Advertisement

Liver Function Assessment

  • Mohamed A. OmarEmail author
Chapter

Abstract

The liver, the largest organ in the body, performs a multitude of complex functions that helps in maintaining homeostasis and health. Due to the multitude of physiological functions that the liver performs, there is no one single test that can be utilized to assess total liver function. However, utilizing a panel of liver tests that can measure some of the functions carried out by the liver or detect liver damage can provide information on the presence of liver disease, type of liver disease, extent of liver damage, as well as response to treatment. Hepatic dysfunction can significantly impair various aspects of drug pharmacokinetics which necessitates close monitoring by the pharmacist. This chapter aims to help the pharmacist to have an assessment of the patient’s liver function and to investigate possible drug-induced causes of liver disease as well as manage drug therapy in patients with existing liver disease.

Keywords

Liver Liver function tests Liver injury Hepatotoxicity 

References

  1. 1.
    Ghany MG, Hoofnagle JH. Approach to the patient with liver disease. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J, editors. Harrison’s principles of internal medicine, 19e [Internet]. New York, NY: McGraw-Hill Education; 2015. [cited 2018 Jul 12]. Available from: accessmedicine.mhmedical.com/content.aspx?aid=1120811388.Google Scholar
  2. 2.
    Lee. Basic skills in interpreting laboratory data. 6th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2017.Google Scholar
  3. 3.
    Giannini EG. Liver enzyme alteration: a guide for clinicians. Can Med Assoc J. 2005;172(3):367–79.CrossRefGoogle Scholar
  4. 4.
    Mofrad P, Contos MJ, Haque M, Sargeant C, Fisher RA, Luketic VA, et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatology. 2003;37(6):1286–92.CrossRefGoogle Scholar
  5. 5.
    Gholson CF, Morgan K, Catinis G, Favrot D, Taylor B, Gonzalez E, et al. Chronic hepatitis C with normal aminotransferase levels: a clinical histologic study. Am J Gastroenterol. 1997 Oct;92(10):1788–92.PubMedGoogle Scholar
  6. 6.
    Dufour DR, Lott JA, Nolte FS, Gretch DR, Koff RS, Seeff LB. Diagnosis and monitoring of hepatic injury. I. Performance characteristics of laboratory tests. Clin Chem. 2000;46(12):2027–49.PubMedGoogle Scholar
  7. 7.
    Neyra NR, Hakim RM, Shyr Y, Ikizler TA. Serum transferrin and serum prealbumin are early predictors of serum albumin in chronic hemodialysis patients. J Ren Nutr. 2000;10(4):184–90.CrossRefGoogle Scholar
  8. 8.
    Pratt DS. Evaluation of liver function. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J, editors. Harrison’s principles of internal medicine, 19e [Internet]. New York, NY: McGraw-Hill Education; 2015. [cited 2018 Jul 12]. Available from: accessmedicine.mhmedical.com/content.aspx?aid=1120811446.Google Scholar
  9. 9.
    Patidar KR, Bajaj JS. Covert and overt hepatic encephalopathy: diagnosis and management. Clin Gastroenterol Hepatol. 2015;13(12):2048–61.CrossRefGoogle Scholar
  10. 10.
    MacLellan A, Fam D, Robblee J, Andrade D. A rare cause of a common presentation: hyperammonemic encephalopathy secondary to mycoplasma hominis pneumonia (P3.220). Neurology [Internet]. 2016;86(16 Supplement). Available from: http://n.neurology.org/content/86/16_Supplement/P3.220.abstract
  11. 11.
    Peng Y, Qi X, Guo X. Child–pugh versus MELD score for the assessment of prognosis in liver cirrhosis. Medicine (Baltimore) [Internet]. 2016 [cited 2018 Jul 24];95(8). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779019/.
  12. 12.
    Kamath PS, Kim WR. The model for end-stage liver disease (MELD). Hepatology. 2007;45(3):797–805.CrossRefGoogle Scholar
  13. 13.
    Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003;124(1):91–6.CrossRefGoogle Scholar
  14. 14.
    Tisdale JE, Miller DA, American Society of Health-System Pharmacists, editors. Drug-induced diseases: prevention, detection, and management. 2nd ed. Bethesda, MD: American Society of Health-System Pharmacists; 2010. 1110 pGoogle Scholar
  15. 15.
    LiverTox [Internet]. [cited 2018 Aug 4]. Available from: LiverTox.nih.gov.
  16. 16.
    Navarro VJ, Senior JR. Drug-related hepatotoxicity. N Engl J Med. 2006;354(7):731–9.Google Scholar
  17. 17.
    Russo MW, Watkins PB. Are patients with elevated liver tests at increased risk of drug-induced liver injury? Gastroenterology. 2004;126(5):1477–80.CrossRefGoogle Scholar
  18. 18.
    Lee WM, Dienstag JL. Toxic and drug-induced hepatitis. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J, editors. Harrison’s principles of internal medicine, 19e [Internet]. New York, NY: McGraw-Hill Education; 2015. [cited 2018 Jul 12]. Available from: accessmedicine.mhmedical.com/content.aspx?aid=1120811719.Google Scholar
  19. 19.
    Kirchain WR, Allen RE. Drug-induced liver disease. In: JT DP, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, editors. Pharmacotherapy: a pathophysiologic approach, 10e [Internet]. New York, NY: McGraw-Hill Education; 2017. [cited 2018 Aug 4]. Available from: accesspharmacy.mhmedical.com/content.aspx?aid=1145220291.Google Scholar
  20. 20.
    Fisher K, Vuppalanchi R, Saxena R. Drug-induced liver injury. Arch Pathol Lab Med. 2015;139:12.CrossRefGoogle Scholar
  21. 21.
    Danan G, Benichou C. Causality assessment of adverse reactions to drugs--I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. J Clin Epidemiol. 1993;46(11):1323–30.CrossRefGoogle Scholar
  22. 22.
    Maria VA, Victorino RM. Development and validation of a clinical scale for the diagnosis of drug-induced hepatitis. Hepatology (Baltim, MD). 1997;26(3):664–9.CrossRefGoogle Scholar
  23. 23.
    Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239–45.CrossRefGoogle Scholar
  24. 24.
    Bauer LA. Drug dosing in special populations: renal and hepatic disease, dialysis, heart failure, obesity, and drug interactions. In: Applied clinical pharmacokinetics, 3e [Internet]. New York, NY: McGraw-Hill Medical; 2015. [cited 2018 Aug 3]. Available from: accesspharmacy.mhmedical.com/content.aspx?aid=1106302753.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of Alberta Hospital, Pharmacy DepartmentEdmontonCanada

Personalised recommendations