Alcohol, Other Drugs, and the Liver

  1. EMANUEL RUBIN, M.D.; and
  2. CHARLES S. LIEBER, M.D.
  1. Department of Pathology
    Mount Sinai School of Medicine
    New York, N. Y.
  2. Department of Medicine
    Mount Sinai School of Medicine and Liver Disease and Nutrition Unit
    Bronx Veterans Administration Hospital
    New York, N. Y.

    Excerpt

    During the last decade numerous biochemical and ultrastructural studies have greatly expanded our understanding of the mechanisms involved in drug metabolism. Comprehensive recent reviews of this subject include those of Conney (1), Remmer (2), and Gillette (3). Most exogenous substances—such as pharmacologic agents, carcinogens, and insecticides—are detoxified by enzyme systems located in the microsomal fraction of the liver cell, which corresponds to the membranes of the endoplasmic reticulum seen with the electron microscope. Detoxification generally involves conversion of the molecule to a more polar form, thus rendering lipid soluble materials more water soluble for urinary excretion. This is usually accomplished

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