Hepatitis drugs used

Individuals may minimize their risk of acquiring both hepatitis B and C infection by avoiding contaminated blood products and not indulging in high-risk behavior such as intravenous drug use. 

Colchicine (a drug used in treatment of gout) and vinblastine (a cancer chemotherapy agent) may decrease liver uptake of americium. In rats that received an intraperitoneal injection of either colchicine and vinblastine prior to an intravenous or intramuscular injection of americium citrate, liver uptake of americium was lower, relative to controls, and kidney and skeletal americium uptake were higher (Seidel 1984, 1985). The effect is thought to involve disruption of hepatic microtubule formation, which is critical to the formation and intracellular processing of lysosomes, the initial site of accumulation of americium in the liver. 

Lau, Y.Y. et al. 2002. Development of a novel in vitro model to predict hepatic clearance using fresh, cryopreserved, and sandwich-cultured hepatocytes. Drug Met. Disp. 30 1446. 

Lamivudine (also known as Epivir and 3TC) is a potent antiviral drug used in the treatment of HIV and hepatitis B virus (HBV) infections. Although both enantiomers are equipotent antiviral agents, the unnatural enantiomer (with respect to natural nucleosides) is far less cytotoxic, and so a method of selectively accessing the single enantiomer was required. 

Neural networks are a relatively new tool in data modelling in the field of pharmacokinetics [54—56]. Using this approach, non-linear relationships to predicted properties are better taken into account than by multiple linear regression [45]. Human hepatic drug clearance was best predicted from human hepatocyte data, followed by rat hepatocyte data, while in the studied data set animal in vivo data did not significantly contribute to the predictions [56]. 

Hepatic disease Use with caution in patients with hepatic disease or in conjunction with hepatotoxic drugs. 

Il.b.l.1. Adverse effects of anti-secretory treatment. Histamine H2 antagonists and proton pump inhibitors are very safe as well as effective treatments. Cimetidine has small effects on hepatic drug metabolism which are only of clinical signiflcance with drugs used in doses close to toxic levels, notably phenytoin, aminophylline and warfarin. Other adverse effects such as headache, rash and thrombocytopenia are rare. 

Wodak A (1994). Managing illicit drug use a practical guide. Drugs, 47, 446-57 Wodak A (1997). Hepatitis C waiting for the Grim Reaper. Medical Journal of Australia, 166, 290-3... 

It is also important to remember that these agents are primarily metabolized by the liver, and because various medical disorders can compromise hepatic function (e.g., congestion secondary to heart failure, metastases, or cirrhotic states), the elimination half-lives of these drugs may be significantly prolonged. This may lead to excessive accumulation over several days to weeks of treatment, ultimately culminating in further deterioration. Thus, the judicious use of as-needed or short-term drug use is ideal. 

Most drugs used in anaesthesia are metabolised in the liver by phase I reactions, mediated by cytochrome P-450 enzymes. These are susceptible to destruction by cirrhosis, so that the biotransformation of drugs, such as opioids (except morphine), benzodiazepines, barbiturates, and inhalational agents, may be markedly altered in severe liver disease. These enzymes are found in the centrilobular areas, which are more prone to hypoxia. In contrast, the enzymes responsible for phase II reactions, found predominantly in the peripheral areas, often function normally even in advanced disease. The disposition of benzodiazepines that are eliminated primarily by glucuronidation, e.g. lorazepam and oxazepam, are unaffected by chronic liver disease. For drugs with low hepatic extraction, advanced hepatocytic dysfunction decreases phase I and II biotransformation with a reduced clearance and prolongation of the elimination half-life. This is often partially offset by an increased free fraction due to decreased protein binding. 

Important alterations in hepatic drug excretion and metabolism also occur. Estrogens in the amounts seen during pregnancy or used in oral contraceptive agents delay the clearance of sulfobromophthalein and reduce the flow of bile. The proportion of cholic acid in bile acids is increased while the proportion of chenodeoxycholic acid is decreased. These changes may be responsible for the observed increase in cholelithiasis associated with the use of these agents. 

Table 49-6 Drugs Used to Treat Viral Hepatitis. ...

---