Biliary excretion of a drug metabolite can sometimes lead to 'Enterohepatic Recirculation'. This occurs when:
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Correct answer: Intestinal bacteria deconjugate the metabolite and the drug is reabsorbed
After a glucuronide conjugate is excreted in bile, gut bacteria can produce beta-glucuronidase enzymes that strip away the glucuronic acid. This releases the original lipid-soluble drug, which is then reabsorbed into the portal blood.
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