Posted by Larry Hoover on November 18, 2004, at 22:43:58
In reply to Re: How do I know IF I am a slow metabolizer?, posted by Phillipa on November 18, 2004, at 22:15:04
> Stresser, He doesn't intimidate me, I respect him for his knowledge and would commend Lar for being so informed. I would like to see it in layman's terms though because I am not good at chemistry.Phillipa
OK. Hmmm.
Your liver is your toxic waste incinerator. In so many words, it oxidizes, transforms and labels waste for disposal via feces or urine.
We know enough to say that certain chemical structures are more likely to be transformed in one type of liver reaction than another. The chemical reactions themselves are helped along by enzymes, special purpose "factories" with one specific task. One kind might snap a piece off of this molecule, and another might tack on an extra bit onto that other one, but the whole point is to accomplish two main things. One, to make toxins less toxic. Your liver sees the drugs we take as toxins, and it wants them nullified. Two, it labels them for excretion. Many molecules get "flagged" with special molecular tags, so the kidney knows to let them go on out with the rest of the waste in urine.
There are a whole lot of different chemicals that the body sees as toxic, so there are a whole lot of different enzymes to take care of things. Some are general purpose enzymes, the workhorse enzymes. Mess with those, and a lot of nasty stuff stays nasty instead of being detoxified. Examples of those workhorses are 2D6, 3A4, 2C19, and 1A2. Many drug treatment schemes require those enzymes to be working properly, or the drugs will build up to toxic levels, or their metabolites will instead.
Drug interactions are caused, really, by liver stress. If you ask the liver to do too much at the same time, it doesn't do the work efficiently. Adding in a new drug can make an old drug toxic, one that didn't cause toxic problems before. That's a drug interaction. Taking tylenol while you have alcohol in your blood causes a severe interaction in the liver, so severe it can cause liver cells to die. Interactions aren't always obvious.
Nowadays, drug metabolism is determined for every new drug that comes to market. You can usually find out how it is metabolized by reading the drug monograph. Hopefully, we can learn what sorts of drugs are probably okay for one individual to take, and others not okay, based on the individual's liver capacity. We're on the verge of being able to do that.
Ask me questions, if you wanna.
Lar
poster:Larry Hoover
thread:417092
URL: http://www.dr-bob.org/babble/20041118/msgs/417723.html