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The Impact of Liver Disease on Drug Metabolism

  • Jessica E. Bollinger
Chapter

Abstract

Any drug that is introduced to the body must be eliminated by either metabolism or excretion. The liver is the primary site of drug metabolism. Hepatic drug clearance depends upon liver blood flow, metabolic activity, and degree of protein binding. Cirrhosis may alter any or all of these variables. Caution must be exercised to interpret the impact of cirrhosis on drug metabolism.

Keywords

Drug metabolism Cirrhosis Pharmacokinetics Adverse drug reactions Cytochrome Therapeutic drug monitoring 

Abbreviations

ACE

Angiotensin converting enzyme

AUC

Area under the concentration-time curve

CLH

Hepatic clearance

CLint

Intrinsic clearance

CLp

Total plasma clearance

Cmax

Maximum serum concentration

CYP

Cytochrome P450

EH

Hepatic extraction ratio

FDA

Food and Drug Administration

fu

Fraction of unbound drug in blood

GFR

Glomerular filtration rate

IV

Intravenous

NAPQI

N-acetyl-p-benzoquinone imine

QH

Hepatic blood flow

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PharmacyCleveland ClinicClevelandUSA

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