Liver Flashcards
What is the significance of first pass metabolism in the liver?
It metabolises orally absorbed drugs before systemic circulation
What are the symptoms of liver disease?
- Jaundice
- Ascites
- Change in faeces/urine colour
- Blood clotting irregularities
Define acute liver disease.
- Self limiting
- Less than six months
- Often caused by paracetamol or viral infections
Define chronic liver disease.
- Long term damage
- Over six months
- Potentially irreversible structural changes like cirrhosis
What are two major causes of liver disease?
- Alcohol abuse
- Chronic hepatitis B and C
Name the key enzymes measured in liver function tests (LFT).
- ALT and AST indicate inflammation on liver and muscles
- ALP and GGT indicate damage to bile ducts
What does a high AST:ALT ratio (>2) indicate?
Alcoholic liver disease
What is the role of albumin in liver function assessment?
- Assesses the liver’s synthetic function
- Oncotic pressure regulation
- Decreases may cause fluid retention and indicate liver disease
What is the role of bilirubin?
- Bilirubin is a breakdown product of Hb
- Should be removed by liver: Increased Bilirubin levels → Liver disease
What is cirrhosis?
Irreversible scarring where fibrous tissue divides liver cells into nodules
Name one treatment strategy to prevent cirrhosis.
- Alcohol cessation
- Antiviral therapy for hepatitis
List the stages of Alcoholic Fatty Liver Disease (AFLD) and Non-Alcoholic Fatty Liver Disease (NAFLD).
Who is at risk of NAFLD?
- Type II diabetes
- Obese
- Hypertension
- Smokers
- 50+
How does liver disease affect drug metabolism?
Reduced hepatic blood flow increases bioavailability of drugs with high first pass metabolism
Why are albumin levels important for drug therapy?
- Hypoalbuminemia increases free drug levels
- Less albumin → Less drugs remain unbound → Increased drug reactivity → More side effects
Which types of hepatitis are transmitted via the fecal-oral route?
- Hepatitis A
- Hepatitis E
What is the treatment for hepatitis C?
Sustained viral clearance with antivirals like ribavirin
What percentages of Hepatitis B cases lead to chronic liver disease?
3-5%
How is paracetamol overdose treated?
IV N-acetylcysteine to replenish glutathione and prevent liver damage
Why must staggered overdose be treated immediately?
They cause prolonged toxic paracetamol liver damage
