Physiology and Pharmacology of the liver Flashcards
What are the metabolic functions of the liver?
Carbohydrate metabolism
- gluconeogenesis, glucogenolysis and glycogenesis
Fat metabolism and synthesis of
- lipoproteins, cholesterol, triglycerides, phospholipids, ketogenesis
Protein metabolism
- demination of amino acids and convert ammonia into urea
What is the liver a major site of degradation for?
insulin
steroid hormones
glucagon
ADH
What does normal thyroid function depend on?
hepatic formation of active T3 from T4
What does the liver activate vitamin D to produce?
25(OH)D
What does the liver store?
Vit A, B12, E, D and K
Copper
Iron
Glycogen
What does the liver coagulate?
factor 2, 7, 9 and 10
Protein C and S
What is the site of synthesis of plasma proteins (albumin)?
the liver
What is the role of Kupffer cells?
digest and destroy cellular debris like RBC and any invading bacteria
What does bile contain?
secretion of hepatocytes
secretion of bile duct cells
What are the main bile acids?
Cholic
Chendeoxycholic
What is the most common pathology of the biliary tract?
cholelithiasis - gall stones
How is biliary spasm relieved?
GTN
Atropine
How are symptomatic gall stones treated?
Laprascopic cholecystectomy
When are bile acid sequestrants used?
hyperlipidemia, cholestatic jaundice
Act by binding bile acids and prevent their reabsorption
Name the bile acid sequestrants?
Colesvelam
Colestipol
Colestryamine
What happens in phase 1 of drug metabolism in the liver?
oxidation
reduction
hydrolysis
What happens in phase 2 of drug metabolism in the liver?
conjugation
What is Hepatic Encephalopathy?
decline in brain function that occurs as a result of severe liver disease
- liver cannot remove toxins from the blood
What are the treatment options for Hepatic Encephalopathy?
Lactulose - converts ammonia to ammonium (which is not absorbed)
Antibiotics - neomycin and rifaximin
What do raised blood NH3 levels result in?
coma
