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

THANKS!

ANY QUESTIONS?