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Related Concept Videos

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

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

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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...
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Drug Toxicity: Dose-Dependent Reactions01:24

Drug Toxicity: Dose-Dependent Reactions

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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...
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Drug Toxicity: Overview01:00

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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...
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Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug01:14

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

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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...
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Glutathione, a tripeptide made up of glutamate, cysteine, and glycine, is a critical player in the detoxification of drugs and xenobiotics via a process known as glutathione conjugation or mercapturic acid formation. This phase II biotransformation reaction involves the covalent binding of glutathione to a drug or its metabolite, enhancing the compound's water solubility and enabling its excretion.
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Partial Lobular Hepatectomy: A Surgical Model for Morphologic Liver Regeneration
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Acetaminophen hepatotoxicity: an updated review.

Elizabeth M Lancaster1, Jonathan R Hiatt, Ali Zarrinpar

  • 1UCLA David Geffen School of Medicine, Los Angeles, CA, USA.

Archives of Toxicology
|December 25, 2014
PubMed
Summary

Acetaminophen overdose causes acute liver failure (ALF), often requiring transplantation. Early diagnosis and novel treatments are crucial for managing this public health concern.

Area of Science:

  • Hepatology
  • Toxicology
  • Transplantation Medicine

Background:

  • Acetaminophen-induced hepatotoxicity is a leading cause of acute liver failure (ALF) in the USA and UK.
  • Unintentional or chronic overdose of acetaminophen-containing products contributes to over 50% of ALF cases.
  • Current life-saving therapy for established ALF is liver transplantation, which has limited donor availability.

Purpose of the Study:

  • To review recent advancements in the diagnosis and management of acetaminophen-induced ALF.
  • To highlight the critical need for early and accurate diagnosis in patients requiring transplantation.
  • To discuss emerging therapeutic strategies aimed at bridging patients to recovery.

Main Methods:

  • Literature review of recent studies on acetaminophen-induced ALF.

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  • Analysis of diagnostic criteria and prognostic indicators for ALF.
  • Evaluation of novel treatment modalities, including support systems.

    • Main Results:

    • N-acetylcysteine is effective for acute overdose if administered early.
    • Liver transplantation remains the primary treatment for established ALF.
    • Research is ongoing for auxiliary, artificial, and bioartificial liver support systems.

    Conclusions:

    • Prompt diagnosis and intervention are vital for managing acetaminophen-induced ALF.
    • Development of novel therapies is essential to improve outcomes and reduce the need for transplantation.
    • Continued research into diagnostic tools and bridge-to-recovery treatments is critical.