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Related Concept Videos

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

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

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

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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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Hepatic Drug Clearance: Role of Transporters01:14

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In the liver and bile canaliculi, influx and efflux transporters modification can influence intrinsic clearance. Transporters play a significant role in moving drugs within liver cells. Elaborate models, such as the Biopharmaceutical Classification System (BCS), are essential to relate transporters to drug disposition. This system categorizes drugs into four classes based on solubility and permeability, providing insights into elimination routes and the effects of transporters following oral...
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Passive Diffusion: Overview and Kinetics01:17

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Passive diffusion is a critical process that allows small lipophilic drugs to cross the cell membrane along a concentration gradient. This mechanism's efficiency depends on four primary factors: the membrane's surface area, the drug's lipid-water partition coefficient, the concentration gradient, and the membrane's thickness.
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An Intestine/Liver Microphysiological System for Drug Pharmacokinetic and Toxicological Assessment
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Liver Apparent Diffusion Coefficient Changes during Telaprevir-Based Therapy for Chronic Hepatitis C.

Nagihan İnan Gürcan1, Zakir Sakçı1, Sıla Akhan2

  • 1Department of Radiology, Kocaeli University School of Medicine, Kocaeli, Turkey.

Balkan Medical Journal
|December 21, 2016
PubMed
Summary

Diffusion-weighted imaging (DWI) can detect liver fibrosis, with lower apparent diffusion coefficient (ADC) values in fibrotic livers. DWI shows changes during antiviral therapy, indicating its potential for research.

Keywords:
Liverchronic hepatitis Cdiffusion-weighted magnetic resonance imagingfibrosismagnetic resonance imagingtelaprevir

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Area of Science:

  • Radiology
  • Hepatology
  • Medical Imaging

Background:

  • Diffusion-weighted imaging (DWI) is crucial for assessing liver parenchymal changes in diffuse liver fibrosis.
  • Chronic hepatitis C virus (HCV) infection is a common cause of liver fibrosis.

Purpose of the Study:

  • To evaluate changes in liver apparent diffusion coefficient (ADC) values during telaprevir-based triple therapy using DWI.
  • To assess the utility of DWI in detecting liver fibrosis and monitoring antiviral treatment effects.

Main Methods:

  • A diagnostic accuracy study involving 17 HCV patients and 25 healthy volunteers.
  • 3 Tesla MRI with DWI was performed before, during (12 weeks), and after (24 weeks) telaprevir therapy.
  • Liver fibrosis was histopathologically classified, and ADC values were quantitatively analyzed.

Main Results:

  • Significantly lower liver ADC values were observed in fibrotic livers compared to healthy livers (p<0.001).
  • ADC values showed a declining trend with increasing fibrosis stage, but a discriminative threshold was not identified.
  • Liver ADC values decreased significantly after 12 weeks of telaprevir therapy and returned to baseline by 24 weeks.

Conclusions:

  • Liver ADC values can indicate the presence of fibrosis but not its stage.
  • DWI shows promise as a research tool for evaluating the impact of antiviral medications on liver parenchyma.