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Related Concept Videos

Pharmacokinetics: Drug–Drug Interactions01:25

Pharmacokinetics: Drug–Drug Interactions

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Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
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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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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...
104
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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Enzyme Inhibition01:30

Enzyme Inhibition

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Inhibitors are molecules that reduce enzyme activity by binding to the enzyme. In a normally functioning cell, enzymes are regulated by a variety of inhibitors. Drugs and other toxins can also inhibit enzymes. Some inhibitors bind to the enzyme’s active site, while others inhibit enzymatic activity by binding to other sites on the protein structure.
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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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An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
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Checkpoint Inhibitors and Hepatotoxicity.

Stephen D H Malnick1, Ali Abdullah1, Manuela G Neuman2,3

  • 1Department of Internal Medicine C, Kaplan Medical Center, Rehovot 76100, Israel.

Biomedicines
|January 26, 2021
PubMed
Summary

Tumor cells evade immune surveillance by activating immune checkpoints. This review focuses on immune checkpoint inhibitors, their side effects, and particularly hepatic adverse reactions in cancer treatment.

Keywords:
checkpoint inhibitorscytokinesdrug induced liver injuryhepatotoxicityimmunological escapemalignant cellstumor cells

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Area of Science:

  • Oncology
  • Immunology
  • Pharmacology

Background:

  • Uncontrolled immune responses cause tissue damage and autoimmune diseases.
  • Tumor cells exploit immune checkpoints to evade immune surveillance and promote tumor formation.
  • Transforming growth factor β (TGF-β) and antigenic modulation are key tumor escape mechanisms.

Purpose of the Study:

  • To review the role of immune checkpoint inhibitors in cancer therapy.
  • To emphasize the side effects of these novel biological drugs, with a focus on hepatic adverse reactions.

Main Methods:

  • Literature review of immune checkpoint inhibitors and their clinical applications.
  • Analysis of reported side effects, particularly liver-related adverse events.

Main Results:

  • Immune checkpoint inhibitors are approved therapies enhancing anti-tumor immune responses.
  • These therapies can cause significant side effects, including hepatic adverse reactions.
  • Understanding and managing these side effects is crucial for patient care.

Conclusions:

  • Immune checkpoint inhibitors represent a significant advancement in cancer immunotherapy.
  • Hepatic adverse reactions are a notable concern requiring careful monitoring and management.
  • Further research into mitigating side effects will enhance the efficacy and safety of these treatments.