TAILIEUCHUNG - CLINICAL PHARMACOLOGY 2003 (PART 34)

The liver is the most important organ in which drugs are structurally altered. Some of the resulting metabolites may be biologically inactive, some active and some toxic (see Chapter 7).The liver is exposed to drugs in higher concentrations than are most organs because most are administered orally and are absorbed from the gastrointestinal the whole dose must pass through the liver to reach the systemic circulation. Because of this the liver is a vulnerable target for injury from chemicals and drugs, and disordered hepatic function is an important cause of abnormal drug handling and response. . | SECTION 7 Liver biliary tract pancreas SYNOPSIS The liver is the most important organ in which drugs are structurally altered. Some of the resulting metabolites may be biologically inactive some active and some toxic see Chapter 7 .The liver is exposed to drugs in higher concentrations than are most organs because most are administered orally and are absorbed from the gastrointestinal the whole dose must pass through the liver to reach the systemic circulation. Because of this the liver is a vulnerable target for injury from chemicals and drugs and disordered hepatic function is an important cause of abnormal drug handling and response. Drugs and the liver Pharmacodynamic and pharmacokinetic changes Prescribing in liver disease Drug-induced liver injury Aspects of therapy Bile salts and gallstones Pancreas and drugs PHARMACODYNAMIC CHANGES IN LIVER DISEASE Patients with severe liver disease characteristically show abnormal end-organ response to drugs. For example CNS sensitivity to opioids sedatives and antiepilepsy drugs is increased. The effect of oral anticoagulants is increased because synthesis of coagulation factors is impaired. Fluid and electrolyte balance are altered. Sodium retention may be more readily induced by NSAIDs or corticosteroids ascites and oedema become more resistant to diuretics. PHARMACOKINETIC CHANGES IN LIVER DISEASE The liver has a large metabolic reserve and it is only when disease becomes decompensated that 651 SECTION 7 23 LIVER biliary tract pancreas important changes in drug handling occur. Parenchymal liver disease . chronic viral or alcoholic liver disease has more impact on hepatic drugmetabolising enzyme activity than primarily cholestatic conditions . primary biliary cirrhosis although clearance of drugs eliminated mainly by biliary excretion will be impaired in the latter. Hepatocellular injury toxic infectious leads to decreased activity of drug-metabolising enzymes which is reflected in diminished plasma .

• Y học thường thức
• Liver
• biliary tract
• pancreas
• clinical pharmacology
• sách học ngành dược
• dược lý lâm sàng
• tài liệu học dược sĩ
• bảo quản thuốc
• Liver rescue
• The high fat trend
• Liver myths debunked
• Liver troublemakers
• Liver rescue meditations
• Liver rescue recipes
• Ultrasound Guided liver surgery
• Liver transplantation
• Minimally invasive surgery
• Interventional procedures
• Liver transplantation from living donors
• Liver pathology
• An atlas and concise guide
• Approach to liver specimens
• Structural alterations
• Acute liver diseases
• Chronic liver disorders
• Transplant liver disorders
• Focal lesions
• Neoplastic diseases
• Pediatric liver diseases
• Pediatric liver biopsy
• Sluggish liver
• Liver enzyme guess tests
• The liver’s immune system
• Mystery hunger
• Weight gain
• Acute liver failure
• Miliary liver metastasis
• Particularly in early stages
• Medical emergency
• Liver uncommonly results in ALF
• BMC Pediatrics
• Childhood obesity
• Non alcoholic fatty liver disease
• Male gender
• Liver echogenicity
• Liver enzymes
• Impaired glucose tolerance
• BMC Cancer
• Liver metastases
• Rectal cancer
• Liver steatosis
• Chemotherapy induced liver injury
• Liver Imaging
• Liver Anatomy
• Clinico Pathological
• Liver Hemangioma
• Focal Nodular Hyperplasia
• Imaging Landmarks
• Segmental Lesion Localization
• Liver MR Imaging
• Histopathologic Classification
• Hepatoblastoma
• Parenchymal Disease
• Infectious Diseases
• HIV associated Liver Diseases
• Liver Pathologies
• Liver Metabolism
• Fatty Liver Disease
• Methionine Adenosyltransferase Genes
• Hepatocellular Carcinoma
• Gan nhiễm mỡ
• Chuyển hóa gan
• AX7 cells
• Metastatic liver carcinoma
• Original cancer
• Human metastatic liver carcinoma
• Histopathology examination
• Liver diseases
• Impact of different biochemical markers
• Different biochemical markers
• Serum of patients
• Benign and malignant liver diseases
• Malignant liver diseases
• Carbohydrate intake
• Pediatric nonalcoholic fatty liver disease
• Aspartate aminotransferase
• BMC Pharmacology and Toxicology
• Liver injury
• Liver biochip
• Anti inflammatory properties
• Colorectal cancer
• Colorectal liver metastases
• Hepatic resection
• Liver surger
• Thermal ablation
• Radiofrequency ablation
• Liver cirrhosis
• Magnetic resonance imaging
• Dynamic liver computed tomography
• Pediatric acute liver failure
• Mushroom poisoning
• Prognostic model
• Case report
• Microvascular invasion
• UCSF criteria
• Living donor liver transplantation
• Lesson Anatomic liver resection
• Parenchymal saving anatomical liver resection
• Liver surgery
• Caudate lobectomy
• Right hepatectomy
• Acute intestinal obstruction
• Intra organ vascular bed of the liver
• Arteries of the liver
• Veins of the liver
• Experimental animals
• Liver MRI
• Abdominal CT scan
• BMC Public Health
• Liver fibrosis
• Chronic liver disease
• Vibration controlled transient elastography
• Chronic liver diseases
• Personalized Medicine
• Liver Biopsy
• Percutaneous Liver
• Biopsy rocedure
• Liver Disease
• Pathological View
• Transient Elastography
• Sherlock’s diseases of the liver and biliary system
• Biliary system
• Hepatic encephalopathy
• Hepatic fibrogenesis
• Hepatic cirrhosis
• Biopsy of the liver