LIVER PHYSIOLOGY & PATHOPHYSIOLOGY TILLY ADAMSON HELEN TURNBULL-ROSS

MAJOR FUNCTIONS OF THE LIVER DRUG METABOLISM AND DETOXIFICATION EXCRETION OF BILIRUBIN SYNTHESIS OF PLASMA PROTEINS PRODUCTION, STORAGE AND SECRETION OF BILE IMMUNE FUNCTIONS CHOLESTEROL PROCESSING ENERGY METABOLISM AND SUBSTRATE CONVERSION

PHASES OF DRUG METABOLISM PHASE I – ADDITIONAL FUNCTIONAL GROUP PHASE II – CONJUGATION PHASE III - EXCRETION

PHASE I PROVIDES FUNCTIONAL GROUP INCREASE POLARITY PROVIDE A SITE FOR PHASE 2 REACTIONS OXIDATION / REDUCTION / HYDROLYSIS

PHASE II CONJUGATION ATTACHMENT OF LARGE CHEMICAL GROUP PRODUCES HYDROPHILIC, MORE PHARMACOLOGICALLY INACTIVE COMPOUND  MORE EASILY EXCRETED

PHASE III EXCRETION VIA CIRCULATION / BILE

WHAT IS THE HALLMARK OF LIVER DISEASE? ENCEPHALOPATHY

WHAT ARE THE CAUSES OF LIVER DISEASE? ALCOHOL FAT IRON VIRUS

FATTY LIVER DISEASE NON ALCOHOLIC FATTY LIVER DISEASE (NAFLD) - MAY BE ASYMPTOMATIC NON ALCOHOLIC STEATOHEPATITIS (NASH) - MORE SEVERE AND CAN PROGRESS AND LEAD TO CIRRHOSIS

CIRRHOSIS ADVANCED LIVER DISEASE LIVER IS PERMANENTLY DAMAGED AND UNABLE TO FUNCTION NORMALLY REPLACEMENT OF LIVER TISSUE BY FIBROSIS  SCAR TISSUE

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