The effect of protein-binding interactions

Drugs may bind, to a greater or lesser extent, to macromolecules found in the blood. The resulting drug-macromolecule complex is too large for 

The general equation that expresses the apparent volume of distribution at steady state V as a function of its contributing parameters is  

hepatic extraction ratio CIh, hepatic clearance from plasma lolol drug concentration at steady state (0,), concentration of unbound (free) drug at steady state I, reduction f, increase no change. 

From this equation, we can see that the degree to which an increase in the fraction of drug unbound in the plasma will tend to increase a drug s apparent volume of distribution is dependent on the size of the ratio of the fraction of drug unbound in the plasma to the fraction unbound in the tissues ifupifut)- For the case of a drug with a small volume of distribution, this ratio is small. 

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