wk 6 1 Physiology Pharmacology of Liver Flashcards Preview

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Flashcards in wk 6 1 Physiology Pharmacology of Liver Deck (24)
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1
Q

metabolic functions of liver can be divided into carbohydrate metabolism, fat metabolism/synthesis, and protein metabolism, what does each cover

A

carbo

  • gluconeogenesis
  • glycogenolysis
  • glycogenesis

fat metabolism and synthesis of

  • lipoproteins
  • cholesterol/triglycerides
  • phospholipids
  • ketogenesis (starvation)

protein

  • deamination of amino acids
  • ammonia - urea conversion
2
Q

in hormone metabolism, the liver is the major site of degredation for 4

A

insulin
steroid hormones
glucagon
ADH

3
Q

which plasma protein in synthesised in liver

A

albumin

4
Q

5 vitamins, 2 metals and one carbohydrate is stored in liver, what are else

A

vits
- Vit A, B12, E,D, K

metals
-Copper, Iron

carbo
- Glycogen

5
Q

what are kupffer cells, what do they do

A

liver phagocytes

destroy cellular debris (RBCs) and invading bacteria

6
Q

what happens to bile between meals

A

stored - sphincter of oddi closed

7
Q

what happens to bile during a meal

A

chyme in stomach stimulates gall bladder smooth muscle to contract ( CCK and vagal impulses)

sphincter of oddi opens (CCK)

bile enters duodenum via cystic and common bile ducts

8
Q

bile is used for the

A

digestion and absorption of fats

9
Q

2 types of acid bile adds

A

cholic and chenodeoxycholic acids

10
Q

which immunoglobulin is found in bile

A

IgA

11
Q

symptomatic stones in biliary system are treated by

A

laparoscopic cholecystectomy

12
Q

if the stone is not impairing the gall bladder function, what may be given instead

A

Ursodeoxycholic acid

13
Q

biliary colics is when the gallstone blocks the tract, v painful. Morphine causes contraction of sphincter of Oddi, so what may be given instead

A

Buprenorphine

pethidine

14
Q

2 drugs that may be given to relieve biliary spasm

A

GTN

atropine

15
Q

enterohepatic recycling prevents most of the bile salts from being excreted, what is the type of transport used

A

active transport via Na+ transporters

SLCOA2 + SLCOA1

16
Q

how does bile acid sequestrants such as Colesevelam, Colestipol, and Colestyramine work

A

bind to bile acids and prevent reabsorption through the enterohepatic recycling systen

17
Q

when would colesevelam be given

A

lowes plasma cholesterol

in hyperlipidemia, cholestatic jaundice

18
Q

explain how colestipol indirectly lowers cholesterol

A

promote hepatic conversion of cholesterol into bile acids

increases LDL-receptor activity, and so increases clearance from plasma

19
Q

what is the problems with bile acid sequestranrs (colsevelam, Colestipol, Colestyramine) 3

A

unplatable, inconvient - large doses
GI side effects
fat soluble vitamin defiency

20
Q

most of the time drug metabolism is to either make the drug more polar (not readily absorbed by kidneys, can be excreted) or into a form that is pharmalogically less active. However they may also convert from inactive - active, have unchanged activity, or possess a different action. Give an example of eac hq

A

inactive to active - codeine to morphine

unchanged - diazepam - nordiazepam

different - aspirin (antiplatelet) - salicylic acid (no platelet activity)

21
Q

drug metabolism is usually in two sequential phases. what is each

A

phase I - oxidation, reduction and hydrolysis (more polar)

phase II - conjugation

22
Q

which protein mediates the oxidation reactions observed in phase in (in lipid soluble drugs)

A

Haem proteins

23
Q

in liver failure, what rises which leads to a coma

A

blood NH3 levels (cannot detoxify into urea and so cannot be removed)

24
Q

2 therapeutic options for Hepatic Encephalopathy

A

Lactulose (reduces pH)

Antibiotics - Neomycin, Rifaxmin (suppress colonc flora and inhibits ammonia generation)

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