Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

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

38
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...
38
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

39
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...
39
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

36
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...
36
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

42
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...
42
Phase II Reactions: Acetylation Reactions01:24

Phase II Reactions: Acetylation Reactions

460
Acetylation, a phase II biotransformation reaction, introduces an acetyl group to drugs or their metabolites. Acetyltransferase enzymes facilitate this reaction, which resembles α-amino acid conjugation due to the addition of a functional group to the drug molecule.
The substrates for acetylation are typically drugs or their metabolites with an amino, sulfonamide, or hydrazine functional group. Acetylation can occur at several points in the drug molecule, including primary, secondary, and...
460
Hepatic Drug Excretion: Influencing Factors01:16

Hepatic Drug Excretion: Influencing Factors

292
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...
292

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Antibiotic Target Attainment: What Are We Aiming for?

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·2024
Same author

Evaluation of an Enteral Clonidine Taper following Prolonged Dexmedetomidine Exposure in Critically Ill Children.

Journal of pediatric intensive care·2022
Same author

Creation of a Combination Antibiogram for <i>Pseudomonas aeruginosa</i> in a Pediatric Intensive Care Unit.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG·2021
Same author

A Quality Improvement Approach to Influence Value-based Mucolytic Use in the PICU.

Pediatric quality & safety·2021
Same author

Dexmedetomidine: A Multipurpose Tool Which Is Difficult to Analyze.

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·2020
Same author

IV Acetaminophen-As Benign As We Thought?

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·2019
Same journal

Ganciclovir Therapeutic Drug Monitoring in Critically Ill Pediatric Patients Receiving Continuous Renal Replacement Therapy.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG·2026
Same journal

Commentary on "Examining the Evidence Around Acetaminophen and Autism Risk".

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG·2026
Same journal

Sweet or Salty: Comparing Dextrose and Sodium Acetate Umbilical Arterial Catheter Fluids.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG·2026
Same journal

A Case of Prolonged Serotonin Toxicity After Fluoxetine Ingestion in an Adolescent Patient.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG·2026
Same journal

Efficacy and Safety of Tranexamic Acid in Pediatric Trauma: A Systematic Review and Meta-Analysis.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG·2026
Same journal

Heparin Resistance - A Reality or Fallacy.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG·2026
See all related articles

Related Experiment Video

Updated: Oct 29, 2025

Partial Lobular Hepatectomy: A Surgical Model for Morphologic Liver Regeneration
05:37

Partial Lobular Hepatectomy: A Surgical Model for Morphologic Liver Regeneration

Published on: May 31, 2018

12.4K

Acute Hepatic Dysfunction Related to Chronic Acetaminophen Administration.

Ellen Rootring, Cheryl L Sargel, Joseph D Tobias

    The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
    |July 9, 2021
    PubMed
    Summary
    This summary is machine-generated.

    Chronic acetaminophen use, even at recommended doses, can lead to liver toxicity. This case highlights the importance of monitoring acetaminophen in pediatric patients receiving prolonged therapeutic administration.

    Keywords:
    acetaminophenadverse drug effectdrug-induced liver injuryhepatotoxicityliver dysfunction

    More Related Videos

    Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
    09:44

    Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen

    Published on: November 27, 2019

    10.6K
    Visualization and Analysis of Blood Flow and Oxygen Consumption in Hepatic Microcirculation: Application to an Acute Hepatitis Model
    10:40

    Visualization and Analysis of Blood Flow and Oxygen Consumption in Hepatic Microcirculation: Application to an Acute Hepatitis Model

    Published on: August 4, 2012

    12.8K

    Related Experiment Videos

    Last Updated: Oct 29, 2025

    Partial Lobular Hepatectomy: A Surgical Model for Morphologic Liver Regeneration
    05:37

    Partial Lobular Hepatectomy: A Surgical Model for Morphologic Liver Regeneration

    Published on: May 31, 2018

    12.4K
    Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
    09:44

    Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen

    Published on: November 27, 2019

    10.6K
    Visualization and Analysis of Blood Flow and Oxygen Consumption in Hepatic Microcirculation: Application to an Acute Hepatitis Model
    10:40

    Visualization and Analysis of Blood Flow and Oxygen Consumption in Hepatic Microcirculation: Application to an Acute Hepatitis Model

    Published on: August 4, 2012

    12.8K

    Area of Science:

    • Pediatric Medicine
    • Pharmacology
    • Toxicology

    Background:

    • Acetaminophen (APAP) overdose is a common cause of acute liver injury.
    • Chronic APAP administration, even at therapeutic doses, can also lead to hepatotoxicity.
    • Pediatric patients undergoing prolonged medical treatment may be at risk for chronic APAP toxicity.

    Purpose of the Study:

    • To present a case of acetaminophen-induced hepatotoxicity in a pediatric patient receiving therapeutic doses.
    • To discuss the potential role of chronic acetaminophen administration in liver injury.
    • To highlight prevention strategies for acetaminophen toxicity in children.

    Main Methods:

    • Case report of a 20-month-old female toddler.
    • Review of acetaminophen administration (oral and intravenous) during multiple surgical interventions.
    • Discussion of the potential mechanisms of acetaminophen hepatotoxicity.

    Main Results:

    • The patient received therapeutic doses of acetaminophen over a prolonged period.
    • Acetaminophen administration was considered a potential contributor to hepatotoxicity.
    • The case underscores the risk of chronic acetaminophen toxicity.

    Conclusions:

    • Chronic acetaminophen use, even at recommended doses, poses a risk for hepatotoxicity in pediatric patients.
    • Close monitoring of liver function is crucial in children receiving prolonged acetaminophen therapy.
    • Implementing preventive strategies is essential to mitigate acetaminophen-induced liver injury.