nature 189: 927–928 (1961).
S. Øie and L.Z. Benet, Altered drug disposition in disease states, Ann. Rep. Med. Chem. 15: 277–287 (1980).
L.G. Wesson, A theoretical analysis of urea excretion by the mammalian kidney, Amer. J. Physiol. 179: 364–371 (1954).
W.L. Shary, Ph.D. thesis, University of Manchester, England (1979).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1984 Plenum Press, New York
About this chapter
Cite this chapter
Rowland, M. (1984). Clearance — Models, Validation and Implications. In: Benet, L.Z., Levy, G., Ferraiolo, B.L. (eds) Pharmacokinetics. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2799-8_13
Download citation
DOI: https://doi.org/10.1007/978-1-4613-2799-8_13
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-9725-3
Online ISBN: 978-1-4613-2799-8
eBook Packages: Springer Book Archive