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Distribution. ¿Where do drugs go?
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Volume of distribution
• Apparent and hypothetical volume in which the
drug is dispersed.
Dose
Vd 
Plasma concentrat ion
• Why is it relevant?
• To calculate the loading dose of a drug
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Volume of distribution
Relative size of
various
distribution
volumes within a
70-kg individual
• Plasma: 4 liters.
• Interstitial
volume: 10 liters.
• Intracelullar
volume: 28 liters
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Plasma compartment
• Vd: around 5 L.
• Very high molecular weight
drugs, ordrugs that bind to
plasma proteins excesively
• Example: heparin 4L (3-5)
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Extracellular fluid
Vd: between 4 and
14 L.
Drugs that have a
low molecular
weight but are
hydrophilic.
Example
Atracuronium 11 L
(8-15)
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Vd equal or higher than total body
water
• Diffusion to intracelullar fluid .
Vd equal to total body water.
– Ethanol 38 L (34-41)
– Alfentanyl 56 L (35-77)
• Drug that binds strongly to
tissues. Vd higher than total
body water.
– Fentanyl: 280 L
– Propofol: 560 L
– Digoxin:385 L