Metabolic function of the liver Flashcards Preview

GI Pharmacology > Metabolic function of the liver > Flashcards

Flashcards in Metabolic function of the liver Deck (25)
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1
Q

what produces bile

A

hepatocytes and bile duct

2
Q

where is bile stored between meals

A

gall bladder

3
Q

during a meal what causes gallbladder to contract opening sphincter of oddi for bile to enter duodenum

A

chyme

4
Q

4 functions of bile

A

micelle formation
neutralisation of chyme
pH adjustment for digestive enzyme action
protects mucosa

5
Q

what ducts does bile travel through to enter the duodenum

A

cystic duct

common bile duct

6
Q

where do hepatocytes secrete primary juice to

A

canaliculi

7
Q

what is in primary juice secreted by hepatocytes

A
bile acids
water
electrolytes 
lipids 
cholesterol 
IgA
bilirubin 
metabolic wastes
8
Q

what is cholelithiasis

A

pathology of the bile duct due to concentration of bile in gallbladder that causes cholesterol to crystallise into gall stone

9
Q

how is symptomatic cholelithiasis treated

A

laparoscopic cholecystomy

10
Q

how is cholelithiasis treated if liver does work

A

ursodeoxycholic acid

11
Q

what should you give to help Biliary colic pain

A

Buprenorphone or pethidine

NOT MORPHINE

12
Q

what can relieve biliary spasm

A

atropine

glycerytitrate

13
Q

what happens to bile salts

A

some is lost in faeces

majority is reabsorbed by active transport in the terminal ileum where it undergoes enterohepatic recycling

14
Q

what happens to primary acids

A

dehydroxylated by gut bacteria to form secondary bile acids which are returned to the ileum and conjugated with glycine/taurine and recycled as bile salts

15
Q

when are bile acid sequestrants used

A

hyperlipidaemia
cholestatic jaundice
bile acid diarrhoea

16
Q

examples of bile acid sequestrants

A

colveselam
colestipol
colestyramine

17
Q

side effects of bile acid sequestrants

A

diarrhoea
reduced absorption of fat soluble vitamins and thiazide diuretics
unpalatable

18
Q

what do xenobiotics facilitate

A

excretion

19
Q

main organ of drug metabolism

A

liver

20
Q

phase 1 metabolism reactions

A

oxidation, reduction, hydrolysis

21
Q

phase 2 metabolism reactions

A

add endogenous substance

conjugation

22
Q

where do phase 2 reactions usually occur

A

liver

23
Q

what happens in hepatic encephalopathy

A

severe hepatic failure where detoxification of ammonia to urea fails causing a toxic effect on CNS

24
Q

what can be used in severe hepatic failure

A

lactulose to convert NH3 to NH4+ which is not absorbed

antibiotics to inhibit NH3 generation

25
Q

which antibiotics are used to inhibit NH3 generation in hepatic encephalopathy

A

neomycin

rifamixin