Cholestasis and hepatic drug metabolism

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Abstract
The antipyrine metabolic clearance rate (MCR) was studied in two groups of patients with similar degrees of cholestasis and hepatic damage, but differing mechanisms of cholestasis. The plasma disappearance rate of antipyrine in 18 patients with extrahepatic cholestasis and 11 patients with intrahepatic cholestasis was compared with that of two groups of control subjects without liver disease who were matched for age. Whereas no significant difference was observed for the antipyrine MCR between patients with extrahepatic cholestasis and their controls [30.7±11.2 (sd) as against 31.6±10.0 ml/min], the antipyrine MCR was significantly lower (Pper se does not change the rate of metabolism of drugs by the liver. The decrease of antipyrine MCR in patients with intrahepatic cholestasis could be due to a reduced functional parenchymal mass related to some degree of hepatic necrosis.