The liver plays a central role in the pharmacokinetics of the majority of drugs. Liver
dysfunction may not only reduce the blood/plasma clearance of drugs eliminated by hepatic …

First-pass elimination takes place when a drug is metabolised between its site of
administration and the site of sampling for measurement of drug concentration. Clinically …

Successful pain management with opioids requires that adequate analgesia be achieved
without excessive adverse effects. By these criteria, a substantial minority of patients treated …

Glucuronidation is a major metabolic pathway for a large number of drugs in humans.
Conjugation of drugs and other chemicals with glucuronic acid is catalyzed by the multigene …

The liver is the major site of biotransformation for most opioids. Thus, the disposition of these
drugs may be affected in patients with liver insufficiency. The major metabolic pathway for …

The physiological changes that accompany hepatic impairment alter drug disposition. Porto-
systemic shunting might decrease the first-pass metabolism of a drug and lead to increased …

Unfortunately, there is no endogenous marker for hepatic clearance that can be used as a
guide for drug dosing. In order to predict the kinetic behaviour of drugs in cirrhotic patients …

1. The oral and intravenous kinetics of morphine were investigated in seven cirrhotic
patients with a history of encephalopathy. The plasma concentrations of morphine and its …

Background Prescription information for many drugs entering the market lacks dosage
guidance for hepatic impairment. Dedicated studies for assessing the fate of drugs in hepatic …

Presystemic metabolism occurring in the intestinal epithelium and/or liver is frequently an
important determinant of drug bioavailability after oral administration. Several factors are …