Drug detoxification Flashcards

1
Q

Microsomal enzymes

A

Cytochrome P450
Flavin mono-oxygenase
UDP glucoronysltransferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Non-microsomal enzyme features

A

Non-specific (phase I and II reactions)

Non-inducible (synthesised continuously regardless of conditions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Non-microsomal enzymes examples

A
Protein oxidase
Esterase
Amidase
Conjugases
Alcohol dehydrogenase
Aldehyde dehydrogenase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why are lipophillic drugs not effectively removed by the kidney?

A

They are passively absorbed due to the fact that they can diffuse through cell membranes easily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the aim of drug metabolism in the liver?

A

Make drugs more polar, so they cannot get across membranes and a thus easily excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the aim of Phase I reactions?

A

Make drug more hydrophillic so it can be excreted by the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do Phase I reactions achieve their aim?

A
  • They add a hydroxyl group to the drug (-OH)

- or: a reactive site that can be used for conjugation/Phase II reactions is introduced or exposed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What kind of reactions take place in Phase I?

A

Oxidation
Reduction
Hydrolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Oxidation

A
  • Hydroxylation (add -OH)
  • Dealkylation (remove -CH side chains)
  • Deamination (remove -NH)
  • Hydrogen removal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Reduction

A

Add hydrogen (saturate unsaturated bonds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hydrolysis

A
  • Split amide bonds (peptide bond between COOH and NH)

- Split ester bonds (H from COOH is replaced by hydrocarbon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which enzyme normally catalyses Phase I functionalisation reactions

A

Cytochrome P450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does Cytochrome P450 work?

A
  • Cytochrome P450 reductase is the enzyme required to transfer electrons from NADPH to CYP450
  • It contains flavoprotein which in turn consists of FAD and FMN
  • FAD and FMN - electron donors and acceptors …
    • FAD = accepts electrons from NADPH
    • FMN = electron donor to CYPs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Overall word equation

NADPH …

A

NADPH + H+ + O2 + R-H ⇒ NADP+ + H2O + R-OH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What kind of reactions are Phase II reactions?

A
  • Synthetic anabolic reactions

- Synthesis: simple → complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Examples of Phase II reactions (7)

A
  • Glucuronidation
  • Sulfation
  • Glutathione conjugation
  • Amino acid conjugation
  • Acetylation
  • Methylation
  • Water conjugation
17
Q

Phase II reactions are known as ‘conjugation reactions’. What is their aim?

A

Attachment of substituent groups to significantly increase hydrophilicity for renal excretion

18
Q

What is a common feature of products of phase II reactions?

A

they are usually inactive

19
Q

What is a glucuronidation reaction?

A

Adding a glucuronic acid group to the drug makes it more hydrophilic

20
Q

What enzyme is involved in glucuroindation reactions?

A

Glucuronosyltransferase

21
Q

What is the co-enzyme/donor compound required to conjugate glucuronic acid?

A

UDPGA

22
Q

Metabolism of aspirin

A

PHASE I

  • Since its a pro-drug it is activated upon metabolism
  • Undergoes a hydrolysis reaction
  • Aspirin + H2O → Salcylic acid + Ethanoic acid

PHASE II

  • Conjugated with glycine or glucuronic acid
  • Forms a range of ionised metabolites, thus wont be passively absorbed, so can be excreted by the kidneys and excreted in the urine.
23
Q

Metabolism of paracetamol

A

Predominantly metabolised in a Phase II reaction - conjugated with glucuronic acid and sulphate

24
Q

Toxicity of paracetamol - what happens if glucuronic acid and sulphate are running low?

A
  • Paracetamol will undergo Phase I mechanism via oxidation to produce toxic NAPQI
  • This is removed by conjugation with glutathione
  • In overdoses, stores of glutathione can run low resulting in toxicity
  • Treated with N-acetyl cysteine
25
Q

Alcohol metabolism reaction

A

Ethanol (ADH) → Acetaldehyde (ALDH) → Acetate → CO2 + H2O

26
Q

What is ADH

A

Alcohol dehydrogenase

27
Q

What is ALDH?

A

Aldehyde dehydrogenase

28
Q

What product is carcinogenic in the alcohol metabolism reaction

A

Acetaldehyde