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. | |
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