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Summary medical biochemistry block 2

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the complete package of medical biochemistry block 2 has all the substance required for examof the second block

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Detoxification alcohol

1. Urea cycle
Fasting leads to high glucagon levels > mobilization of AA. Low carb diet: degradation of AA
for ketone bodies or gluconeogenesis. 2 favoured amino acids: Glutamine and Alanine.


or




Urea cycle only happens in the liver.
1. surplus AA leads to glutamate > easy
deamination -NH4
2. NH4 + HCO3 via CPSi become carbonyl
phosphate
3. carbonyl phosphate become citrulline
4. moved outside to cytosol to become
aspartate > argininosuccinate > arginine
5. Arginine cleave urea and become
citrulline and can recycled
6. direct linked to TCA
cycle and gluconeogenesis.


Feed forward:
Regulated via: more ammonium more arginine > build up > speed up
urea cycle. Speed up via NAG because more carbonyl phosphate can be made.
Inborn error in later cycle (after succinate less problem) because of hyperammonemia.
Treat this via: AA that can be excreted immediately are used (glycine & glutamine).

2. detoxification xenobiotic/drugs
The half life of the drugs determines the effectiveness of a drugs.
Detoxification via oxidation happens by cytochrome P450.
Need of NADPH for detoxification. All that is done is making the
compound more water soluble for excretion. The liver does this by 3
structures: glutathione, glucuronate (UDP) and PAPS.
Glucose is needed for detoxification:
1. make NADPH in PPP for glutathione to excrete xenobiotica
(ROH) and detox ROS
2. to generate gluconate that couples the ROH and is excreted via the bile or urine
If they are to hydrophobic: example is damaged red blood cells > bilirubin-albumin is coupled
to UDP > excretion via bile > feces.
In babies this is not optimal > build up leading to yellow color.

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