Bilirubin liver function test

Evaluation Frequent physical examination, complete blood count (CBC), reticulocyte, and urinalysis based on symptomatology, the following may be needed needle aspiration to rule out osteomyelitis, abdominal studies (x-ray, computed tomography scan, etc), liver function tests, bilirubin, culture, and chest x-ray. 

TC, lamivudine ABC, abacavir APV, amprenavir AST, aspartate aminotransferase ALT, alanine aminotransferase ATV, atazanavir CBC, complete blood cell count D/C, discontinue ddl, didano-sine d4T, stavudine EFV, efavirenz FTC, emtricitabine P1BV, hepatitis B virus F1CV, hepatitis C vims HIV, human immunodeficiency virus IDV, indinavir IV, intravenous LFT, liver function tests LPV/r, lopinavir + ritonavir NNRTI, nonnucleoside reverse transcriptase inhibitor NRTI, nucleoside reverse transcriptase inhibitor NVP, nevirapine PI, protease inhibitor PT, prothrombin time T.bili, total bilirubin TDF, tenofovir disoproxiI fumarate TPV, tipranavir ULN, upper limit of normal ZDV, zidovudine. 

Liver function tests [international normalization ratio (INR), activated partial thromboplastin time (aPTT), and bilirubin] may be abnormal if disease has metastasized to the liver. 

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). 

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. 

Monitoring Patient management should include laboratory evaluation of renal (particularly serum creatinine) and hepatic function (particularly liver function tests and bilirubin). 

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. 

Serum amylase, bilirubin, cholesterol, lipase, and triglyceride levels blood glucose level CBC CD4+ cell count and liver function test results... 

Liver function tests bilirubin, AST, ALT, alk phosphatase before and during therapy... 

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

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. 

A 70-year-old man developed diabetes and started to take repaglinide 1 mg tds. After 2 weeks he developed malaise, anorexia, and jaundice. Liver function tests, including bilirubin, were raised. Repaglinide was withdrawn and the liver function tests returned to normal. There were no other obvious causes. 

A 67-year-old man took pioglitazone 30 mg/day after having taken glibenclamide 2.5 mg/day for 10 years and voglibose 0.6 mg/day for 5 years (104). His liver function was normal before and during 6 months of pioglitazone therapy, but at 7 months he had abnormal liver function tests (total bilirubin 10 pmol/l, aspartate... 

A 38-year-old woman was given insulin when glibenclamide and acarbose failed. Troglitazone 400 mg/day was added and increased to 800 mg/day 1 month later. After 2 months her liver function tests were normal, but she developed jaundice after 4 months. Total and direct bilirubin were 127 and 101 pmol/l and alanine transaminase was 34 pkat/l. After withdrawal of troglitazone her symptoms disappeared and her liver function tests normalized within several months. Metformin 1000 mg bd reduced her insulin requirement. Rosiglitazone 4 mg bd was added and her liver function tests remained normal for 10 months. 

Fletcher and Galambos 1963 Humphreys and Halpert 1931 Rao and Brown 1974 Simon and Pickering 1976 Wechsler and Wechsler 1951), increased levels of serum bilirubin (Caley and Kellock 1955 Fletcher and Galambos 1963 McCarron et al. 1981 Pietras et al. 1968), impaired liver function test results (Fletcher and Galambos 1963 Newburger et al. 1948 ... 

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). 

Hepatic function. As Mrs CR has baseline liver impairment, it will be essential to monitor her liver function tests closely, not only to assess disease response (as previously discussed) but also to check for deterioration that may preclude further use of docetaxel (e.g. if serum bilirubin were to rise outside the normal range). 

A 27-year-old man developed hepatitis (with raised bilirubin and liver enzymes) without overt jaundice after taking nefazodone 200 mg/day for 12 weeks (7). No other cause for the hepatitis could be established and the abnormal liver function tests settled 4 weeks after nefazodone withdrawal. They became abnormal again 1 week after nefazodone rechallenge and settled once again on withdrawal. 

The effect of ethinylestradiol 50 pg daily on liver function tests was examined in five women with PBC. These patients had been previously exposed to various HRT preparations (oestrogen or an oestrogen-progestogen combination). Three of the women, who had normal or near-normal serum bilirubin before treatment, tolerated HRT well. However, the remaining two, who were profoundly jaundiced (with serum bilirubins of 193 pmol/L and 365 pmol/L, respectively) before treatment, experienced a further increase in serum bilirubin levels two to three months after starting treatment. A decrease in bilirubin levels occurred in both patients upon withdrawal of ethinylestradiol [18]. 

As this patient has cholestasis they may be at a higher risk of HRT causing a further increase in bilirubin levels and worsening cholestasis. Liver function tests should be measured before treatment is started, and be monitored closely during treatment. Treatment should be stopped if a significant change occurs. 

Interference with bilirubin metabolism and excretion. Jaundice is induced selectively with minimal or no disturbance of other liver function tests recovery ordinarily occurs on stopping the drug. Examples are ... 

Indocyanine green was introduced by J. Caesar et al. in 1961 as a liver function test. Anionic tricarbocyanine dye is referred to as an ideal test substance (1.) it is tolerated very well there have been no reports of any incidents so far, and even paravenous injection is tolerated (2.) it is excreted unchanged by hepatocytes in the bile as there is no bio transformation - this is why ICG clearance is valid as a measure of hepatocellular uptake and transport processes (3.) there is no interference with drugs (except rifamycin), haemolysis, bilirubin (up to approx. 4 mg/dl) or hyperlipidaemia (4.) the substance is not subject to the enterohepatic circulation (J.) the rapid elimination, which depends on hepatic perfusion ( flow-limited ), allows the calculation of the hepatic flow volume as a whole based on ICG clearance (6.) the method is simple to perform. 

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