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Related Concept Videos

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

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...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

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...
Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
Hepatic Drug Excretion: Influencing Factors01:16

Hepatic Drug Excretion: Influencing Factors

The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
Drug Toxicity: Overview01:00

Drug Toxicity: Overview

Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

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...

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Related Experiment Video

Updated: May 18, 2026

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
11:06

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

Published on: January 31, 2022

Voriconazole hepatotoxicity in severe liver dysfunction.

Pablo Solís-Muñoz1, Juan Carlos López, William Bernal

  • 1Liver Intensive Therapy Unit, Institute of Liver Studies, Kings College Hospital of London, United Kingdom. pablo.a.solis@hotmail.com

The Journal of Infection
|October 9, 2012
PubMed
Summary

Voriconazole frequently causes severe liver damage in patients with severe liver dysfunction. Liposomal amphotericin B is a safer alternative, with careful monitoring of liver function tests recommended for voriconazole use.

Related Experiment Videos

Last Updated: May 18, 2026

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
11:06

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

Published on: January 31, 2022

Area of Science:

  • Hepatology
  • Pharmacology
  • Infectious Diseases

Background:

  • Limited data exists on voriconazole's hepatotoxicity in severe liver dysfunction.
  • Voriconazole is a widely used antifungal agent.

Purpose of the Study:

  • To characterize voriconazole-induced hepatotoxicity in patients with severe liver dysfunction.
  • To compare voriconazole's safety profile with liposomal amphotericin B in this patient population.

Main Methods:

  • Observational study design.
  • Inclusion of adult patients receiving at least 4 doses of voriconazole.
  • Comparison with a matched cohort treated with liposomal amphotericin B.

Main Results:

  • 69% of voriconazole patients experienced liver function test abnormalities.
  • Severe hepatotoxicity occurred in all affected patients.
  • A loading dose >300 mg correlated with increased hepatotoxicity risk (p < 0.001).
  • Only 10.3% of the control group showed LFT alterations.

Conclusions:

  • Voriconazole necessitates cautious use in severe liver dysfunction, especially post-liver transplant.
  • Frequent liver function monitoring is crucial when using voriconazole.
  • Liposomal amphotericin B presents a safer alternative for patients with severe liver dysfunction.