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Anti-infective agents and hepatic disease

S J Tschida1, K Vance-Bryan, D E Zaske

  • 1University of Minnesota College of Pharmacy, Minneapolis, USA.

The Medical Clinics of North America
|July 1, 1995
PubMed
Summary

Hepatic disease significantly alters how the body processes anti-infective drugs, affecting drug levels and toxicity risks. Careful patient monitoring and dose adjustments are crucial due to unpredictable pharmacokinetic changes.

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Area of Science:

  • Pharmacology
  • Hepatology
  • Infectious Diseases

Background:

  • Hepatic disease causes physiological changes affecting drug processing.
  • These changes impact drug efficacy and safety, particularly for anti-infectives.
  • Limited research exists on these pharmacokinetic alterations in liver disease.

Purpose of the Study:

  • To investigate the impact of hepatic disease on anti-infective pharmacokinetics.
  • To highlight the clinical significance of altered drug disposition in liver disease.
  • To emphasize the need for further research in this area.

Main Methods:

  • Review of existing literature on drug metabolism and distribution in hepatic disease.
  • Analysis of pharmacokinetic data for selected anti-infective agents.
  • Discussion of interpatient variability in drug disposition.

Main Results:

  • Hepatic disease alters plasma protein binding, tissue binding, hepatic blood flow, and metabolism.
  • Significant interpatient variability in pharmacokinetic variables complicates accurate drug prediction.
  • Pharmacokinetics of certain anti-infectives are demonstrably altered in patients with liver disease.

Conclusions:

  • Altered pharmacokinetics of anti-infectives in hepatic disease necessitate vigilant monitoring.
  • Dosage titration is essential to prevent elevated drug concentrations and potential toxicity.
  • Further investigation is required to understand and manage these drug disposition changes.

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