Why does administering a drug metabolized via hepatic glucuronidation to a patient with Gilbert's syndrome potentially increase drug toxicity?

💡 Explanation

Gilbert's syndrome causes reduced activity of the UDP-glucuronosyltransferase 1A1 (UGT1A1) enzyme, which is responsible for bilirubin conjugation and also the glucuronidation of many drugs. Because glucuronidation is impaired, the drug's half-life increases, therefore drug toxicity can increase, rather than blood flow changes reducing drug effect.

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