Value of profiling liver function in the elderly

Lubin, Jack; Coles, Jonathan A.; Millward, B. A.; Croker, J. R.

doi:10.1136/pgmj.59.698.763

Cited by 5 publications

(2 citation statements)

References 11 publications

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“…However, not all patients who presented initially with either heart failure or acute infection had transiently raised ALP. Twenty-two patients with these initial diagnoses were subsequently shown to have persistently raised ALP due to hepatic metastases (3) and bone disease (8) (2) and septicaemia (1). The age of this group did not differ significantly from that of the other groups (Table I), 3 patients were jaundiced; 12 had raised serum aspartate transaminase (AST), 15 had raised gamma glutamyl transferase (GGT).…”

Section: Resultsmentioning

confidence: 99%

Transient hyperphosphatasaemia in association with acute infection in adults

Parker

1991

Postgraduate Medical Journal

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Summary:The causes of raised serum alkaline phosphatase were determined prospectively in a consecutive series of 2884 acute medical admissions. Diagnoses were established by pre-defined clinico-pathological criteria. Two hundred and four patients had hyperphosphatasaemia. Liver and bone disease accounted for only 98 (48%) of the established diagnoses. The diagnosis was not established in 31 (15%). Transient hyperphosphatasaemia occurred in 66 (32.4%) cases. In 25 ofthese patients (12% ofthe total) an acute infection was the sole illness identified. In this infected group, the isoenzyme type was predominantly hepatic, although jaundice occurred in only 3 patients. Discriminant analysis revealed that this group was characterized by haematological and biochemical features of an acute phase response.Transient hyperphosphatasaemia is commonly found in acutely ill medical inpatients and is frequently associated with acute extrahepatic infection.

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Section: Resultsmentioning

confidence: 99%

Transient hyperphosphatasaemia in association with acute infection in adults

Parker

1991

Postgraduate Medical Journal

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“…26 However, impaired liver function and abnormality occur more often in the elderly. 28,29 Given the importance of the liver in the metabolism of galantamine, it is important to assess any effects of reduced hepatic function on the pharmacokinetics of the drug. This study evaluated the pharmacokinetics and safety of galantamine in individuals with hepatic impairment compared with subjects with normal hepatic function.…”

confidence: 99%

Pharmacokinetics and Safety of Galantamine in Subjects with Hepatic Impairment and Healthy Volunteers

Zhao

Iyer

Verhaeghe³

et al. 2002

The Journal of Clinical Pharma

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The objective of this study was to compare the pharmacokinetics and safety of galantamine in subjects with hepatic impairment with those in healthy subjects. This was an open-label study in which a single oral 4-mg dose of galantamine was administered to volunteers with mild (Child-Pugh score of 5-6, n = 8), moderate (Child-Pugh score of 7-9, n = 8), or severe hepatic impairment (Child-Pugh score of 10-15, n = 1) and to healthy, matched control subjects (n = 8). Galantamine pharmacokinetics and safety (adverse events, laboratory test results, electrocardiograms, vital signs, and cardiac events) were assessed over 6 days after administration of galantamine. The pharmacokinetic parameters of galantamine were similar in subjects with mild hepatic impairment compared with healthy controls. Compared with the healthy control group, subjects with moderate hepatic impairment showed relative increases in the area under the plasma-concentration curve from zero to infinity (AUC0-infinity) (+33%) and terminal half-life (t1/2) (+30%) (p = 0.051 and p = 0.003, respectively), a 23% relative decrease in total plasma clearance (p = 0.061), and a small but significant relative increase in the fraction of free plasma galantamine (p = 0.009). Galantamine was well tolerated by all subjects. There were no serious adverse events (AEs) or premature withdrawals from the study because of AEs. Reported AEs were headache (three cases), nausea (one case), and paresthesia (one case). There were no clinically relevant changes in clinical laboratory findings, vital signs, and electrocardiograms. Low patient recruitment (n = 1) precluded statistical analysis of galantamine pharmacokinetics and safety in severe hepatic impairment. It was concluded that the pharmacokinetics of galantamine in subjects with mild hepatic impairment was similarto those in healthy subjects. In subjects with moderate hepatic impairment, galantamine clearance was decreased by approximately 23% compared with normal volunteers. Galantamine was also well tolerated and appeared to be safe in subjects with mild ormoderate hepatic impairment. Based on the study results, it appears that it would not be necessary to adjust doses of galantamine during administration to subjects with mild hepatic impairment. In subjects with moderately impaired hepatic function, dose titration should proceed cautiously. Unfortunately, difficulties with patient recruitment did not allow adequate assessment of the safety of galantamine in subjects with severe hepatic impairment in this study. Therefore, the use of galantamine in subjects with severe hepatic impairment is not recommended.

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The Liver

Hurley¹,

Green²

2010

Brocklehurst's Textbook of Geriatric Medicine and Gerontology

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Value of profiling liver function in the elderly

Cited by 5 publications

References 11 publications

Transient hyperphosphatasaemia in association with acute infection in adults

Transient hyperphosphatasaemia in association with acute infection in adults

Pharmacokinetics and Safety of Galantamine in Subjects with Hepatic Impairment and Healthy Volunteers

The Liver

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