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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

271
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...
271
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

382
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...
382
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

379
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...
379
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

358
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...
358
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

400
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
400
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

354
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
354

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Related Experiment Videos

Cardiovascular-Related Polypharmacy and Its Association with Liver and Kidney Function: A Cross-Sectional Study Using

Caroline Trin1, Harvey Jia Wei Koh1,2, Zhomart Orman1,2

  • 1PharmacoEpidemiology Research Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Alfred Precinct, Melbourne, VIC, 3004, Australia.

Drugs & Aging
|April 29, 2026
PubMed
Summary

Cardiovascular disease (CVD) polypharmacy is common in patients on lipid-lowering therapy and linked to older age and multiple health conditions. This polypharmacy is associated with kidney dysfunction, indicating a need for careful prescribing.

Related Experiment Videos

Area of Science:

  • Pharmacology
  • Nephrology
  • Geriatrics

Background:

  • Polypharmacy is prevalent in patients with cardiovascular disease (CVD), increasing risks of adverse outcomes like kidney and liver dysfunction.
  • This study investigates the link between CVD polypharmacy and kidney/liver dysfunction in patients on lipid-lowering therapy in Australia.

Purpose of the Study:

  • To examine the association between CVD-related polypharmacy and biochemical indicators of kidney and liver dysfunction.
  • To identify predictors of CVD-related polypharmacy in patients prescribed lipid-lowering therapy.

Main Methods:

  • Retrospective cross-sectional study using electronic medical records (2013-2022).
  • CVD polypharmacy defined as >5 concurrent cardiovascular medications.
  • Kidney dysfunction assessed by eGFR; liver dysfunction by ALT, AST, or bilirubin levels.
  • Multivariable logistic regression adjusted for age, sex, and comorbidities.

Main Results:

  • 33.7% of 13,568 participants exhibited CVD-related polypharmacy.
  • Predictors included diabetes, chronic kidney disease, hypertension, and older age (≥80 years).
  • CVD polypharmacy was significantly associated with kidney dysfunction (OR 1.45), but not liver dysfunction (OR 1.19).

Conclusions:

  • CVD polypharmacy is common in patients on lipid-lowering therapy, associated with aging and multimorbidity.
  • The link with kidney dysfunction highlights the interplay between cardiovascular risk, physiological decline, and treatment burden.
  • Emphasizes the need for integrated, patient-centered prescribing for high-risk populations.