Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Related Concept Videos

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...

Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug

Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug

In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...

Drug Toxicity: Dose-Dependent Reactions

Drug Toxicity: Dose-Dependent Reactions

Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...

Drug toxicity: Idiosyncratic Reactions

Drug toxicity: Idiosyncratic Reactions

Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Encephalomyeloradiculitis (Guillain-Barré syndrome) as a complication of infectious hepatitis.

Annals of internal medicine·2010

Same author

Infectious hepatitis; clinical and laboratory features of 295 cases.

The American journal of the medical sciences·2010

Same author

Drug- and chemical-induced cholestasis.

Clinics in liver disease·2001

Same author

Management of drug-induced liver disease.

Current gastroenterology reports·2001

Same author

Therapeutic misadventures with acetaminophen: hepatoxicity after multiple doses in children.

The Journal of pediatrics·1998

Same author

Hepatitis associated with varicella infection in an immunocompetent adult.

Journal of clinical gastroenterology·1996

Search research articles

Related Experiment Video

Updated: Jul 16, 2026

The Dimethylnitrosamine Induced Liver Fibrosis Model in the Rat

The Dimethylnitrosamine Induced Liver Fibrosis Model in the Rat

Published on: June 17, 2016

Drug-induced liver disease.

H J Zimmerman¹

¹Armed Forces Institute of Pathology, Washington, DC, USA.

Clinics in Liver Disease

|March 10, 2001

Summary

Drug-induced liver disease is a significant cause of abnormal liver enzymes and acute liver failure in adults, particularly those over 50. It presents in various forms and can mimic other liver conditions, necessitating consideration of all ingested substances.

Area of Science:

Hepatology
Clinical Pharmacology
Toxicology

Background:

Drug-induced liver disease (DILD) is a major cause of liver enzyme elevation in adults, ranging from 10% to 50%.
DILD accounts for approximately 25% of fulminant hepatic failure cases.
It is a critical consideration in patients over 50 years old.

Purpose of the Study:

To highlight the prevalence and diverse clinical presentations of drug-induced liver disease.
To emphasize the importance of considering all ingested agents, including herbal and traditional remedies, in diagnosing liver injury.
To discuss the varied patterns of liver injury and potential mimicry of other hepatic disorders.

Main Methods:

Review of clinical presentations and etiological factors of drug-induced liver injury.

More Related Videos

Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms

Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms

Published on: May 29, 2020

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro

Published on: January 31, 2022

Related Experiment Videos

Last Updated: Jul 16, 2026

The Dimethylnitrosamine Induced Liver Fibrosis Model in the Rat

The Dimethylnitrosamine Induced Liver Fibrosis Model in the Rat

Published on: June 17, 2016

Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms

Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms

Published on: May 29, 2020

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro

Published on: January 31, 2022

Analysis of the spectrum of liver damage, including cytotoxic, cholestatic, and mixed patterns.

Case-based considerations of differential diagnoses for abnormal hepatic biochemistry.

Main Results:

Liver injury patterns can be cytotoxic, cholestatic, or mixed.
DILD can present with systemic manifestations and mimic autoimmune hepatitis, cirrhosis, or veno-occlusive disorders.
A wide range of systemic drugs and herbal/traditional agents can cause liver injury.

Conclusions:

Drug-induced liver disease is a common and complex condition with diverse presentations.
Thorough patient history, including the use of herbal and traditional agents, is crucial for diagnosis.
Recognizing DILD is essential to differentiate it from other liver diseases and ensure appropriate management.