Alkaline phosphatase liver function test

The dosage of flucytosine is 150—200 mg/kg orally in four portions every six hours. A 1% flucytosine solution has been developed for intravenous adrninistration. In some countries, a 10% ointment is also available. In patients with normal renal function, flucytosine is seldom toxic, but occasionally severe toxicity may be observed (leukopenia and thrombocytopenia). Plasma levels should be determined and the dose in patients with impaired renal function should be checked. Liver function tests (transaininases and alkaline phosphatase) should be performed regularly. In some patients with high flucytosine plasma levels, hepatic disorders have been observed (24). 

A complete physical examination and laboratory analysis are needed to rule out secondary causes and to assess kyphosis and back pain. Laboratory testing may include complete blood count, liver function tests, creatinine, urea nitrogen, calcium, phosphorus, alkaline phosphatase, albumin, thyroid-stimulating hormone, free testosterone, 25-hydroxyvitamin D, and 24-hour urine concentrations of calcium and phosphorus. Urine or serum biomarkers (e.g., cross-linked N-telopeptides of type 1 collagen, osteocalcin) are sometimes used. 

Current nutritional intake Complete blood cell count Serum electrolytes Sodium Potassium Chloride Bicarbonate Magnesium Phosphorous Calcium Serum glucose Serum albumin Markers for organ function Liver function tests Alkaline phosphatase Aspartate aminotransferase Alanine aminotransferase Total bilirubin Prothrombin time or International normalized ratio Renal function tests Blood urea nitrogen Creatinine Fluid balance Input Oral... 

Liver function tests Alkaline phosphatase Aspartate aminotransferase Alanine aminotransferase Total bilirubin Prothrombin time or International normalized ratio (as necessary)... 

Hepatic Effects. Liver function tests (serum bilirubin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase) completed in 11 hexachloroethane workers were within the normal range (Selden et al. 1994). Plasma hexachloroethane levels in these workers, who wore protective equipment, were 7.3 + 6.04 pg/L at the time of the tests (Selden et al. 1993). Mild skin and mucous membrane irritation were reported in the exposed group, suggesting that exposure may have been through either the inhalation or dermal routes of exposure. 

Hepatic Effects. Liver function tests (serum bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase) were not affected in 11 hexachloroethane-exposed workers who wore protective clothing (Selden et al. 1993). 

A measurement of renal function (creatinine and/or BUN) is an essential test for most clinical studies, as is the inclusion of an panel of liver function tests (SGOT, SGPT, LDH, CPK, GGT, and/or alkaline phosphatase). The specific tests chosen to be included in a study are somewhat dependent on both the investigator s and/or clinical scientist s experiences and the characteristics of the drug. Other important parameters to measure include serum electrolytes and at least some of the tests listed in Table 20.12. 

Hepatotoxicity A few cases of reversible clinical hepatotoxicity have occurred in some patients, asymptomatic rises in serum alkaline phosphatase or serum transaminase levels have been observed. If anorexia, weight loss or pruritus develop in patients on allopurinol, evaluation of liver function should be part of their diagnostic workup. Perform periodic liver function tests during early stages of therapy. 

Hepatic complications Perform periodic liver function tests, such as bilirubins, alkaline phosphatase, or transaminases during therapy discontinue at the first sign of hepatic dysfunction or jaundice. 

Liver function test abnormaiities - Increased AST, ALT, GGT, bilirubin, alkaline phosphatase, and LDH. 

Adverse reactions occurring in at least 3% of patients included the following abnormal vision, alkaline phosphatase increased, ALT/AST increased, chills, fever, hallucinations, headache, hepatic enzymes increased, liver function test abnormal, nausea, peripheral edema, photophobia, rash, vomiting. 

Transient abnormalities in liver function tests (eg, elevation in serum bilirubin, alkaline phosphatase, serum transaminases), and reduced biliary excretion of contrast media used for visualization of the gallbladder have also been observed. Drug/Food interactions Food interferes with the absorption of rifampin, possibly resulting in decreased peak plasma concentrations. Take on an empty stomach with a full glass of water. 

Liver function test, including bilirubin, alkaline phosphatase, AST, and ALT. 

Blood pressure, CBC, ECG, serum potassium level, and liver function test results, including serum alkaline phosphatase, bilirubin, AST (SCOT), and ALT (SGPT) levels... 

CBZ can cause a mild, transient increase in serum transaminases and alkaline phosphatase levels. They usually do not exceed 1.5 times normal levels and subside with ongoing treatment. If liver function tests (LFTs) increase two to three times normal levels, hepatotoxicity may result. With prolonged CBZ therapy, a syndrome resembling a mild viral hepatitis may occur but usually improves after drug discontinuation. 

A 73 year old Japanese woman, weight 33.5 kg, took nateglinide 270 mg/day and pioglitazone 15 mg/day for 6 months (105). Her HbAic concentration was 8.6% and fasting glucose 11.4 mmol/1. Metformin 250 mg bd was added and 3 weeks later she developed jaundice and fatigue. A few months before her liver function tests had been normal. Aspartate transaminase activity was 689 IU/1, alanine transaminase 772 IU/1, alkaline phosphatase 639 IU/1, and bilirubin 6.5 mg/dl. All oral therapy was withdrawn and insulin started. Her liver function improved over the next few weeks. 

There are no clear markers of liver dysfunction. Standard liver function tests such as rises in alkaline phosphatase and alanine aminotransferase (see Section 11.10.1) are only crude markers of liver function and have not proved useful in characterizing liver function in relation to drug pharmacokinetics. The effect of liver dysfunction on drug clearance is therefore often addressed descriptively rather than quantitatively (see Weeks and Tomlin, 2006, for further discussion). 

The hepatic effects observed in animals after inhalation exposure to chromium or its compounds were minimal and not considered to be adverse. Rats exposed to as much as 0.4 mg chromium(VI)/m3 as sodium dichromate for 90 days did not have increased serum levels of alanine aminotransferase or alkaline phosphatase, cholesterol, creatinine, urea, or bilirubin (Glaser et al. 1990). Triglycerides and phospholipids were increased only in the 0.2 mg chromium(VI)/m3 group exposed for 90 days (Glaser et al. 1985). Chronic exposure of rats to 0.1 mg chromium(VI)/m3 as sodium dichromate, to 0.1 mg total chromium/m3 as a 3 2 mixture of chromium(VI) trioxide and chromium(III) oxide, or to 15.5 mg chromium(IV)/m3 as chromium dioxide did not cause adverse hepatic effects as assessed by histological examination and liver function tests (Glaser et al. 1986,1988 Lee et al. 1989). 

Increased liver function tests - Mrs CR s alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) levels are all increased above the normal ranges and indicate moderate liver impairment. This may have implications on the ability of the liver to metabolise drugs and must be borne in mind when prescribing any drugs that are metabolised by it. 

There is no indication for routine liver function tests in patients taking tricyclic antidepressants raised transaminases and alkaline phosphatase within the limits of the reference ranges are not a cause for serious concern, unless they are accompanied by clinical signs or symptoms indicative of liver dysfunction. 

A 63-year-old man, who had taken amiloride and alfuzosin for 9 months for hypertension and benign prostatic hyperplasia, became jaundiced. His aspartate transaminase was 3013IU/1, alanine transaminase 2711 IU/1, alkaline phosphatase 500 IU/1, and total bilirubin 415 pmol/l. Viral causes, autoimmune hepatitis, and biliary obstruction were excluded. After withdrawal of alfuzosin, his liver function tests gradually returned to normal within 6 months. 

Certain aminoglycosides affect liver function tests. Increases in alkaline phosphatase after gentamicin and tobramycin have been described. 

Abnormal liver function tests (above normal serum alkaline phosphatase and transaminases and, less often, raised serum bilirubin concentrations) have all been reported. Hepatic involvement is rarely serious (SED-12, 675) (22). 

A 23-year-old Asian butcher developed diffuse abdominal pain, vomiting, and diarrhea, followed by constipation (4). He had a sinus tachycardia and generalized abdominal tenderness without peritonism. His serum bilirubin concentration and alanine transaminase activity were raised, but alkaline phosphatase activity, albumin concentration, and prothrombin time were normal. He had a blood lead concentration of 767 ng/ml and a raised zinc protoporphyrin concentration, diagnostic of lead poisoning. He had taken an herbal medicine, purchased in India, for vague aU-ments. He stopped taking it, and 3 months later was asymptomatic, with normal liver function tests and marked falls in blood lead (387 ng/ml) and zinc protoporphyrin. 

Most of the general biochemical results are within normal limits. The blood urea is also normal, except in subjects on a low protein diet, when it is decreased. The blood pH is frequently near the upper limit of normal, and sometimes even above it. Although some liver function tests are normal, the serum GOT, GPT, and the LDH are raised, sometimes markedly, especially when a normal protein diet is taken. The alkaline phosphatase is also usually raised. 

Again most of the general biochemical tests yielded normal results. However, of the liver function tests the serum transaminases were usually raised, especially during the severe phase when the child was comatose. On the other hand, the alkaline phosphatase has been reported normal. Renal function is normal. Blood urea was normal in two of the children, but in one case, it was usually low or very low. 

It must be pointed out that the connection between abnormal liver function tests and serum alkaline phosphatase is often not clear. It then becomes important to devise means of identifying the particular mechanism or mechanisms that have been damaged in the liver, in order to interpret precisely the significance of hyperphosphatasemia in liver disease. 

Chaparral can be found in health food stores as capsules and tablets and is used as an antioxidant and anti-cancer herbal product. Leaves, stems and bark in bulk are also available for brewing tea. However, this product can cause severe hepatotoxicity. Several reports of chaparral-associated hepatitis have been reported. A 45-year-old woman who took 160 mg of chaparral per day for 10 weeks presented with jaundice, anorexia, fatigue, nausea and vomiting. Liver enzymes and other liver function tests showed abnormally high values (ALT 1611 U L- AST 957 U L, alkaline phosphatase 265 U L, GOT 993 U L and bilirubin... 

Routine liver tests include alkaline phosphatase, bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), and y-glutamyl transpeptidase (GGT). Additional markers of hepatic synthetic activity include albumin and prothrombin time. Liver function tests are... 

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