Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacokinetics > Liver Disease and Drug Handling > Flashcards

Liver Disease and Drug Handling Flashcards

1
Q

Name some main functions of the liver.

A

Synthesis of plasma proteins -> Albumin and Clotting Factors.
Bile production and excretion.
Storage
Immun System

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 main liver function tests used?

A

Prothrombin Time

Serum Albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the ‘PT’ test measure?

A

Measures how long it takes the blood to clot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the ‘Serum Albumin’ test measure?

A

Measures the amount of albumin in the blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 2 enzymes that are looked for when assessing for liver damage?

A 
Aspartate Aminotransferase (AST)
Alanine Aminotransferase (ALT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In viral hepatitis, which enzyme level is greater?

A

ALT is greater than in AST -> however, when cirrhosis is present, AST is greater than ALT levels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is hepatitis?

A

Describes the inflammation of the liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name some causes of hepatitis.

A 
Alcohol - induced. 
Viral. 
Drug induced. 
Autoimmune.
Hereditary.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some causes of acute hepatic failure?

A

Paracetamol Overdose
Viral Hepatitis
Excessive alcohol consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the mechanisms involved in production of damage for hepatic failure?

A

Apoptosis
Disruption of calcium homeostasis
Inhibition of mitochondrial function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What % of cardiac output passes through the liver?

A

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

At a normal dosage, which pathway does paracetamol take?

A

Phase 2 metabolism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does phase 2 metabolism contain (in a normal dosage)?

A

Conjugation with glucoronide // sulphate -> Forms non - toxic metabolites and thus is eliminated by the kidney.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does phase 1 metabolism contain (in a normal dosage)?

A

Metabolism by CYP450 isoforms to form NABQI.
This is detoxified via conjugation with glutathione.
Eliminated via the kidney.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is NABQI bad?

A

It’s hepatotoxic and nephrotoxic -> thus, can cause kidney and liver damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

At an overdose, which pathway does paracetamol take?

A

Phase 2 metabolism can’t occur as this pathway is saturated.
Undergoes phase 1 metabolism but CAN’T undergo conjugation with glutathione as it has been depleted.
So NABQI levels just increase.

17
Q

How is glutathione levels replenished?

A

Via the usage of nacetyl cysteine.

18
Q

Why can Type A toxicity occur for anyone?

A

It is dose - related.

19
Q

Why are high levels of NABQI dangerous?

A

Apoptosis alongside renal failure occur.

20
Q

What is cholestasis?

A

Decrease in bile flow due to impaired secretion by hepatocytes.

21
Q

What is intrahepatic liver injury?

A

Involves the hepatocytes and results in the INCREASED level of liver enzymes.

22
Q

What is extrahepatic liver injury?

A

Damage done to the bile ducts.

23
Q

What is used to determine intrahepatic damage?

A

Symptoms
Examination
Liver Function blood tests

24
Q

What are the symptoms for intrahepatic damage?

A

Nausea
Anorexa
Jaundice
Right hypochondriac pain

25
Q

What are the symptoms for extrahepatic damage?

A

Jaundice

Itching

26
Q

What is gross ascites?

A

Build up of fluid in the peritoneal cavity.

27
Q

What are the 3 main effects of alcohol on the liver?

A

Alcohol Metabolism
Alcoholic Liver Injury
Alcoholic Cirrhosis

28
Q

What kind of damage can alcoholic cirrhosis cause?

A

Destruction and fibrosis with regenerating nodules.

29
Q

What kind of damage can alcoholic liver injury cause?

A

Can cause fatty change alongside hepatitis.

30
Q

What kind of damage can alcohol metabolism cause?

A

Alcohol dehydrogenase buildup alongside cytochrome p450 changes.

31
Q

Overtime, what can hepatitis lead to?

A

Cirrhosis.

This disrupts liver function and can reduce blood flow.

32
Q

What can impaired liver function disrupt?

A

Disrupts metabolism.

33
Q

What is portosystemic shunting?

A

Drug is transferred elsewhere in order to carry on being metabolised.

34
Q

What does hypoproteinaemia reduce in some drugs?

A

Protein Binding = This means MORE drugs are freely circulating within the body.

35
Q

What drugs should be avoided during liver failure?

A 
Opioids
Diuretics
Warfarin 
ACE inhibitors
NSAIDS

Pharmacokinetics (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions