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Dose adaptation of drugs in patients with liver disease

Tchambaz, Lydia. Dose adaptation of drugs in patients with liver disease. 2004, Doctoral Thesis, University of Basel, Faculty of Science.

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Official URL: http://edoc.unibas.ch/diss/DissB_6820

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Abstract

In my thesis I defined strategies for dosage adaptation of drugs in patients with liver disease. The major goal of the thesis was to classify antineoplastic drugs and central nervous agents according to pharmacokinetic principles (hepatic extraction and bioavailability) and to provide recommendations for their use in patients with liver disease. The antineoplastic drugs and central nervous agents available on the market in Switzerland were therefore studied. In a second time a clinical study was planned in patients with liver cirrhosis to define methods of dose adaptation for high-extraction drugs.
The dose adaptation of drugs in patients with liver disease is more difficult than in patients with renal disease. The dosage may have to be adjusted but the problem is to quantify the required changes.
Ideally, there should be a predictive liver function test that allows a more precise dosing in patients with liver disease analogous to the creatinine clearance for patients with renal dysfunction. Unfortunately, no such practical system is available as yet. Despite the absence of such a test, kinetic parameters and clinical studies can both help determining the kinetic behavior of a drug and providing dosage adjustments.
Advisors:Krähenbühl, Stephan
Committee Members:Drewe, Jürgen and Wenk, Markus
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Former Units at DBM > Clinical Pharmacology (Drewe)
UniBasel Contributors:Krähenbühl, Stephan and Drewe, Jürgen and Wenk, Markus
Item Type:Thesis
Thesis Subtype:Doctoral Thesis
Thesis no:6820
Thesis status:Complete
Bibsysno:Link to catalogue
Number of Pages:152
Language:English
Identification Number:
Last Modified:22 Apr 2018 04:30
Deposited On:13 Feb 2009 14:52

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