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Related Concept Videos

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Jaundice

Jaundice, or icterus, is the yellow discoloration of the skin, sclerae, and mucous membranes. It happens when plasma bilirubin levels rise above 2.5-3 mg/dL, leading to bilirubin deposition in tissue.Bilirubin is a byproduct of hemoglobin degradation. In macrophages, hemoglobin breaks down into globin and heme. Globin is converted into amino acids, while heme is turned into biliverdin by heme oxygenase, which is then reduced to unconjugated bilirubin by biliverdin reductase.Unconjugated...
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Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
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Pharmacogenetics of Phase II Enzymes: N-acetyltransferase, Thiopurine S-methyltransferase, UDP-glucuronosyltransferase

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Related Experiment Video

Updated: Jun 28, 2026

Synthesis of a Borylated Ibuprofen Derivative Through Suzuki Cross-Coupling and Alkene Boracarboxylation Reactions
08:56

Synthesis of a Borylated Ibuprofen Derivative Through Suzuki Cross-Coupling and Alkene Boracarboxylation Reactions

Published on: November 30, 2022

Spurious hyperbilirubinemia caused by naproxen.

Nafila Al Riyami1, Amanda C Zimmerman, Frances M Rosenberg

  • 1University of British Columbia Department of Pathology and Laboratory Medicine, Vancouver, BC, Canada.

Clinical Biochemistry
|November 4, 2008
PubMed
Summary

The naproxen metabolite O-desmethylnaproxen causes falsely high total bilirubin readings. This interference with the Jendrassik and Grof method may explain hyperbilirubinemia in naproxen overdose cases.

Related Experiment Videos

Last Updated: Jun 28, 2026

Synthesis of a Borylated Ibuprofen Derivative Through Suzuki Cross-Coupling and Alkene Boracarboxylation Reactions
08:56

Synthesis of a Borylated Ibuprofen Derivative Through Suzuki Cross-Coupling and Alkene Boracarboxylation Reactions

Published on: November 30, 2022

Area of Science:

  • Clinical Chemistry
  • Pharmacology
  • Analytical Toxicology

Background:

  • Naproxen is a common nonsteroidal anti-inflammatory drug (NSAID).
  • Drug metabolites can interfere with laboratory assays.
  • Accurate bilirubin measurement is crucial for diagnosing liver conditions and monitoring drug toxicity.

Observation:

  • A case of naproxen overdose presented with spurious hyperbilirubinemia.
  • The Jendrassik and Grof method is a standard assay for total bilirubin.
  • O-desmethylnaproxen is a major metabolite of naproxen.

Findings:

  • Laboratory analysis confirmed that O-desmethylnaproxen directly interferes with the Jendrassik and Grof total bilirubin assay.
  • A linear relationship was observed between O-desmethylnaproxen concentration and measured total bilirubin levels.
  • The study suggests that naproxen and its glucuronide metabolites may also interfere with bilirubin testing.

Implications:

  • This interference can lead to misdiagnosis and inappropriate patient management in cases of naproxen overdose.
  • Clinical laboratories should be aware of potential drug interferences with bilirubin assays.
  • Further investigation into the interference of naproxen glucuronide metabolites is warranted.