Liver Disease Flashcards
what are the functions of a healthy liver?
Synthesis and secretion of bile- digestion of food and fats
Metabolism- drugs, glucose, fatty acids, lipids
secretion of plasma proteins (albumin and clotting factors)
Endocrine function
Macrophage storage
What are consequences of liver impairment
Loss of glucose homeosasis Loss of protein synthesis- albumin, clotting and immune factors Loss of immune cells loss of lipid homeostasis altered drug metabolism
What are the causes of liver impairment?
Alcohol consumption Non alcoholic fatty liver disease- obesity Viral infection Autoimmune Hepatitis Metabolic Disorders Toxins e.g. Paracetamol overdose
What is NAFLD?
Non-alcoholic fatty liver disease which leads to fatty infiltration, inflammation and cirrhosis
What are the stages of liver disease?
Inflammation (the liver is inflamed/enlarged)
Fibrosis, scar tissue begins to replace healthy tissues in the inflamed liver.
Cirrhosis; severe scarring has built up, making it difficult to function properly
What are early signs and symptoms of liver impairment?
Generally feeling unwell and tired all the time Loss of appetite Loss of weight and muscle wasting feeling sick (nausea) and vomiting Red palms disturbed sleep pattern
Later signs and symptoms of liver impairment?
Fluid retention (swelling of the legs, ankles and feet, swelling of the abdomen- ascites)
What is portal hypertension
in liver cirrhosis the liver is smaller and becomes scarred making it harder for blood to flow through the liver, this increases pressure in the portal vein= portal hypertension.
what are the later signs and symptoms of liver impairment?
Jaundice
Bleeding/ bruising
In men; enlarged breasts and shruken testes
In women; irregular or lack of menstrual periods
Confusion, memory difficulties, hepatic encephalopathy
Increased sensitivity to alcohol and medications
Liver function tests (LFTs)
ALT: Alanine aminotransferase (liver specific)
AST (aspartate aminotrasnferase) (Less specific)
Liver function tests (for impaired synthetic and detoxifying functions)
Albumin; Plasma protein produced by liver, reduced levels if liver function is impaired.
Ammonia; reduced ability to detoxify the blood then ammonia levels rise and may cause encephalopathy
How can we prevent Liver disease (how can pharmacists help)
Alcohol related liver disease Non alcoholic fatty liver disease (NAFLD) and NASH Hepatitis B and C Autoimmune hepatitis Genetic disorders
Treating liver disease
Hepatitis C is now curable Hepatitis B is treatable Abstinence from alcohol Healthy diet and exercise Transplant Immunosupression for autoimmune hepatitis
How do we treat the signs and symptoms of liver disease? Managing Pruitis (itch)
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