Drugs and hepatotoxicity

Question 1

what are the types of adverse drug reactions?

Answer 1

Augmented
Biarre
Continued use
End of treatment
Delayed Onset

Question 2

what is phase one of hepatic drug metabolism?

Answer 2

The aim of making the drug more polar

Question 3

what are the possible reaction of phase 1 metabolism?

Answer 3

Oxidation
Reduction
Hydrolysis

Question 4

what is phase 2 drug metabolism?

Answer 4

Coupling of a drug or polar metabolite to substrate catalysed by an enzyme

Question 5

what is the mechanism of paracetomal breakdown?

Answer 5

• phase 2 first which is conjugation with gluruonide and sulphate
• phase 1 when two becomes full. Forms toxic NAPQI

Question 6

what type of drug reaction is paracetomal poisoning?

Answer 6

A

Question 7

how does N acetyl cysteine work?

Answer 7

It acts as a glutathione donor making NAPQI less toxic

Question 8

what is a type B drug reaction?

Answer 8

• not dose related

- upredictable

Question 9

what is inflammatory drug induced cholestasis?

Answer 9

• Allergic or immune mediated. Will show lots of purple nuclei

Question 10

what is non-inflammatory drug induced cholestasis?

Answer 10

Due to interference with the biliary transport systems

Question 11

what is a type C drug reaction?

Answer 11

Due to chronic exposure to a drug leading to liver dmaage.

Question 12

what is a type D drug reaction?

Answer 12

Liver damage that isn’t apparant until some years after the drug is taken

Question 13

what drugs should be avoided in patients with liver failure?

Answer 13

• opiates
• diuretics
• oral hypoglycaemics
• warfarin