Lecture 6: Metabolism Flashcards

1
Q

Blood flow out of the liver

A

-through hepatic veins into the inferior vena cava

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2
Q

Bile flow out of the liver

A

-out the bile duct

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3
Q

Oxygen-rich blood flow INTO the liver

A

through hepatic artery

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4
Q

nutrient rich blood coming from bowel INTO liver

A

-via portal vein

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5
Q

Bile composition

A

-water
-bile salts
-bilirubin
-fats

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6
Q

Bile Fuction

A

-surfactants
-helps fat digestion
-bilirubin elimination
-drug elimination

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7
Q

Bilary excretion into intestine

A

-gall bladder to cystic duct to duodenum

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8
Q

Hepatic blood flow

A

1.5 L/min

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9
Q

Liver tissue

A

-sinusoid w central vein
-portal triad

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10
Q

portal triad

A

-branch of bile duct
-branch of portal vein
-branch of artery

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11
Q

Blood flow in liver tissue

A

-from portal triad to center vein

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12
Q

bile flow in liver tissue

A

-flows out

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13
Q

Kupfer cells

A

-macrophage cells in liver
-part of reticuloendothelial system

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14
Q

Liver sinusoidal endothelial cells

A

-make up 15-20% of liver cells
-contain many open pores (fenestrae)

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15
Q

Sinusoidal capillary

A

-has holes
-allows direct exchange between blood and hepactocytes

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16
Q

Hepatocyte

A

-synthesis of plasma proteins (albumin, coagulation factors)
-regulation of nutrient balance
-synthesis of bile acids
-detox bilirubin
-detox xenobiotics

-oxireductase-CYP complex in ER

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17
Q

Principles of drug metabolism

A
  1. convert lipophilic to hydrophillic
  2. can be categorized by one of 4 chemical reactions
  3. Is catalyzed by limited munber of enzymes w broad substrate specificity
  4. Certain drug-metabolizing enzymes’ expression can be upregulated, leading to inc metabolism of drugs
  5. Drug metabolism can be inhibited by drugs
  6. gut microbiota mediate some drug metabolism
18
Q

Conversion of lipophilic to hydrophilic

A

-phase 1: functionalization
-phase 2: conjugation

=excretion into bile or urine

19
Q

Phase 1: functionalization

A

-adds functional group

20
Q

Phase 2: conjugation

A

-attaches hydrophillic group to functional group

21
Q
  1. chemical reactions of drug metabolism
A
  1. oxidation
  2. conjugation
  3. Hydrolysis
  4. Reduction
22
Q

Oxidation

A

-add -OH
-usually followed by conjugation

23
Q

Hydrolysis

24
Q

Reducation

25
Enzyme that mitigates oxidation
-CYP450
26
Conjugation enzyme
-UDP glucuronosyl transferase (UGT)
27
Hydrolysis enzymes
-carboxyesterase
28
Major reactions of hepatic drug metabolism
-Oxidation -Conjugation
29
Cyt P450
-#1 catalytic versatility -highest level in the liver -mono-oxygenase -more than 50 but 10 do the most
30
mono-oxygenase
-adds -OH
31
CYP complex
-contains heme group Fe -responsible for oxidation
32
Major CYP enzymes
-CYP3A4 -CYP2D6
33
CYP3A4 reactions
-aromatic hydroxylation
34
CYP2D6 reactions
-aliphathic hydroxylation -N-dealkylation -O-dealkylation
35
Glucuronidation
-UGT -morphine conjugated to morphine 3-glucuronide
36
Be able to predict where
-rxns occur on molecule
37
Drug metabolism study tools
-metabolite ID in liver -CYP phenotyping using recombinant CYP
38
Enzyme inducing drugs
-activate transcription factor PXR -leads to dec exposure to enzyme substrates -rifampin -cause of drug drug interactions
39
Enzyme inhibiting drugs
-inhibit activities of drug-metabolising enzyme -lead to inc substrate drug exposure -ketoconazole
40
Gut microbiota
-outnumber human cells -fiber digestion -mainly reduction and hydrolysis
41
Double peak phenomenon
cause of enterohepatic cycling of drugs and metabolites -second peak in plasma chart