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Pharmacokinetics in Patients with Hepatic Dysfunction

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Pharmacokinetics in Patients with Hepatic Dysfunction

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Questions and Answers

How does liver dysfunction impact drug pharmacokinetics?

Increases blood/plasma clearance

Reduces the extent of drug absorption

Decreases plasma protein binding

Affects presystemic elimination of high extraction drugs (correct)

In advanced liver cirrhosis, what effect can portal-systemic shunting have on drug pharmacokinetics?

Enhances drug metabolism

Decreases CYP450 enzyme activity

Reduces presystemic elimination of high extraction drugs (correct)

Increases plasma protein binding

How are drug-metabolizing activities affected in chronic liver diseases?

Uniform increase in all CYP450 enzyme activities

Enhancement of all drug metabolism processes

Improved presystemic elimination

Greater reduction in glucuronidation than in CYP450 metabolism (correct)

Why is it important to consider hepatic dysfunction when adjusting drug dosages?

To account for variable reductions in drug-metabolizing activities Signup and view all the answers

What is the main purpose of the recommendations from the FDA and EMEA discussed in the text?

To generate specific dosage recommendations for patients with hepatic dysfunction Signup and view all the answers

Why is further research needed, according to the text?

To develop more sensitive liver function tests for drug dosage adjustment Signup and view all the answers

Which parameter is highlighted as not only the most important biotransformation site but also crucial for drug pharmacokinetics?

The liver Signup and view all the answers

What does the text suggest as a key area for future development in drug dosage adjustment?

More sensitive liver function tests Signup and view all the answers

Why is it necessary to adjust drug dosages in patients with advanced cirrhosis?

Because impaired renal function affects drug elimination in these patients Signup and view all the answers

What is a limitation of the Child-Pugh score in adjusting drug dosages for patients with liver dysfunction?

It lacks sensitivity to quantitate the liver's specific ability to metabolize individual drugs Signup and view all the answers

Which statement is true regarding liver tests to predict drug elimination capacity in cirrhotic patients?

They use marker substrates like galactose and sorbitol to evaluate liver function Signup and view all the answers

Why are cirrhotic patients more sensitive to the adverse effects of certain drugs?

As a result of impaired liver function impacting drug pharmacokinetics Signup and view all the answers