What hepatic function markers are evaluated to decide dose reductions in hepatic impairment?

• A. Kidney function tests (creatinine, BUN).
• B. Bilirubin and transaminases.
• C. Serum lipids.
• D. Platelet count.

Answer: (B)

When dosing in hepatic impairment, you focus on how well the liver can metabolize and clear drugs. Bilirubin and transaminases are direct indicators of liver function: bilirubin elevation points to impaired bile processing and clearance, while elevated ALT/AST shows hepatocellular injury that can reduce metabolic capacity. Together, these markers help determine how much a drug’s exposure may increase in liver disease and guide dose reductions to avoid toxicity.

Other options don’t directly reflect hepatic metabolic function: kidney tests assess renal clearance, serum lipids aren’t a measure of liver processing for drug metabolism, and platelet count doesn’t gauge hepatic drug handling (though it can be affected by liver disease, it isn’t used to tailor hepatic dosing).