Pharmacokinetics is currently defined as the study of the time course of drug absorption, distribution, metabolism, and excretion. Clinical pharmacokinetics is the application of pharmacokinetic principles to the safe and effective therapeutic management of drugs in an individual patient. The primary goal of clinical pharmacokinetics includes enhancing efficiency and decreasing toxicity of a drug therapy.
The development of significant correlations between drug concentration and their pharmacologic responses has enabled clinicians to apply pharmacokinetic principles to actual patient situations. Before achieving a desired therapeutic action of the oral drug, it needs to be administrated and distributed in the human body to finally reach a tissue and be taken up by the target place to exert its therapeutic effect. The process of drug absorption relies on taking it into the bloodstream via digestive tract usually by passive diffusion across membranes. However, it should be emphasized that there are plenty of factors altering drug absorption.
Does it matter?
We need to remember that drug absorption is the first disposition step of a pharmaceutical compound within a human organism. In other words, absorption is one of the criteria, which influences the drug kinetics, and its concentration in the human plasma. Therefore, it affects the compound’s bioavailability and what is more important – a pharmacological activity of the drug. To the factors, which modify the degree of absorption, there should be included: drug solubility, drug dose, gastric emptying time, intestinal transit time, gut inflammation, state of mucous surfaces and much more.
However, what if we are able to increase drug absorption, by altering the composition of gut microbiome?
In theory the better drug absorption is, the higher drug can be concentrated in human plasma. Then, why do we take so great amount of chemical compounds, which after all needs to be eliminated from our body? It is stated in numerous studies, that process of absorption critically determines the compound bioavailability. Gastrointestinal disease may also alter oral dose requirements by producing variation in both the amount and rate of drug absorption. Does it mean that we are able to control and to increase the efficiency of pharmacotherapy by altering the microbiome? How does the process of absorption function while dysbiosis? Should patients with confirmed dysbiosis take the same dose of drugs as usual? Maybe, instead of constantly increasing the drug dose, we should take a look at microbiome condition?
Once again. The principle of our mission is still the same – to better understand microbiome-host interactions and to provide new solutions with proven efficiency of treating method and routine use in clinical practice.