Join Eoin Tabb on the Irish Haematology Oncology Podcast for a deep dive into hepatic impairment in cancer patients. We'll break down the vital functions of your liver, how we measure its health, and why this is crucial when planning chemotherapy. Whether you're a new healthcare professional or a seasoned expert, this episode is packed with insights on how to navigate the complexities of chemo dosing when the liver isn't functioning at its best. Tune in to learn how to keep your patients safe and optimize their treatment outcomes!

Podcast Show Notes:

• The Liver: Your Body's Metabolic Powerhouse and Detoxification Center

• The liver's multiple roles: detoxification, nutrient processing, production of essential substances

• The liver's role in medication metabolism

• The impact of hepatic impairment on chemotherapy: increased drug levels, decreased drug activation, altered blood flow, and protein binding issues

• When the Liver Hits a Snag: Types and Causes of Hepatic Impairment

• Degrees of hepatic impairment: mild, moderate, severe

• Common causes: chronic liver diseases (cirrhosis, hepatitis, NAFLD), medications (chemotherapy, other drugs), alcohol abuse, other causes

• Types of liver damage: hepatocellular, cholestatic, mixed

• Measuring Liver Health: The Tools and the Challenges

• Child-Pugh score: assessing liver function based on bilirubin, albumin, INR, ascites, and encephalopathy

• NCI Organ Dysfunction Criteria: focusing on bilirubin and liver enzymes (ALT, AST)

• The importance of context and clinical judgment in interpreting test results

• The Domino Effect of Hepatic Impairment on Chemo:

• Increased risk of toxicity

• Issues with prodrugs

• Impact on biliary excretion, blood flow, and protein binding

• The importance of individualizing treatment based on cancer type, treatment goals, and patient resilience

• The challenges of dose adjustments

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