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A comprehensive overview of first pass metabolism, a crucial concept in pharmacokinetics. It explains the process, its impact on drug bioavailability and efficacy, and factors influencing its extent. The document delves into drug-specific factors, enzyme activity, individual variations, and attributes of drugs with high first pass metabolism. It also highlights the importance of understanding first pass metabolism for drug dosing and interactions.
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First Pass (Presystemic) Metabolism Definition : First pass metabolism (also called presystemic metabolism) refers to the process by which a drug is metabolized in the liver and intestinal wall before it reaches the systemic circulation. This occurs primarily after oral administration, but also in other routes like transdermal (skin) and pulmonary (lungs). Pharmacokinetics of First Pass Metabolism: