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scottyboy218 OP t1_j2kjdr5 wrote

Let's say target organ is the liver. Couldn't that be handled numerous ways (injested, injected, orally, rectally, vaginally?) I'm thinking of all the ways that people can administer alcohol into their systems.

Do pharma companies evaluate all those methods when testing a drug intended to target the liver?

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Kingjoe97034 t1_j2kkdx7 wrote

They would love to deliver it the way that is most likely to be done correctly and most welcomed by the patients and doctors. That’s oral pills. They’ve come up with clever ways to do slow release that is protected from the stomach but absorbed in the intestines, for some drugs. Then it has to be protected from degrading enzymes so it stays in the blood or liver at the right level the longest before another pill is needed. Then the degradation products have to be harmless.

When a drug can’t be designed for this, you end up with things like multiple pills per day, or injections, or liquids, or patches, or nasal sprays, or rectal suppositories. Sometimes a patch is best because it can be slow release.

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CardiOMG t1_j2kjnw9 wrote

The answer is no, they don’t. Those modalities are tested and approved by the FDA individually.

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IamBatma t1_j2mhmdc wrote

Most drugs have a delivery dependent on molecule type. Most „small molecules“ are delivered orally as they can pass through the intestinal walls and are not denatured whereas big molecules (for example antibodies) would be denatured in the gut and hence rendered useless which means they are generally injected. Another thing to consider is pharma cocinnetics but in the end you will never be able to use a big molecule drug in a pill to be swallowed

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nothingtoseehere____ t1_j2mad3o wrote

No, the FDA does not run these tests. They'd have to pay for them then, rather than get the company to do them and pay for them.

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CardiOMG t1_j2mmesf wrote

I meant tested (by the companies) and then approved (by the fda). I know lol.

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arettker t1_j2nm6cq wrote

Oral is the most effected for reaching the liver. All those other administration techniques skip first pass metabolism which means they’ll go everywhere in the body THEN then liver while oral admin will go mouth>stomach>intestines>liver> rest of body

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Leica--Boss t1_j2nniy2 wrote

There's not typically a problem with the pharmacokinetics, where additional benefit can potentially be extracted from alternative delivery methods. If the oral route works, that's almost always the best way to go.

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