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Metabolism and excretion: the liver and kidneys

Explains the 'big problem' the liver solves: kidneys can't hold onto lipid-soluble drugs until metabolism makes them water-soluble.

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Elimination: the greatest amount is renal excretion (urine) through the kidneys. A big problem: lipid-soluble drugs are hard for kidneys to hold onto. Solution: metabolism – chemical changes that usually reduce the effect of drugs and increase their excretion, mostly by liver enzymes (cytochrome P450 = CYP) in Phase I and Phase II (conjugation) reactions.

Términos del curso

Las palabras de tu profesor, tal cual aparecen en las diapositivas. Aprende el término y esta definición; la explicación de abajo solo ayuda a entenderla.

Renal excretion
“Renal excretion (urine)”Diapositivas 04, p. 30

By far the most common route of elimination.

The kidney problem
“Lipid-soluble drugs are hard for kidneys to hold onto”Diapositivas 04, p. 32

They diffuse back into circulation before being excreted — so the liver makes them less lipid-soluble.

Active metabolite
“May produce another molecule that is still able to cross the BBB and still has psychoactive effects - an “active metabolite””Diapositivas 04, p. 34

Metabolism doesn't always switch a drug off.

CYP (cytochrome P450)
“Referred to as microsomal enzymes (main category = cytochrome P450 = CYP)”Diapositivas 04, p. 35

Mostly nonspecific; CYP2D6 and CYP3A4/5 metabolize over 50% of drugs.

Phase I
“Phase I: CYP enzymes”Diapositivas 04, p. 36

Oxidation (most common), reduction, hydrolysis.

Oxidative stress
“excess free radicals (reactive molecule/chemical due to missing electron) causing oxidative stress”Diapositivas 04, p. 36

Antioxidants target excess free radicals.

Phase II (conjugation)
“Combining drug with another molecule (e.g., glucuronidation)”Diapositivas 04, p. 36

Makes the drug more water-soluble so it dissolves in urine.

De tu curso: Course slides 04, pp. 28–36

Consejo: las teclas ← y → recorren la lección.

Lección completa: Enzymes and phases of metabolism · Excretion and the kidney-liver connection

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