liver 1 Flashcards
describe the liver
underneath the diaphragm
hepatic artery brings blood in
venous drainage system to remove blood
has hepatic ducts which drains bile into the gallbladder
what is the function of the liver
produces bile salts - allows for emulsification of fats and absorption of vitamin A DEK
filtering of blood
kuppfer cells - metabolise microbes
exocrine function- excretion of bilirubin, bile salts and cholesterol
synthesis of clotting factors, antibodies and albumin
how does drug metabolism o occur
phase 1 makes it more polar and water soluble Hydrolysis
Reduction
Hyroxylation
Oxidation
which happens by cytochrome p450
what is phase 2 of drug metabolism
Make molecule, less active, more soluble
Conjugation (sulphate, gluconate, glucuronide etc)
Can be filtered
Less fat soluble
where does first pass metabolism occur
liver
lung
gut
what might occur when drugs get metabolised
when drugs are metabolised by cp450 it can result in increased/inhibited metabolism of another drug
eg erythromycin inhibits p450 and enhanced warfarin
give examples of when drugs are metabolised further
Erythromycin:
Inhibits p450: enhances activity of warfarin
Miconazole:
Inhibits p450: enhances activity of warfarin
Grapefruit juice:
Enhances p450: reduces activity of warfarin.
describe ascites
fluid in the peritoneal cavity
signs and symptoms of liver disease
jaundice on skin/sclera
finger clubbing
dupuytrens contracture
gynacomastia
sialosis- bilateral swelling of the salivary gland
what are causes of liver disease
acute causes:
alcohol
drugs - paracetamol
infections - viral hepatitis
if acute causes persist it can cause chronic:
cirrhosis
infections
how does alcoholic liver disease occur
ethanol is converted to acetaldehyde and this is highly reactive and damage cells - inflammation and death of hepatocytes
this should be converted into acetate and this is less toxic
how does paracetamol cause liver disease
paracetamol is converted into phase II metabolism( sulphate and glucuronide which is non toxic and removed by kidney) and in overdose too much N acetyl p benzoquinone imine which is highly reactive and toxic (5% metabolism)
describe hepatitis
inflammation of the liver
this occurs by viral infections AB,CE
malaria
what are signs of hepatitis
abdominal pain upper right abdomen
fever
jaundice
itchy skin
dark urine
pale bowel motions
which hepatitis has a faecal oral route of entry
A
E
