LIVER 1 Flashcards
What are the consequences of fibrosed/ diseased/ inflammation
- impedes blood flow
- Gastroreflux
-peptic ulcer - oeseophageal varices
What is the function of the liver
- produce bilesalts for emulsification of fat soluble vitamins
- Metabolism of drugs and nutrients
- filtering microbes etc
- gluconeogenesis
- bilirubin breakdown
- Exocrine function: bilirubin, bile salts, cholesterol
- synthesis: clotting factors/ antibodies
How does the liver handle drugs?
Transports drugs via plasma proteins
site for metabolising drugs
liver excretes some drugs
activates/ deactivates drugw
What is the solubility of drugs?
most drugs insoluble in water, solbule in fats
What are the phases of drug metabolism
Phase 1: . make molecules more polar
- hydrolysis
- reduction
- hydroxylation
- oxidation
phase 2: makes molecules less active, more water soluble
- conjugate with
What is the effect of first pass metabolism?
Can affect peak concentration & activity of drugs
- therefore affects the drug administration route
What affects drug metabolism?
-Age
-Gender
-Genetics
-Diet and gut flora
-Pathological conditions which reduce enzyme activity→ liver disease, kidney disease, reduced hepatic blood flow in heart failure/ shock
-Enzyme induction/ enzyme inhibition
What does the liver synthesis (endocrine function)
Clotting factors
Albumin
Antibodies
What does the liver metabolise
Drugs: first pass metabolism
Bilirubin cycle
Hormones→ not functioning well can affect hormone activity
Energy gluconeogenesis
What are the signs and symptoms of liver disease
jaundice (increase bilirubin)
- finger clubbing
- gynaecomastia
-SIALOSIS: Bilateral swelling- diabetes, alchoholism
- bleed a lot
Causes of liver disease:
Alcohol
Drugs→ paracetamol
Infections→ viral hepatitis
Chronic:
Cirrhosis (scarring)
Infections
Alcohol
How does alcohol cause liver disease/
Ethanol metabolism: Ethanol→ acetaldehyde→ Acetate
Highly reactive
Toxic
Causes inflammation & death of hepatocytes
How does paracetamol cause liver disease?
95% of paracetamol is metabolised into sulphate & glucoronide
5% metablised into N-acetyl-p-benzoquinone imine (highly reactive & toxic)
exceeding the dose saturates phase 2 metabolism
- causes death of hepatocytes & inflammation
What is hepatitis and its causes
Inflammation of the liver:
Infections
Viral→ A,B,C,E
Malaria
Alcohol
Drugs
Toxins
What is the route of transmission, consequences and recovery of Hep A
route of transmission: faecal-oral route
risk factors: poor oral hygiene
vaccine avaliable
long term impact: recover <2 months
