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Volume of distribution

 
Wikipedia: Volume of distribution

The volume of distribution (VD) , also known as apparent volume of distribution, is a pharmacological term used to quantify the distribution of a medication between plasma and the rest of the body after oral or parenteral dosing. It is defined as the volume in which the amount of drug would need to be uniformly distributed to produce the observed blood concentration. [1]

Volume of distribution may be increased by renal failure (due to fluid retention) and liver failure (due to altered body fluid and plasma protein binding). Conversely it may be decreased in dehydration.

The initial volume of distribution describes blood concentrations prior to attaining the apparent volume of distribution and uses the same formula.

Contents

Equations

The volume of distribution is given by the following equation:

{V_{D}} = \frac{\mathrm{total \ amount \ of \ drug \ in \ the \ body}}{\mathrm{drug \ blood \ concentration}}

Therefore the dose required to give a certain plasma concentration can be determined if the VD for that drug is known. The VD is not a physiologic value; it is more a reflection of how a drug will distribute throughout the body depending on several physicochemical properties, e.g. solubility, charge, size, etc.

The units for Volume of Distribution are typically reported in (ml or liter)/kg body weight. The fact that VD is a ratio of a theoretical volume to a fixed unit of body weight explains why the VD for children is typically higher than that for adults, even though children are smaller and weigh less. As body composition changes with age, VD decreases.

The VD may also be used to determine how readily a drug will displace into the body tissue compartments relative to the blood:

{V_{D}} = {V_{P}} + {V_{T}} \left(\frac{fu}{fu_{t}}\right)

Where:

  • VP = plasma volume
  • VT = apparent tissue volume
  • fu = fraction unbound in plasma
  • fuT = fraction unbound in tissue

Examples

Further reading: Table of volume of distribution for drugs

Drug VD Comments
Warfarin 8L Reflects a high degree of plasma protein binding.
Theophylline, Ethanol 30L Represents distribution in total body water.
Chloroquine 15000L Shows highly lipophilic molecules which sequester into total body fat.
NXY-059 8L Highly-charged hydrophilic molecule.

Sample values and equations

Variable Abbreviation(s) Example value Formula
Dose (loading dose, or steady state/maintenance) D (LD or MD) 1000 mg =Vd*C0
Volume of distribution Vd 25 L =D/C0
Concentration (initial or steady-state) C0 or Css 40.0 mg/L =D/Vd
Biological half-life T½ 14 hr =0.7/Ke
Elimination rate constant Ke 0.05/hr =0.7/(T½)
=Cl/Vd
Elimination rate,
or rate of infusion to balance elimination
Kin 50 mg/hr =Css*Cl
Clearance Cl 1.25 L/hr =Vd*Ke
Bioavailability F 1 = \frac{[AUC]_{A}*dose_{B}}{[AUC]_{B}*dose_{A}}

Note that the "0.7" constant is a commonly used log approximation, but not the actual value. Another commonly used approximation is 0.693. -(ln(0.5)) = 0.69315.


References

External links


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