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Bones:
Tetracycline antibiotics (by forming
complex with calcium) and heavy metals may
accumulate in bone and bone can become a
reservoir for the slow release of toxic agents
such as lead or radium into the blood; their
effects can thus persist long after exposure has
ceased.
Placental transfer of drugs
The transfer of drugs across the placenta is of
critical importance because drugs may cause
anomalies in the developing fetus.
Lipid solubility, extent of plasma binding, and
degree of ionization of weak acids and bases are
important general determinants in drug transfer
across the placenta.
The fetal plasma is slightly more acidic than
that of the mother (pH 7.0 to 7.2 versus 7.4), so
that ion trapping of basic drugs occurs.
The placenta is a barrier to drugs, however, a
number of influx transporters are also present.
The fetus is to some extent exposed to all
drugs taken by the mother.
Volume of distribution
The actual volume in which drug molecules are
distributed within a patient’s body cannot be
measured.
(Units = volume)
- This volume does not necessarily refer to an
identifiable physiological volume but rather to
the fluid volume that would be required to
contain all the drug in the body at the same
concentration measured in the blood or
plasma.
- The plasma volume of a typical 70-kg man is
3 L, blood volume is about 5.5 L, extracellular
fluid volume outside the plasma is 12 L, and
the volume of total-body water is
approximately 42 L. Many drugs exhibit
volumes of distribution far in excess of these
The volume of distribution (Vd) may be defined
as the volume of fluid in which the drug
appears to distribute with a concentration
equal to that in plasma.