[The metabolism of drugs. Influence of protein-energy malnutrition]. 1985

C Hazane, and M Jalabert, and J L Saubion

The progress of a drug through human body depends not only on the inherent factors of the drug and on its formulation but also on individual physio pathological variations such as nutritional status. Pharmacokinetics of drug depend on 4 main stages (absorption, distribution, metabolisation and excretion) as showed by the serum concentrations curve or by renal elimination function of the time. Thanks to these curves one can deduce parameters currently in use. The mechanism of each of these stages is discussed and their modifications are studied in Protein Energy Malnutrition (P.E.M.). In the P.E.M. (especially in the case of child kwashiorkor) these pharmacokinetic parameters can be modified following perturbations in hydro-mineral balance, gastro-intestinal renal, hepatic functions, but principally following perturbations of the plasmatic proteins. Some of these diminish (R.B.P., albumin, prealbumin) and others increase (alpha glycoprotein acid, C reactive protein, haptoglobin, gamma globulins). Generally speaking the binding between a drug and plasmatic proteins is lowered increasing the non-bound drug quantity, the latter is more easily eliminated thus lowering the half-life of the drug provided the hepatic and renal functions are not too seriously damaged. Clinical consequences are discussed.

UI MeSH Term Description Entries
D007700 Kinetics The rate dynamics in chemical or physical systems.
D007732 Kwashiorkor A syndrome produced by severe protein deficiency, characterized by retarded growth, changes in skin and hair pigment, edema, and pathologic changes in the liver, including fatty infiltration, necrosis, and fibrosis. The word is a local name in Gold Coast, Africa, meaning "displaced child". Although first reported from Africa, kwashiorkor is now known throughout the world, but mainly in the tropics and subtropics. It is considered to be related to marasmus. (From Dorland, 27th ed) Kwashiorkors
D011502 Protein-Energy Malnutrition The lack of sufficient energy or protein to meet the body's metabolic demands, as a result of either an inadequate dietary intake of protein, intake of poor quality dietary protein, increased demands due to disease, or increased nutrient losses. Marasmus,Protein-Calorie Malnutrition,Malnutrition, Protein-Calorie,Malnutrition, Protein-Energy,Malnutritions, Protein-Energy,Protein Calorie Malnutrition,Protein Energy Malnutrition
D001798 Blood Proteins Proteins that are present in blood serum, including SERUM ALBUMIN; BLOOD COAGULATION FACTORS; and many other types of proteins. Blood Protein,Plasma Protein,Plasma Proteins,Serum Protein,Serum Proteins,Protein, Blood,Protein, Plasma,Protein, Serum,Proteins, Blood,Proteins, Plasma,Proteins, Serum
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004364 Pharmaceutical Preparations Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. Drug,Drugs,Pharmaceutical,Pharmaceutical Preparation,Pharmaceutical Product,Pharmaceutic Preparations,Pharmaceutical Products,Pharmaceuticals,Preparations, Pharmaceutical,Preparation, Pharmaceutical,Preparations, Pharmaceutic,Product, Pharmaceutical,Products, Pharmaceutical
D006207 Half-Life The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. Halflife,Half Life,Half-Lifes,Halflifes
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000042 Absorption The physical or physiological processes by which substances, tissue, cells, etc. take up or take in other substances or energy.
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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