Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

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

377
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...
377
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

362
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
362
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

377
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...
377
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

271
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...
271
Dosage Interval and Administration Route: Determination Methods01:19

Dosage Interval and Administration Route: Determination Methods

553
A medication’s effectiveness largely depends on its appropriate dosage and the route of administration. Dosage ensures that a sufficient drug concentration is maintained in the bloodstream to elicit the desired therapeutic effect without causing toxicity. The route of administration affects the drug's bioavailability, rate of absorption, and onset of action, which are crucial for achieving optimal therapeutic outcomes. Drug dosage calculations are critical to tailoring therapy to...
553
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

660
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
660

You might also read

Related Articles

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

Sort by
Same author

Tracking antimicrobial stewardship activities beyond days of therapy (DOT): Comparison of days of antibiotic spectrum coverage (DASC) and DOT at a single center.

Infection control and hospital epidemiology·2023
Same author

Implementation of a consensus protocol for antibiotic use for bone and joint infection to reduce unnecessary outpatient parenteral antimicrobial therapy: A quality improvement initiative.

Antimicrobial stewardship & healthcare epidemiology : ASHE·2022
Same author

Days of Antibiotic Spectrum Coverage: A Novel Metric for Inpatient Antibiotic Consumption.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America·2021
Same author

Antibiotic prescribing in mental health units across the Veterans' Health Administration: How much and how appropriate?

Infection control and hospital epidemiology·2021
Same author

Risk of Acute Kidney Injury and Clostridioides difficile Infection With Piperacillin/Tazobactam, Cefepime, and Meropenem With or Without Vancomycin.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America·2020
Same author

Evaluation of antibiotic prescribing in emergency departments and urgent care centers across the Veterans' Health Administration.

Infection control and hospital epidemiology·2020

Related Experiment Video

Updated: Apr 23, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

11.6K

Antibiotic dosing in cirrhosis.

Jenana Halilovic1, Brett H Heintz2

  • 1Jenana Halilovic, Pharm.D., BCPS, is Assistant Professor of Pharmacy Practice, University of the Pacific Thomas J. Long School of Pharmacy, Stockton, CA, and Pharmacist Specialist, Infectious Diseases, Department of Pharmaceutical Services, University of California Davis Health System, Sacramento. Brett H. Heintz, Pharm.D., BCPS-ID, AAHIVE, is Associate Professor of Clinical Pharmacy, University of Iowa College of Pharmacy, Iowa City, and Pharmacy Specialist, Internal Medicine and Infectious Diseases, Department of Pharmaceutical Services, Iowa City Veterans Affairs Healthcare System. jmaker@pacific.edu.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|September 17, 2014
PubMed
Summary

Cirrhosis significantly impacts how the body processes antibacterial drugs, affecting their effectiveness and safety. Individualized dosing is crucial for patients with liver disease to optimize treatment and minimize risks.

More Related Videos

Reduced Itraconazole Concentration and Durations Are Successful in Treating Batrachochytrium dendrobatidis Infection in Amphibians
06:49

Reduced Itraconazole Concentration and Durations Are Successful in Treating Batrachochytrium dendrobatidis Infection in Amphibians

Published on: March 14, 2014

11.3K
Inducing Acute Liver Injury in Rats via Carbon Tetrachloride CCl4 Exposure Through an Orogastric Tube
06:12

Inducing Acute Liver Injury in Rats via Carbon Tetrachloride CCl4 Exposure Through an Orogastric Tube

Published on: April 28, 2020

11.0K

Related Experiment Videos

Last Updated: Apr 23, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

11.6K
Reduced Itraconazole Concentration and Durations Are Successful in Treating Batrachochytrium dendrobatidis Infection in Amphibians
06:49

Reduced Itraconazole Concentration and Durations Are Successful in Treating Batrachochytrium dendrobatidis Infection in Amphibians

Published on: March 14, 2014

11.3K
Inducing Acute Liver Injury in Rats via Carbon Tetrachloride CCl4 Exposure Through an Orogastric Tube
06:12

Inducing Acute Liver Injury in Rats via Carbon Tetrachloride CCl4 Exposure Through an Orogastric Tube

Published on: April 28, 2020

11.0K

Area of Science:

  • Pharmacology
  • Hepatology
  • Infectious Diseases

Background:

  • Cirrhosis alters drug metabolism and elimination.
  • Antibacterial pharmacokinetics are affected by liver dysfunction.
  • Limited data exist on antibiotic dosing in cirrhotic patients.

Purpose of the Study:

  • To review evidence on antibacterial pharmacokinetics in cirrhosis.
  • To provide dosing recommendations for cirrhotic patients.
  • To develop a decision algorithm for antibiotic selection.

Main Methods:

  • Systematic PubMed search (1960-2013).
  • Review of clinical drug databases, conference abstracts, and package inserts.
  • Identification of 22 antibiotics with hepatic or mixed clearance.

Main Results:

  • Published pharmacokinetic data for antibiotics in cirrhosis are sparse.
  • Many studies predate the Child-Pugh classification system.
  • Dose adjustments are recommended for decompensated liver disease, considering drug properties and patient factors.

Conclusions:

  • Cirrhosis affects the disposition of numerous antibacterial agents.
  • Individualized antibiotic dosing is essential for optimal outcomes.
  • Careful selection and dosing reduce hepatotoxicity risk in cirrhotic patients.