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MEDICAL ANIMATION TRANSCRIPT: Medication absorption is the movement of a drug from its site of administration into the blood. Oral drugs enter the stomach where they either dissolve and pass through the cell membranes of epithelial cells lining the stomach or travel undissolved through the stomach to the small intestine, which is the most common site of absorption. Here, drugs dissolve and pass through the intestinal wall. Oral drugs then travel through the portal venous system to the liver, where they undergo the first pass effect. During this process, the liver metabolizes some of the drug, either inactivating it or excreting it into bile for elimination from the body. The remaining amount of active drug leaves the liver and reaches general circulation and target organs. If a drug is administered via intravenous injection, it passes directly into the bloodstream, thus bypassing absorption in the GI tract. If administered through intramuscular or subcutaneous injection, the drug enters either muscle or subcutaneous tissue, where it passes through gaps between cells into capillary walls and then into general circulation or target organs, also bypassing absorption in the GI tract. Bioavailability is the net amount of a dose of a drug that is actually absorbed into the bloodstream. The bioavailability of oral drugs is less than 100% because of the first pass effect of the liver. In contrast, the bioavailability of IV drugs is 100% because they are not exposed to the first pass effect of the liver. Different drug formulations alter bioavailability, because they are not absorbed at the same rate or to the same extent. For example, tablets dissolve at varying rates. Enteric coated drugs dissolve in the small intestine, not the stomach. Because gastric emptying time differs between individuals, absorption times also vary. Sustained release formulas contain tiny spheres that dissolve at different rates, resulting in a steady drug release throughout the day, but also resulting in variable absorption. Some factors affecting drug absorption are the rate of dissolution. Drugs that dissolve faster are absorbed faster. Surface area, since the lining of the small intestine has more surface area than the lining of the stomach, most drugs are absorbed faster in the small intestine. Blood flow, the greater the concentration gradient between the drug-filled stomach and the rapidly flowing drug-free blood, the faster the absorption. Lipid solubility, highly lipid soluble drugs pass through the phospholipids in the cell membrane more easily than drugs of low lipid solubility. And PH partitioning, absorption is faster when the difference between the PH at the site of administration and the PH of the plasma attracts more drug molecules to ionize in the plasma. ♪ [music] ♪
"Thank you very much for the great work on the medical exhibits. Our trial
resulted in a $16 million verdict for a 9 year old boy with catastrophic
injuries, and the medical illustrations definitely played key role in the
trial."
David Cutt
Brayton Purcell
Salt Lake City, UT
"[Your staff] was extremely efficient, cooperative and gracious and [their]
efforts produced a demonstrative exhibit that we used effectively throughout
our trial. The jury verdict of $3,165,000.00 was, in no small measure, due
to the impact of the demonstrative evidence. You may be sure that we will
call again."
David J. Dean
Sullivan Papain Block McGrath & Cannavo, P.C.
New York, NY
"Medical Legal Art wins our firm's highest accolades for professionalism and
exhibit quality. In fact, many of the doctors I work with request color
copies of your outstanding artwork to show to patients during the informed
consent process."
Jeanne Dolan, BSRN, AlNC Legal Nurse Consultant Golden Valley, MN
"Whether it's demonstrating a rotator cuff tear, neck movement a few
milliseconds after rear impact, or a proposed lumbar fusion, the Doe Report
represents an instant on-line database of medical illustration for
health-care and legal professionals.
Illustrations can be purchased 'as is' or modified within hours and sent
either electronically or mounted on posterboard. An illustration is worth a
thousand words, as juries perk up and look intently to capture concepts
that are otherwise too abstract. Start with good illustrations, a clear and
direct voice, a view of the jury as 12 medical students on day one of
training, and your expert testimony becomes a pleasure, even on cross
examination. An experienced trial lawyer should also emphasize these
illustrations at the end of trial, as a means of visually reinforcing key
concepts covered.
As a treating physician, I also use these accurate illustrations to educate
my own patients about their medical conditions. The Doe Report is an
invaluable resource, and its authors at MLA have always been a pleasure to
work with."
Richard E. Seroussi M.D., M.Sc.
Diplomate, American Boards of Electrodiagnostic Medicine and PM&R
Seattle Spine & Rehabilitation Medicine
www.seattlespine.info
Medical Legal Art creates medical demonstrative evidence (medical
illustrations, drawings, pictures, graphics, charts, medical animations,
anatomical models, and interactive presentations) for use during legal
proceedings, including research, demand letters, client conferences,
depositions, arbitrations, mediations, settlement conferences, mock jury
trials and for use in the courtroom. We do not provide legal or medical
advice. If you have legal questions, you should find a lawyer with whom you
can discuss your case issues. If you have medical questions, you should seek the advice of a healthcare provider.