Clinical Pharmacology & Dosing

Child–Pugh Score

TRChild–Pugh Skoru
Also known as:Child–Turcotte–Pugh score · CTP score · Child–Pugh classification

A clinical scoring system that grades the severity of chronic liver disease, mainly cirrhosis, from five variables into classes A, B and C.

Formula

Score = sum of 5 items (bilirubin, albumin, INR, ascites, encephalopathy), each 1–3 points Class A = 5–6; B = 7–9; C = 10–15

In depth

Total bilirubin, serum albumin, INR (or prothrombin time), ascites and hepatic encephalopathy each score 1–3 points, giving totals of 5–15: class A 5–6, B 7–9 and C 10–15. Originally developed by Child and Turcotte to predict surgical risk and later modified by Pugh, it is used in regulatory pharmacokinetic studies and product labels to define mild, moderate and severe hepatic impairment.

The score reflects synthetic function and portal hypertension rather than drug-metabolising capacity, and its ascites and encephalopathy components are partly subjective, so it predicts the clearance of individual drugs only approximately. Cirrhosis can reduce metabolic clearance, lower albumin binding and, through portosystemic shunting, increase the oral bioavailability of high-extraction drugs.

Clinical pearl

Class B–C cirrhosis calls for caution with high-extraction and narrow-therapeutic-index drugs and with sedatives that may precipitate encephalopathy; many KÜB texts contraindicate specific drugs in Child–Pugh C.

TRIn Turkish

Child–Pugh Skoru

Başta siroz olmak üzere kronik karaciğer hastalığının ağırlığını beş değişkene dayanarak A, B ve C sınıflarına ayıran klinik skorlama sistemidir.

Total bilirubin, serum albümini, INR (veya protrombin zamanı), asit ve hepatik ensefalopati her biri 1–3 puan alır ve toplam puan 5–15 arasındadır: A sınıfı 5–6, B sınıfı 7–9, C sınıfı 10–15. İlk olarak Child ve Turcotte tarafından cerrahi riski öngörmek amacıyla geliştirilen ve daha sonra Pugh tarafından modifiye edilen skor, düzenleyici farmakokinetik çalışmalarda ve ürün bilgilerinde hafif, orta ve ağır karaciğer yetmezliğini tanımlamak için kullanılır.

Skor ilaç metabolize etme kapasitesinden çok sentez fonksiyonunu ve portal hipertansiyonu yansıtır; asit ve ensefalopati bileşenleri kısmen öznel olduğundan tek tek ilaçların klirensini ancak yaklaşık olarak öngörür. Siroz metabolik klirensi azaltabilir, albümine bağlanmayı düşürebilir ve portosistemik şant yoluyla yüksek ekstraksiyonlu ilaçların oral biyoyararlanımını artırabilir.

Child–Pugh B–C sirozda yüksek ekstraksiyonlu ve dar terapötik indeksli ilaçlarla ve ensefalopatiyi tetikleyebilecek sedatiflerle dikkatli olunmalıdır; pek çok KÜB belirli ilaçları Child–Pugh C'de kontrendike olarak belirtir.

Diğer adları:Child–Turcotte–Pugh skoru · Child–Pugh sınıflaması
Updated 24.09.2026 0 views Educational reference — verify against current sources before clinical use.

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Hepatic ClearanceHepatik Klirens

The component of total clearance due to hepatic metabolism and biliary excretion; the volume of blood cleared of drug by the liver per unit time.

 Hepatic Extraction RatioHepatik Ekstraksiyon Oranı

The fraction of drug entering the liver in the blood that is irreversibly removed during a single pass through the organ, ranging from 0 (no extraction) to 1 (complete extraction).

 First-Pass Effectİlk Geçiş Etkisi

The metabolism of a drug in the liver (or gut wall) before it reaches systemic circulation, often reducing the bioavailability of orally administered drugs.

 HepatotoxicityHepatotoksisite

Liver injury caused by a drug, herbal or dietary supplement or other chemical, ranging from asymptomatic aminotransferase elevation to cholestasis, hepatitis and acute liver failure.

 Narrow Therapeutic Index DrugDar Terapötik İndeksli İlaç

A drug for which small differences in dose or blood concentration may lead to serious therapeutic failure or serious adverse drug reactions.

 Drug–Disease Interactionİlaç–Hastalık Etkileşimi

A situation in which a drug worsens a coexisting disease or condition, or in which a disease alters a drug's pharmacokinetics or pharmacodynamics so that it becomes less effective or more toxic.