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The Impact of Liver Disease on Drug Metabolism

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Surgical Procedures on the Cirrhotic Patient

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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.

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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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Author information

Authors and Affiliations

  1. Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA

    Jessica E. Bollinger Pharm D, BCPS

Authors
  1. Jessica E. Bollinger Pharm D, BCPS
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Correspondence to Jessica E. Bollinger Pharm D, BCPS .

Editor information

Editors and Affiliations

  1. Transplantation Center, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio, USA

    Bijan Eghtesad

  2. Department of Surgery, University of Chicago, Chicago, Illinois, USA

    John Fung

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Bollinger, J.E. (2017). The Impact of Liver Disease on Drug Metabolism. In: Eghtesad, B., Fung, J. (eds) Surgical Procedures on the Cirrhotic Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-52396-5_3

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  • DOI: https://doi.org/10.1007/978-3-319-52396-5_3

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  • Publisher Name: Springer, Cham

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