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Related Concept Videos

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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...
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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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Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
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Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
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Drug toxicity: Drug–Drug Interaction01:30

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Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
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DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic...
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Related Experiment Video

Updated: May 5, 2026

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

A J Ellis1, J A Wendon, B Portmann

  • 1Institute of Liver Studies, King's College School of Medicine and Dentistry, London.

Gut
|March 1, 1996
PubMed
Summary

Ecstasy (MDMA) can cause severe acute liver damage, including liver failure requiring transplantation. Early referral to a specialized liver unit is crucial for patients with jaundice or liver failure, as transplantation may be their only hope for survival.

Area of Science:

  • Hepatology
  • Toxicology
  • Pharmacology

Background:

  • Ecstasy (3,4-methylenedioxymethamphetamine) is a recreational drug with known potential for systemic toxicity.
  • Acute liver injury is a recognized, albeit uncommon, adverse effect of recreational drug use.

Observation:

  • This study describes eight cases of ecstasy-related acute liver damage admitted to a specialized liver unit.
  • Presentations varied, including hyperthermia, hypotension, disseminated intravascular coagulation, rhabdomyolysis, and acute liver failure.
  • Histological findings ranged from microvesicular fatty change to submassive lobular collapse and lobular hepatitis with cholestasis.

Findings:

  • Two patients with hyperthermia and collapse developed severe hepatic damage; one recovered, and one died after transplantation due to microvesicular fatty change.

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  • Four patients presented with acute liver failure without hyperthermia; three died (one awaiting transplant, two from sepsis post-transplant).
  • Two patients with jaundice and abdominal pain recovered with conservative management, showing lobular hepatitis and cholestasis.

    • Implications:

    • Patients with ecstasy-induced jaundice or liver failure, especially with encephalopathy or prolonged INR, require urgent referral to a liver unit.
    • Liver transplantation may offer the only chance of survival for individuals with severe ecstasy-related acute liver failure.
    • This highlights the critical need for awareness among clinicians regarding the hepatotoxic potential of ecstasy.