Excretion

a. Excretion is the process of eliminating a drug or its metabolites from the body. The major organ of excretion is the kidney. Secondary routes of excretion are hepatic (liver), through the bile into the feces, lungs, saliva, sweat, and breast milk.

b. The inability of a patient to excrete drugs and other waste can be life threatening. The elimination of drugs through sweat, saliva, and the lungs is of minor interest in this subcourse. Of course, the excretion of drugs in breast milk is of concern to mothers who breast-feed their infants. As a rule, drugs that are weakly basic are more likely to be excreted in breast milk, because the milk is slightly acidic; therefore, the basic drugs are more soluble in breast milk.

c. Patients who have limited liver and kidney function usually require lower doses of medication. This is because more of the drug tends to stay in the body.

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