Hepatic Insufficiency

Question 1

What are pharmacokinetic changes in hepatic insufficiency

Answer 1

= dec first-pass and increased bioavailability
= decreased dug-binding proteins and increased unbound (free) drug concentrations –> toxicity
= Phase 1 reactions (CYP450) impaired

Question 2

What are pharmacodynamic changes in hepatic insufficiency

Answer 2

• issues with analgesics, benzodiazepines, loop diuretics, BB
• increased drug sensitivity