The above figure represents the accumulation/distribution (A/D) comparison chart of a stock for a period. Hence, based on the supply and demand pressure of a stock, one can predict the stock’s future price trend. The term “accumulation” denotes the level of buying (demand), and “distribution” denotes the level of selling (supply) of a stock. The accumulation distribution indicator (AD) or accumulation distribution line is a volume-based indicator used to determine the trend of a stock, using the relation between the stock’s price and volume flow. Clin Pharmacol Ther 2002 71: 115-121.Updated OctoWhat is the Accumulation/Distribution Indicator (A/D)? Changes in plasma protein binding have little clinical relevance. Drug-drug interactions with tyrosine-kinase inhibitors: a clinical perspective.
van Leeuwen RW, van Gelder T, Mathijssen RH, Jansman FG.Next page: More about the metabolism process References Clinical Relevanceĭrug interactions associated with distribution are not usually clinically relevant, and they are most likely to be the consequence of metabolism rather than changes in plasma binding. 1 However, the available evidence to support this is low quality. 2 Distribution of Tyrosine Kinase InhibitorsĪll kinase inhibitors are moderately to highly plasma protein bound and, as such, are susceptible to drug interactions when co-administered with other protein-bound agents. 2 However, the effect of drug displacement is difficult to determine because an increase in unbound drug makes more drug available for its biological target and also increases the amount of drug available for elimination. 2 Drug Displacement from Protein-Binding Sitesĭisplacement of bound drug from blood components or tissue-binding sites is thought to increase the apparent volume of distribution of the drug. 1 The unbound drug is biologically active because it can exert its pharmacological effect, while plasma protein binding limits the activity of the bound drug. 1,2 If two highly plasma protein-bound drugs are co-administered, one drug can displace the other from its protein binding site and cause an increased concentration of the unbound drug. The distribution of a drug following absorption is determined by blood flow and the binding to plasma proteins, including albumin, α-1-acid-glycoprotein (AGP), lipoproteins and immunoglobulins.
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