Mechanisms of Multiple Peak Phenomenon in the Plasma Profile of Drugs Following Oral Administration

경구투여된 약물의 혈장중 농도곡선에 나타나는 다중피크 현상의 해석

There are many drugs reproted to show unusual pharmacokinetic behavior by producing a significant secondary peak in the plasma concentration-time curve after oral administration. The drugs are ranitidine, cimetidine, acetaminophen, aspirin, furosemide, bumetanide, piretanide, veralipride, sobrerol, penicillamine and doxycycline etc. Enterohepatic circulation-, two absorption site-, biphasic gastric emptying-, tissue deposition- and multi-fraction absorption theories have been suggested for the mechanisms of this phenomenon. Here, the theories were reviewed and critisized for their validity as a possible mechanism of the multiple peak phenomenon.