Hepatic metabolism of drugs

BT_PO 1.108

Describe the alteration to drug response due to hepatic disease.

Metabolic clearance is usually constant and independent of dose. TRUE/FALSE

For drugs with an extraction ratio of nearly 0, a change in liver blood flow produces a nearly proportional change in clearance. TRUE/FALSE

Alfentanil is an example of a drug whose hepatic metabolism is capacity-limited. TRUE/FALSE

In cirrhosis, hepatic drug clearance is usually reduced. TRUE/FALSE

CYP3A4 is responsible for nearly half of all drug metabolism. TRUE/FALSE. Hint…this is the enzyme system affected by grapefruit juice (and interestingly, propofol).

2017.1 : SAQ 15

Outline the clinical laboratory assessment of liver function

BT_PO 1.106

Many of our drugs are metabolised by the liver, and many of our procedures rely on normal coagulation status.

An elevation in AST is related to zone 1 damage   TRUE/FALSE

Hypoalbuminaemia is seen within 48 hours of a hepatic insult  TRUE/FALSE

There will be hyperglycaemia in severe hepatic insufficiency  TRUE/FALSE

Urea will be low in severe hepatic insufficiency  TRUE/FALSE

Biliary obstruction can cause a high INR  TRUE/FALSE