Paper I
2013 April (2010 Scheme) · 40 marks · 180 min

Question

Kinetics of elimination

Q53 marksShort Notes

Answer

Elimination of drugs follows one of two kinetic patterns:

First-order kinetics

  • A constant fraction of the drug is eliminated per unit time
  • Rate of elimination is proportional to plasma drug concentration
  • Plasma concentration falls exponentially with time; a semilog plot of concentration vs. time is linear
  • Has a constant half-life (t½), independent of dose/concentration
  • Most drugs at therapeutic doses follow first-order kinetics

Zero-order kinetics

  • A constant amount of drug is eliminated per unit time, independent of plasma concentration
  • Occurs when the elimination pathway (usually an enzyme) is saturated
  • Plasma concentration falls linearly with time
  • Half-life is not constant — it increases with dose
  • Examples: Phenytoin, Ethanol, Aspirin (at high/toxic doses)

Clinical significance

  • Drugs with zero-order kinetics show disproportionate rise in plasma levels with small dose increments, making dose titration critical and toxicity more likely (e.g., phenytoin)

Other Years Asked


Revise MBBS
Preview