Drugs and their metabolites may be excreted through the kidneys as well as into bile, feces, sweat, saliva, or tears. Lithium, gabapentin, amantadine, and topiramate are primarily excreted through the kidneys without hepatic metabolism. The half-life is a measure of the amount of time needed to excrete half of the drug from the plasma. It determines the frequency of administration that is required so that, at steady state, drug concentrations do not fluctuate widely. The half-life of highly protein-bound psy-choactive drugs is greatly increased. Although the kidneys are primarily involved in drug elimination, renal disease may also impact drug absorption, distribution, and metabolism.

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