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MEDICAL ANIMATION TRANSCRIPT: Drug metabolism is the chemical conversion of drugs into water soluble compounds that can be excreted by the body. Drug metabolism mainly takes place in the liver, while excretion mainly takes place in the kidneys. Following drug administration, drugs must pass through tightly packed cells, crossing cell membranes to reach their sites of action. Usually drugs are lipophilic or fat soluble compounds, and cell membranes are composed of phospholipids, so drugs are able to cross them. However, for excretion by the kidneys, it's necessary to convert drugs to water soluble or hydrophilic compounds. Drugs are usually administered orally or parenterally. Parenteral drugs bypass the digestive tract. Parental routes include injection, transdermal patches, lotions, inhalants, and suppositories. If injected, the drugs reach general circulation quickly and have an immediate effect. If taken orally, drugs must pass through the cells of the gastrointestinal tract. Drugs cross through cells of the GI tract and travel to the liver via the hepatic portal vein. The liver has a chance to metabolize some of the drug before it goes into general circulation, this is called the first pass effect. In the liver, drugs enter hepatic cells where a series of enzymes in smooth endoplasmic reticulum metabolize them. Drugs move through the phospholipid membrane of endoplasmic reticulum. Hepatic microsomal enzymes such as p450 convert drugs from lipophilic to hydrophilic compounds. Repeated use of certain drugs increases the amount of metabolic enzymes and increases drug metabolism. This is called enzyme induction. Conversely, certain drugs compete to bind to metabolic enzymes thereby decreasing drug metabolism. This is called enzyme inhibition. Once metabolized, these hydrophilic metabolites leave the cell ready for excretion by the kidney. A drug's duration and intensity of effect are largely determined by metabolic rate. Increased metabolic rate will decrease drug duration and intensity by facilitating excretion. Decreased metabolic rate increases drug duration and intensity. A few of the factors affecting metabolic rate are the first pass effect, liver disease such as cirrhosis, neonates in the elderly have decreased liver function, compromised blood flow to the liver will lower metabolic rate, variation in amount and type of hepatic enzymes, poor diet and nutrition can affect normal liver function, and higher circulating drug levels due to dosage or patient's weight take longer to metabolize. ♪ [music] ♪
"Medical illustrations are essential evidence in personal injury litigation and MLA is simply the best I've found at producing high-quality illustrations. Your illustrators are not only first-class artists, but creative and responsive. Your turn around time is as good as it gets. My clients have won over $60 million in jury verdicts and I can't recall a case which did not include one of your exhibits. On behalf of those clients, thanks and keep up the great work!"
"Thank you for the splendid medical-legal art work you did for us in the
case of a young girl who was blinded by a bb pellet. As a result of your
graphic illustrations of this tragic injury, we were able to persuade the
insurance company to increase their initial offer of $75,000.00 to
$475,000.00, just short of their policy limits.
We simply wanted you to know how pleased we were with your work which, to
repeat, was of superlative character, and to let you know that we would be
more than willing to serve as a reference in case you ever need one. Many
thanks for an extraordinary and dramatic depiction of a very serious injury
which clearly "catapulted" the insurance company's offer to a "full and
fair" amount to settle this case."
Philip C. Coulter Coulter &Coulter Roanoke, VA
"We are extremely pleased with the quality of the medical exhibits and the
timely manner in which they were provided. I will certainly recommend
your company to my business associates who could benefit from your services.
Please tell Brian Wilson [Director of Content Development, Senior Medical
Illustrator] that he did an exceptional job on these exhibits."
K. Henderson
Dunaway and Associates
Anderson, SC
"I would like to thank all of you at Medical Legal Art for all the
assistance you provided. It was a result of the excellent, timely work
that we were able to conclude the case successfully.
I feel very confident that our paths will cross again."
Fritz G. Faerber
Faerber & Anderson, P.C.
St. Louis, MO
Medical Legal Art creates medical demonstrative evidence (medical
illustrations, drawings, pictures, graphics, charts, medical animations,
anatomical models, and interactive presentations) for use during legal
proceedings, including research, demand letters, client conferences,
depositions, arbitrations, mediations, settlement conferences, mock jury
trials and for use in the courtroom. We do not provide legal or medical
advice. If you have legal questions, you should find a lawyer with whom you
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