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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: 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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Hepatic Drug Excretion: Enterohepatic Cycling01:17

Hepatic Drug Excretion: Enterohepatic Cycling

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Enterohepatic cycling involves the active secretion of drugs and their metabolites into the bile via transporters in the canalicular membrane of hepatocytes. This secretion is an integral part of the digestive process, releasing these substances into the gastrointestinal (GI) tract.
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
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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

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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: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

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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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Hepatic Drug Excretion: Influencing Factors01:16

Hepatic Drug Excretion: Influencing Factors

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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...
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Development of a Hepatitis B Virus Reporter System to Monitor the Early Stages of the Replication Cycle
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Drugs in Development for Hepatitis B.

Altaf Dawood1, Syed Abdul Basit1, Mahendran Jayaraj1

  • 1Department of Internal Medicine, Section of Gastroenterology, University of Nevada School of Medicine, Las Vegas, NV, USA.

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|June 30, 2017
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Summary
This summary is machine-generated.

New therapies for chronic hepatitis B (CHB) virus are being developed, including direct-acting antivirals and host-targeting agents. A combination approach may lead to a functional cure for CHB.

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Area of Science:

  • Hepatology and Viral Immunology
  • Drug Development and Therapeutics

Background:

  • Chronic hepatitis B (CHB) presents significant global health challenges due to high morbidity and mortality.
  • Numerous investigational agents are under development to combat CHB infection.

Purpose of the Study:

  • To review current and emerging therapeutic strategies for CHB.
  • To discuss agents in clinical development and those in earlier research phases.
  • To explore potential future targets for CHB treatment.

Main Methods:

  • Categorization of investigational CHB agents into direct-acting antivirals (DAAs) and host-targeting agents.
  • Review of DAAs including RNA interference, cccDNA inhibitors, core/capsid inhibitors, and others.
  • Examination of host-targeting agents such as entry inhibitors, immunomodulators, and cytokine-based therapies.

Main Results:

  • DAAs target specific viral replication steps.
  • Host-targeting agents modulate host cell functions, including immune responses.
  • Novel agents like SB 9200 may possess dual antiviral and interferon-inducing properties.

Conclusions:

  • Effective CHB treatment may necessitate a combination of viral replication suppression and host-targeting agents.
  • Recent advancements offer hope for a functional cure for CHB in the near future.