Pharmacokinetic Changes in Liver Failure and Impact on Drug Therapy

Pharmacokinetics is a term that describes the time course and fate of a drug in the body. The term encompasses drug absorption, distribution, metabolism, and elimination and is often referred to as drug disposition.¹ Absorption is defined as the process by which a drug enters the systemic circulation, distribution is the movement of the drug between body compartments, and metabolism encompasses the activation or inactivation of the drug through biotransformation reactions. Elimination is the removal of the drug from the body through different routes, including in urine, feces, and bile.² 

Critically ill patients pose several challenges to health care providers that are related to medication pharmacokinetics. These challenges are due to the complex interactions of the patient’s multiple disease states and often are due to the presence of multiorgan dysfunction. Organ dysfunction affects the safety and effectiveness of medications because many organs are involved in drug disposition.^1...