General Influencing Factors
Various factors affect the rate of glucuronidation, in turn causing increased or decreased glucuronidation of various substances, in turn affecting their clearance. Generally, an increased rate of glucuronidation results in less effect of affected drugs or compounds, and vice versa.
| Factor | Effect on glucuronidation | Main drugs or compounds affected | |
|---|---|---|---|
| Age | Infant | ↑ | Chloramphenicol, morphine, acetaminophen, bilirubin, steroids |
| Elderly | ↑ or unchanged | No change found for acetaminophen, oxazepam, temazepam, or propranolol. Decreased clearance found for codeine-6-glucuronide, and decreased unbound clearance for oxazepam in the very elderly. |
|
| Gender | Females | ↓ | Clearance higher in males for acetaminophen, oxazepam, temazepam, and propranolol. Possible additive role with CYP1A2 resulting in higher clozapine and olanzapine concentrations in females |
| Males | ↑ | ||
| Body habitus | Overweight | ↑ | Clearance of lorazepam, oxazepam, temazepam, and acetaminophen likely the result of an increase in liver size and quantity of enzyme |
| Underweight/malnourished | ↓ | Chloramphenicol, acetaminophen | |
| Disease states | Fulminant hepatitis, cirrhosis | ↓ | Zidovudine, oxazepam, lamotrigine |
| Hypothyroidism | ↓ | Oxazepam, acetaminophen | |
| HIV | ↓ | Acetaminophen | |
| Tobacco smoking | ↑ | Propranolol, oxazepam, lorazepam, acetaminophen. Possible additive role with CYP1A2 induction causing decreased clozapine and olanzapine concentration. | |
Read more about this topic: Glucuronidation
Famous quotes containing the words general, influencing and/or factors:
“The happiest conversation is that of which nothing is distinctly remembered but a general effect of pleasing impression.”
—Samuel Johnson (1709–1784)
“A physician’s physiology has much the same relation to his power of healing as a cleric’s divinity has to his power of influencing conduct.”
—Samuel Butler (1835–1902)
“Language makes it possible for a child to incorporate his parents’ verbal prohibitions, to make them part of himself....We don’t speak of a conscience yet in the child who is just acquiring language, but we can see very clearly how language plays an indispensable role in the formation of conscience. In fact, the moral achievement of man, the whole complex of factors that go into the organization of conscience is very largely based upon language.”
—Selma H. Fraiberg (20th century)