This animation may only be used in support of a single legal proceeding and for no other purpose. Read our License Agreement for details. To license this image for other purposes, click here.
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] ♪
"This past year, your company prepared three medical illustrations for our cases; two in which we received six figure awards; one in which we received a substantial seven figure award. I believe in large part, the amounts obtained were due to the vivid illustrations of my clients' injuries and the impact on the finder of fact."
Donald W. Marcari Marcari Russotto & Spencer, P.C. Chesapeake, VA
"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 wins our firm's highest accolades for professionalism and
exhibit quality. In fact, many of the doctors I work with request color
copies of your outstanding artwork to show to patients during the informed
consent process."
Jeanne Dolan, BSRN, AlNC Legal Nurse Consultant Golden Valley, MN
"A few words about The Doe Report: recently in a brachial plexus injury
case, we used an image from The Doe Report to demonstrate the injury. We
downloaded the PDF file image, and were amazed at the quality. The hard
copies that you sent were even more clear. As well, we could not have been
happier when you customized the image and reversed the injury from the left
shoulder to the right shoulder, which is where our client's injury was.
The speed and cost-effectiveness of the product made it the perfect tool for
our purposes. We will use The Doe Report again in future cases."
Andrew Needle
Needle Gallagher & Ellenberg, P.A.
Miami, FL
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
can discuss your case issues. If you have medical questions, you should seek the advice of a healthcare provider.