Drug metabolism and liver disease

Published on October 1, 2007 Archived on August 21, 2015   40 min

A selection of talks on Metabolism & Nutrition

From the outside, I would like to acknowledge my co-workers at my institution who are involved with me in the study of drug metabolism in liver disease. And if there is any interest, there is contact information in terms of my email and also in terms of a website. And we move to the next slide.
During this presentation I would like to address a number of questions. The first question is, do diseases of different etiology alter the metabolism of different drugs being given to a variable extent? In other words, is there selectivity of the effect of the disease process based on the underlying etiology? Second question that I'd like to address, is there a differential effect of liver disease on different routes of metabolism? This is the selectivity with respect to the drug metabolizing enzymes or active processes involved in drug elimination. Thirdly, does the severity of the underlying liver disease influence the magnitude of the change? Is there a sensitivity of these processes to the presence of liver disease? And then finally, are the changes sufficiently large to justify dosage modification and therefore be of clinical relevance? And we move to the next slide.
From the perspective of clinical relevance, I think it's also important to address the questions, can the extent of change be anticipated in an individual patient when faced with a therapeutic decision? And secondly, can these changes be used, in fact, to assess hepatic function as discrete entities? Thirdly, can we use this information in predictive rules if we are faced with giving drugs that are just being introduced to the market, where we know the disposition in normal people? Can we anticipate when there will be change in the presence of liver disease? And we move to the next slide.