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27 Changes in protein binding (e.g., displacement by another drug or hypoalbuminemia in liver disease) will also alter the clearance of these drugs

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8 In obese individuals, there is an increase in macrophages and neutrophils in the adipose tissue

This is considered to be the rate limiting step because it is dependent on the bioavailability of cysteine and the activity of GCL, the latter of which is modified by competitive inhibition by reduced glutathione (GSH) [3134]