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However, the majority of drugs are too large to diffuse in this way. Many nutrients and a few drugs can pass across the cell membrane by facilitated diffusion. In this case, in addition to the concentration gradient, a membrane protein acts as a carrier to transport a substance from one side of the membrane to the other. Carrier proteins are specific and only transport molecules that they recognize. Glucose enters many body cells by facilitated diffusion and the process appears to be more efficient than simple diffusion. Carrier systems exist for the transport of some amino acids and vitamins and the same carrier can transport drugs that are structurally similar to them.

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At extremes of life absorption, distribution, metabolism and excretion can all be different to normal so that drug action becomes unpredictable. In particular, plasma protein binding, liver and kidney function and the number of drugs being taken concurrently become important in older patients. Special care is needed when prescribing for infants and children and drug use should be avoided if possible in pregnancy and breast feeding. In order to have a therapeutic effect, a drug has to interact with a receptor or other site of action in the body.

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The lungs are adapted for absorption of oxygen having a large surface area for diffusion and a good blood supply. Particle size is a major determinant of absorption from this site of administration. Small particle size favours systemic absorption whereas large particle size discourages absorption into the systemic circulation. A drug commonly given by inhalation for a local effect is salbutamol, used to treat asthma. Many general anaesthetics are given in gaseous form clearly intended to have a cheapest genuine cialis online effect. Drugs can also be given by injection.

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