Learning Objects : Lifelong Application

RLO: Clinical impact of changes in drug clearance

Introduction
Age: Neonates
Age: Elderly
Disease
Activity 1
Genetic factors
Activity 2
Assessment
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Disease

Hepatic and renal function can be affected by a number of disease states which then impact on drug clearance.

Liver disease, including cirrhosis and alcoholic liver disease, will reduce the ability of the liver to effectively metabolise drugs, thereby reducing hepatic clearance.

Similarly, hypothermia affects the rate of hepatic microsomal enzyme activity, reducing the clearance of drugs such as propranolol which are predominantly cleared by hepatic mechanisms.

Renal disease, on the other hand, reduces the ability of the kidneys to clear active drug from the body.

Shock results in reduced blood flow to body organs, including both the liver and the kidneys, and will therefore act to reduce both hepatic and renal drug clearance.

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