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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
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.
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.