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Lipid-soluble drugs may be reabsorbed in this way and as a result, they are eliminated slowly from the body. Metabolism of drugs tends to make them less lipid soluble, more water soluble and therefore more likely to ionize. Tubular filtrate is normally slightly acid and this favours the excretion of basic drugs because they ionize more readily in acidic conditions and therefore do not diffuse easily back into plasma.

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These adverse drug reactions are generally dose-related and most can be predicted. They can be caused by an exaggeration of a drugs intended pharmacological effect or by an unwanted action or side effect. Type A adverse reactions are most likely to occur with drugs that have a steep doseresponse curve andor small therapeutic ratio. The TR of a drug is the ratio of the maximum non-toxic dose to the minimum dose that has a therapeutic effect and is essentially a measure of a drugs safety margin. TR maximum non-toxic doseminimum effective dose The most dangerous drugs are those with a small TR where the maximum non-toxic dose is very close to the effective dose.


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Loprazolam, lormetazepam and temazepam have a shorter duration of action and little or no hangover effect. As a rule, benzodiazepines should be used to treat insomnia only when it is severe, disabling or subjecting the individual to extreme distress.

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Cellular energy in the form of ATP is required to drive the process and transport goes against the concentration gradient. By such a mechanism, substances can be concentrated in certain parts of the body.

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