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Tsai, Chung-Jyi

doi:10.1023/a:1018899506271

Cited by 44 publications

(1 citation statement)

References 23 publications

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“…For orally administered drugs, these changes can affect the rate and extent of absorption. Alterations in intestinal permeability may be due to various gastrointestinal lesions caused by H. pylori gastritis, peptic ulcers or portal hypertensive gastropathy; all conditions which patients with liver impairment may be at an increased risk for [Siringo et al , 1995, Tsai, 1998, Zullo et al , 2003, Zuckerman et al , 2004, Delcò et al , 2005, Lee et al , 2008, Cariello et al , 2010, Scarpellini et al , 2010, Kirchner et al , 2011]. H. pylori gastritis and peptic ulcer disease can also affect absorption due to changes in gastric pH [Lahner et al , 2009].…”

Section: Impact On Pharmacokinetic Processesmentioning

confidence: 99%

Relevance of liver failure for anti-infective agents: from pharmacokinetic alterations to dosage adjustments

Büdingen

González

Tucker

et al. 2014

Therapeutic Advances in Infection

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The liver is a complex organ with great ability to influence drug pharmacokinetics. Due to its wide array of function, its impairment has the potential to affect bioavailability, enterohepatic circulation, drug distribution, metabolism, clearance, and biliary elimination. These alterations differ widely depending on the cause of the liver failure, if it is acute or chronic in nature, the extent of impairment, and comorbid conditions. In addition, effects on liver functions do not occur in a proportional or predictable manner for escalating degrees of liver impairment. The ability of hepatic alterations to influence PK is also dependent on drug characteristics, such as administration route, chemical properties, protein binding, and extraction ratio, among others. This complexity makes it difficult to predict what these effects have on drugs. Unlike certain classes of agents, efficacy of anti-infectives is most often dependent on fulfilling pharmacokinetic/pharmacodynamic targets, such as Cmax/MIC, AUC/MIC, T>MIC, IC50/EC50, or T>EC95. Loss of efficacy, or conversely, increased risk of toxicity may occur in certain circumstances of liver injury. Although important to consider these potential alterations and their effects on specific anti-infectives, many lack data to constitute specific dosing adjustments, making it important to monitor patients for effectiveness and toxicities of therapy.

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Section: Impact On Pharmacokinetic Processesmentioning

confidence: 99%

Relevance of liver failure for anti-infective agents: from pharmacokinetic alterations to dosage adjustments

Büdingen

González

Tucker

et al. 2014

Therapeutic Advances in Infection

View full text Add to dashboard Cite

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Portal Hypertension and Duodenal Ulcer in Children

Hung,

Ni,

Hsu

et al. 2004

J. pediatr. gastroenterol. nutr.

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Objectives:The prevalence of duodenal ulcer (DU) in adult patients with portal hypertension is higher than in patients without portal hypertension. This study investigates the prevalence and characteristics of DU in children with portal hypertension.Patients and Methods:From January 1997 to December 2001, 80 children with portal hypertension who had undergone upper intestinal endoscopic examinations were enrolled. Possible factors contributing to the development of DU including severity of liver disease, portal hypertension, H. pylori, and serum gastrin level were studied. The control group consisted of 80 age‐and sex‐matched children with gastrointestinal symptoms but no liver disease and who underwent endoscopic examination during the same period.Results:The prevalence of DU was significantly higher in children with portal hypertension than in children with digestive symptoms only (22.5%v 8.8%; P =0.017). DU was more common and appeared earlier in children with a history of variceal bleeding. The presence of DU was independent of the severity of liver disease, H. pylori infection and serum gastrin level.Conclusion:DU occurs commonly in children with portal hypertension, especially in those who have had variceal bleeding. It is mandatory to screen a patient with gastrointestinal bleeding for DU even in the presence of esophageal varices. Elevated portal pressure might be a factor contributing to the development of DU.

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Role ofHelicobacter pylori in cirrhotic patients with dyspepsia: A13C-urea breath test study

et al. 2001

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The role of Helicobacter pylori in dyspeptic, cirrhotic patients remains unclear. This prospective outpatient study, conducted to assess the relationship of gastroduodenal disease and H. pylori as determined by the (13C) urea breath test, enrolled 109 consecutive cirrhotic patients with dyspepsia. All patients underwent upper-gastrointestinal endoscopy, which revealed respective prevalences of peptic ulcer, gastric ulcer, and duodenal ulcer of 41.3%, 23.9%, and 22.9%; H. pylori infection was found in 52.3%. The rate of peptic ulcer disease in the H. pylori-positive (45.6%) and -negative (36.5%) groups was not significantly different; neither was the prevalence of H. pylori in patients with or without portal hypertensive gastropathy and with or without esophageal varices. The relationship between peptic ulcer disease and H. pylori in dyspeptic patients with cirrhosis appears to be weak. Likewise, no significant relationship was evident between H. pylori and portal hypertensive gastropathy or esophageal varices. This organism may not be a major pathogenetic factor in gastroduodenal diseases in dyspeptic patients with cirrhosis.

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Untitled

Cited by 44 publications

References 23 publications

Relevance of liver failure for anti-infective agents: from pharmacokinetic alterations to dosage adjustments

Relevance of liver failure for anti-infective agents: from pharmacokinetic alterations to dosage adjustments

Portal Hypertension and Duodenal Ulcer in Children

Role ofHelicobacter pylori in cirrhotic patients with dyspepsia: A13C-urea breath test study

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