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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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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

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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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The liver, an essential organ in the human body, performs over 200 vital functions that can be broadly categorized into metabolic, hematological, endocrine regulation, and bile production.
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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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COVID-19 and the liver.

Dinesh Jothimani1, Radhika Venugopal1, Mohammed Forhad Abedin1

  • 1Institute of Liver disease and Transplantation, Dr Rela Institute and Medical Centre, Bharat Institute of Higher Education and Research, Chennai, India.

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The COVID-19 pandemic impacts liver function, with 14-53% of patients experiencing hepatic dysfunction. Further research is needed to understand coronavirus disease 2019 effects on chronic liver disease.

Keywords:
ACE2COVID-19LiverSARS-CoV-2

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Area of Science:

  • Hepatology
  • Virology
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is a global health crisis.
  • Hepatic dysfunction affects 14-53% of COVID-19 patients, especially those with severe disease.
  • Liver injury in COVID-19 is linked to higher mortality rates.

Purpose of the Study:

  • To review the impact of COVID-19 on liver function.
  • To explore potential mechanisms of hepatic involvement in COVID-19.
  • To highlight the need for research on COVID-19's effects on chronic liver disease.

Main Methods:

  • Literature review of COVID-19 and liver injury studies.
  • Analysis of reported cases of hepatic dysfunction in COVID-19 patients.
  • Discussion of viral entry mechanisms and ACE2 receptor expression.

Main Results:

  • COVID-19 patients exhibit significant rates of hepatic dysfunction.
  • Acute liver injury in COVID-19 is associated with increased mortality.
  • ACE2 receptors, implicated in viral entry, are present in liver cells.

Conclusions:

  • COVID-19 can cause significant hepatic dysfunction through various mechanisms.
  • The effects of COVID-19 on patients with pre-existing chronic liver disease require further investigation.
  • More research is warranted to fully understand and manage liver involvement in COVID-19.