• 
  4.1

  Phase 1 and phase 2 metabolism

  This lesson covers phase 1 reactions (oxidation by CYP enzymes, reduction and hydrolysis) and phase 2 conjugation reactions. Paracetamol shows both phases in one drug, and why an overdose damages the liver.

  8:26
• 
  4.2

  CYP enzymes

  This lesson compares the CYP enzymes by their amount in the liver, their share of drug metabolism, their substrate preference and the effect of inhibitors and inducers. Two midazolam studies show inhibition by ketoconazole and itraconazole and induction by rifampicin.

  8:30
• 
  4.3

  Prodrugs and active metabolites

  This lesson covers prodrugs and active metabolites in four cases: valacyclovir, clopidogrel and its dependence on CYP2C19, codeine, and the toxic paracetamol metabolite NAPQI.

  8:51
• 
  4.4

  Genes and metabolism

  This lesson covers pharmacogenetics: poor, intermediate, normal and ultrarapid metabolizers, the CPIC activity score for CYP2D6, differences between populations, the effect of inhibitors, and what the genotype means for codeine.

  8:37
• 
  4.5

  Hepatic extraction

  This lesson covers hepatic clearance, the extraction ratio and the well-stirred model, with lidocaine as a high-extraction drug and warfarin as a low-extraction drug.

  8:09

Previous moduleDistributionNext moduleExcretion