Factors influencing metabolism
As can be seen in the graphic, age is the most significant physiological cause for changes in metabolic activity. This far outweighs any impact suspected from the effect of liver disease on metabolic activity. From a pathophysiological point-of-view, most patients will have a decreased in metabolic activity from a decrease in cardiac output (thus less drug reaching the liver) than from a decrease in the number of viable liver cells.
Other factors influencing metabolic activity include:
- Genetic polymorphisms
- First pass effect