CREATED BY : GROUP 6

1. Novi meilisyah 11.01.01.077

2. Novi wulandari 11.01.01.078
3. Novita sari oktarina 11.01.01.079
4. Nuraini 11.01.01.080
5. Nurumatun mahmudah 11.01.01.081

A. Introduction
Pharmacokinetics is the study of drug absorption, distribution,
metabolism, and excretion .

Pharmacokinetics clinic is the science that applies the concepts
and principles of pharmacokinetics in humans, aimed to draft a
dose individually so as to optimize the therapeutic response of
drugs while minimizing possible side effects.

B. Liver
liver is has a multitude of important and complex functions, including
to manufacture proteins, including albumin (to help maintain the
volume of blood) and blood clotting factors; to synthesize, store, and
process fats, including fatty acids (used for energy) and cholesterol.

general cause that make liver failure : Hepatitis B, Hepatitis C, Long
term alcohol consumption, Cirrhosis, Hemochromatosis (an inherited
disorder that causes the body to absorb and store too much iron) and
Malnutrition
Type of Liver failure
Liver failure divided into two type : chronic and acute
Symptoms of chronic liver failure is often fatty meals (grilled meat or
fish, eggs, Smoking foods, butter),indigestion, increased body
temperature (fever), the presence of lesions in the skin (dry and
become wet eczema).
Symptoms of liver failure
Symptoms of heart failure include:
1. Aplastic anemia
2. Ascites
3. Edema or swelling under the skin
4. Encephalopathy
5. Enlarged liver and burning (pain)
6. Enlarged spleen
7. Changes in mental status or level of consciousness
8. Prone to bleeding
Liver disease in humans encompasses a wide range of pathological
disturbances that can lead to a reduction in liver blood flow,
extrahepatic or intrahepatic shunting of blood,hepatocyte dysfunction,
quantitative and qualitative changes in serum proteins, and changes in
bile flow. Different forms of hepatic disease may produce different
alterations in drug absorption, disposition and pharmacologic effect.
The pharmacokinetic or pharmacodynamic consequences of a specific
hepatic disease may differ between individuals or even within a single
individual over time. Each of the major determinants of hepatic
clearance and vascular architecture may be independently altered.
Although there are numerous causes of hepatic injury, it appears that
the hepatic response to injury is a limited one and that the functional
consequences are determined more by the extent of the injury than by
the cause. At this time there is no generally 7 available test that can be
used to correlate changes in drug absorption and disposition with the
degree of hepatic impairment. (Adedoyin A : 1988)



Effects of Liver Disease on
Pharmacokinetics
Therapy
Therapyh liver failure :
- Therapy without medication
- Treatment with drugs ((aminoglycosides, Anti
amoeba: dehydroemetine, Anti malaria: chloroquine
diiodohydroxyquinoline, Anti-virus: Lamivudine)
- Therapy with vaccination
- Liver transplant therapy

Reperence
Guidance for industry: Pharmacokinetics in patients with
impaired renal function study design, data analysis, and
impact on dosing and labeling. FDA,
CDER,CBER,1998.http://www.fda.gov/cder/guidance/ind
ex.html
Adedoyin A, Selective effect of liver disease on the
activities of specific metabolizing enzymes. Clin
Pharmacol Ther 1998;64:8-17