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Volume of Distribution (Vd)

Definition

The apparent volume in which a drug is distributed in the body, calculated as dose divided by plasma concentration at time zero. Low Vd (<0.5 L/kg) means the drug stays largely in plasma; high Vd (>3 L/kg) means extensive tissue binding. Vd governs how a drug behaves in post-mortem redistribution.

Low Vd threshold
Below 0.5 L/kg means the drug stays largely in plasma
High Vd threshold
Above 3 L/kg indicates extensive tissue binding
Clinical significance
Vd governs how a drug behaves in post-mortem redistribution

Common questions

What does a high volume of distribution tell you about a drug?+

A high Vd (above 3 L/kg) means the drug is binding extensively to tissues beyond the bloodstream. This indicates a lipophilic (fat-soluble) drug that concentrates in tissues rather than staying in plasma. It's particularly pronounced in obese individuals.

How is volume of distribution calculated?+

Vd is calculated as the dose divided by the plasma concentration at time zero. This gives the apparent volume into which a drug has distributed throughout the body. It's a theoretical volume, not a measurable anatomical space.

Why does body composition matter for volume of distribution?+

Lipophilic drugs preferentially distribute into fatty tissues. In obese subjects, the same drug dose reaches a higher Vd because it has more fat to bind to. Lean subjects show lower Vd for the same drug, resulting in higher plasma concentrations.

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