Similarly, the liver is the primary site of biotransformation, yet extrahepatic metabolism takes place in a variety of organ systems affecting multiple drugs. While excretion is primarily carried out by the kidneys, other organ systems are involved as well. It is accomplished in two ways, either by excretion of an unmetabolized drug in its intact form or by metabolic biotransformation followed by excretion. Also other factors include genetic variation among individuals, disease states affecting other organs, and pathways involved in the way the drug distributes through the body, such as first-pass metabolism.ĭrug elimination is the removal of an administered drug from the body. Any significant dysfunction in either organ can result in the accumulation of the drug or its metabolites in toxic concentrations.Ī variety of other factors impact elimination - intrinsic drug properties, such as polarity, size, or pKa. Hydrophilic drugs, on the other hand, can undergo excretion directly, without the need for metabolic changes to their molecular structures.Īlthough many sites of metabolism and excretion exist, the chief organ of metabolism is the liver, while the organ primarily tasked with excretion is the kidney. Hydrophobic drugs, to be excreted, must undergo metabolic modification making them more polar. In the pharmacokinetic ADME scheme (absorption, distribution, metabolism, and excretion), it is frequently considered to encompass both metabolism and excretion. Drug elimination is the sum of the processes of removing an administered drug from the body.
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