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Evaluation of the clinical significance of the first-pass effect of verapamil in patients

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Methods in Clinical Pharmacology

Part of the book series: Methods in clinical pharmacology ((MECLPH,volume 1))

Abstract

It has long been known that the hepatic clearance of drugs with high hepatic extraction ratios is largely determined by liver blood flow. Indeed, several such compounds, including bromosulphthalein and indocyanine green, were intensively investigated as indicators for measuring liver blood flow. Interest in this type of compound has been rekindled with the introduction of several therapeutic agents which are also avidly extracted by the liver, notable examples being lidocaine and propranolol. In addition to their elimination being effected by liver blood flow, it is now recognised that highly extracted drugs must undergo significant presystemic (or first pass) metabolism during their passage from the gut to the systemic circulation as a result of the anatomic arrangement of the hepatic portal circulation, even when gastrointestinal absorption is complete [11].

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Author information

Authors and Affiliations

  1. Department of Clinical Pharmacology, University Clinic, Frankfurt a. M., Germany

    Barry George Woodcock

  2. Schloßparkklinik, Berlin, Germany

    Hans Friedrich Vöhringer

Authors
  1. Barry George Woodcock
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  2. Hans Friedrich Vöhringer
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Editor information

Editors and Affiliations

  1. Abteilung für klinische Pharmakologie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main, Germany

    Norbert Rietbrock

  2. Department of Clinical Pharmacology, University Clinic, Frankfurt/Main, Germany

    Barry G. Woodcock

  3. Berlin, Germany

    Günter Neuhaus

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© 1980 Springer Fachmedien Wiesbaden

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Woodcock, B.G., Vöhringer, H.F. (1980). Evaluation of the clinical significance of the first-pass effect of verapamil in patients. In: Rietbrock, N., Woodcock, B.G., Neuhaus, G. (eds) Methods in Clinical Pharmacology. Methods in clinical pharmacology, vol 1. Vieweg+Teubner Verlag, Wiesbaden. https://doi.org/10.1007/978-3-663-14027-6_31

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  • DOI: https://doi.org/10.1007/978-3-663-14027-6_31

  • Publisher Name: Vieweg+Teubner Verlag, Wiesbaden

  • Print ISBN: 978-3-528-07902-4

  • Online ISBN: 978-3-663-14027-6

  • eBook Packages: Springer Book Archive

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