Llarenas, Kimberly Kaye P. 11.25.

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Fat soluble vitamins (A, D, E, K) name and properties

Fat-soluble vitamins are most abundant in high-fat foods and are much better absorbed into your bloodstream when you eat
them with fat. Vitamins are essential nutrients that your body needs in small amounts to function. They fall into two categories:
water-soluble and fat-soluble. The water-soluble vitamins - C and the B-complex vitamins - dissolve in water before your body
can absorb them. Fat-soluble vitamins - A, D, E, and K - dissolve in fat and can be stored in your liver and fat tissue until needed.
Fat-soluble vitamins have a multitude of functions from keeping your bones strong to helping your muscles move.

Functions of Fat Soluble Vitamins

 Vitamin A helps your vision, immune, and reproductive systems. It is essential to bone growth and tooth development.
It also keeps your heart, lungs and kidneys working properly.
 Vitamin D, along with calcium, keeps your bones strong by preventing diseases such as rickets, a disorder that causes
bones to become soft and weak in children. It also helps prevent osteoporosis, which makes your bones weak and more
likely to break. Vitamin D also helps your muscles move, improves your immune function and helps reduce
inflammation.
 Vitamin E acts as an antioxidant that protects your body from free radicals, which are molecules that damage your cells.
It also boosts your immune system and keeps blood moving through your blood vessels without clotting.
 Vitamin K, conversely, allows your blood to clot. It also helps your body by making proteins for healthy bones and
tissues.

Characteristics of Fat Soluble Vitamins

 Storage: Fat-soluble vitamins are stored in your liver and fatty tissue.
 Longevity: Fat-soluble vitamins last longer in your body, because you do not need them every day. They can be tucked
away until they are required for such functions as blood clotting, as in the case of vitamin K.
 Absorption and Excretion: The fat-soluble vitamins are absorbed through the small intestine with dietary fat and are
excreted slowly.
 Toxicity: Because fat-soluble vitamins are stored in your body longer they are more likely to cause toxicity, since the
body cannot excrete them quickly enough. In general, a healthy diet will not cause toxicity, but taking supplements at
high levels may create an imbalance of vitamins and cause illness. So, try not to get too addicted to those delicious
gummy vitamins!

Chemical properties
The chemical properties of fat-soluble vitamins determine their biological activities, functions, metabolism, and excretion.
However, while the substances in each group of fat-soluble vitamins are related in structure, indicating that they share similar
chemical properties, they do have important differences. These differences impart to the vitamins unique qualities, chemical and
biological, that affect attributes ranging from the manner in which the vitamins are stored to the species in which they are
active.

Metabolism
The fat-soluble vitamins are transported primarily by lymph from the intestines to the circulating blood. Bile salts are required
for efficient absorption of fat-soluble metabolites in the intestine; anything that interferes with fat absorption, therefore, also
inhibits absorption of the fat-soluble vitamins. Since a fatty acid (preferentially palmitic acid) is added to the retinol (vitamin A
alcohol) molecule before it is transported by the lymph, this ester form predominates in the bloodstream during digestion.
Vitamins D, E, and K do not require the addition of a fatty acid molecule for absorption. Small amounts of vitamin A (and possibly
vitamin K) may be absorbed directly into the bloodstream; however, both vitamins A and D are bound to a protein during
transport in the bloodstream.

Reference/s:
https://www.healthline.com/nutrition/fat-soluble-vitamins
https://study.com/academy/lesson/what-are-fat-soluble-vitamins-definition-functions-characteristics-examples.html
Llarenas, Kimberly Kaye P. 11.25.19
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Steroid drugs in sports

Some athletes take a form of steroids — known as anabolic-androgenic steroids or just anabolic steroids — to increase their
muscle mass and strength. The main anabolic steroid hormone produced by your body is testosterone.
Testosterone has two main effects on your body:
Anabolic effects promote muscle building
Androgenic effects are responsible for male traits, such as facial hair and a deeper voice.

Some athletes take straight testosterone to boost their performance. The anabolic steroids used by athletes are often synthetic
modifications of testosterone. These hormones have approved medical uses. But improving athletic performance isn't one of
them.

Why are these drugs so appealing to athletes? Besides making muscles bigger, anabolic steroids may reduce the muscle damage
that occurs during a hard workout, helping athletes recover from the session more quickly and enabling them to work out
harder and more frequently. Some athletes, as well as nonathletes, may like the muscular appearance they get when they take
the drugs.
Designer steroids

A particularly dangerous class of anabolic steroids are the so-called designer drugs — synthetic steroids that have been illicitly
created to be undetectable by current drug tests. They are made specifically for athletes and have no approved medical use.
Because of this, they haven't been tested or approved by the Food and Drug Administration (FDA) and represent a particular
health threat to athletes.
Risks

Many athletes take anabolic steroids at doses that are much higher than those prescribed for medical reasons. Anabolic steroids
have serious physical side effects.

Men may develop: Prominent breasts, Shrunken testicles, Infertility, Prostate gland enlargement
Women may develop A deeper voice, which may be irreversible, An enlarged clitoris, which may be irreversible, Increased body
hair, Baldness, which may be irreversible, Infrequent or absent periods

Taking anabolic-androgenic steroids to enhance athletic performance is prohibited by most sports organizations — and it's
illegal. In the past 20 years, more-effective law enforcement in the United States has pushed much of the illegal steroid industry
into the black market.
This poses additional health risks because the drugs are either made in other countries and smuggled in or made in clandestine
labs in the United States. Either way, they aren't subject to government safety standards and could be impure or mislabeled.

Reference/s:
https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/performance-enhancing-drugs/art-20046134
Llarenas, Kimberly Kaye P. 11.25.19
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Anti-Inflammatory drugs mode of action

Ketorolac (Toradol) is a very potent NSAID and is used for treating severe pain that normally would be managed with
narcotics. Ketorolac causes ulcers more frequently than other NSAIDs and should not be used for more than five days.

Celecoxib (Celebrex), blocks COX-2 but has little effect on COX-1. Therefore, celecoxib (Celebrex) is sub-classified as a selective
COX-2 inhibitor, and it causes fewer ulcers and less bleeding than other "non-selective" NSAIDs.

Although NSAIDs have a similar mechanism of action, individuals who do not respond to one NSAID may respond to another.
The reason for this is unclear.

What are the side effects of NSAIDs?

The most common side effects are:

vomiting,
nausea,
constipation,
diarrhea,
reduced appetite,
headache,
dizziness,
rash, and
drowsiness.

NSAIDs also may cause swelling of the arms and legs due to the retention of fluid from their renal effects.

The most serious side effects are ulcers, bleeding, kidney failure, and, rarely, liver failure.

Individuals allergic to NSAIDs may experience shortness of breath after taking an NSAID and may experience a similar reaction
when other NSAIDs are taken.

People with asthma are at higher risk for experiencing serious allergic reactions to NSAIDs.

Administering aspirin to children or teenagers with chickenpox or influenza has been associated with Reye's syndrome, a serious
and potentially fatal disease of the liver. Therefore, aspirin and salicylates for example, salsalate (Disalcid), should not be used in
children and teenagers with suspected or confirmed chickenpox or influenza.

NSAIDs (except aspirin) may increase the risk of heart attacks, stroke, and related conditions, which can be fatal. This risk may
increase with duration of use and in patients who have underlying risk factors for disease of the heart and blood vessels. NSAIDs
should not be used for the treatment of pain resulting from coronary artery bypass graft (CABG) surgery.

NSAIDs, particularly non-selective NSAIDs, cause an increased risk of serious, even fatal, stomach and intestinal adverse
reactions such as bleeding, ulcers, and perforation of the stomach or intestines. These events can occur at any time during
treatment and without warning symptoms. Elderly patients are at greater risk for these types of reaction.

Low doses of aspirin, less than 325 mg/day, taken for preventing heart attacks and strokes, also are associated with stomach and
intestinal adverse reactions; however, the heart attack and stroke preventing actions of the low doses may compensate for the
increased risk of these adverse reactions.

Reference/s:
https://www.rxlist.com/nsaids_nonsteroidal_antiinflammatory_drugs/drug-class.htm
Llarenas, Kimberly Kaye P. 11.25.19
MC02 25288

Bile Acid/Bile pigments

Regulation of Bile Acid Homeostasis

Bile acids, in particular chenodeoxycholic acid (CDCA) and cholic acid (CA), can regulate the expression of genes involved in their
synthesis, thereby, creating a feed-back loop. The elucidation of this regulatory pathway came about as a consequence of the
isolation of a class of receptors called the farnesoid X receptors, FXRs. The FXRs belong to the superfamily of nuclear receptors
that includes the steroid/thyroid hormone receptor family as well as the liver X receptors (LXRs), retinoid X receptors (RXRs), and
the peroxisome proliferator-activated receptors (PPARs).

The most abundant bile acids in human bile are chenodeoxycholic acid (45%) and cholic acid (31%). These are referred to as the
primary bile acids. Before the primary bile acids are secreted into the canalicular lumen they are conjugated via an amide bond
at the terminal carboxyl group with either of the amino acids glycine or taurine. These conjugation reactions yield
glycoconjugates and tauroconjugates, respectively. This conjugation process increases the amphipathic nature of the bile acids
making them more easily secretable as well as less cytotoxic. The conjugated bile acids are the major solutes in human bile.

Structures of conjugated cholic acid

Structure of the conjugated cholic acids

Bile salts are secreted from hepatocytes, into the bile canaliculi, via the action of the bile salt export protein (BSEP; ATP-binding
cassette B11, ABCB11). Transport of phospholipids into the canaliculi requires the transporter ABCB4. ABCB4 is also known as
multi-drug resistance protein 3 (MDR3, a member of the P-glycoprotein family of transporters). Some free cholesterol is also
transported out of hepatocytes into the canaliculi via the action of the obligate heterodimeric transporter ABCG5/ABCG8. The
transport of cholesterol via this complex also requires ABCB4. The ABCB4 requirement is consistent with the known actions of
phospholipids in the bile canaliculi functioning as a sink to accept cholesterol tranported out by ABCG5/ABCG8. Each of these
hepatic lipid transporters is critical for normal hepato-biliary function since mutations in any of the genes encoding the
transporters have been shown to be associated with cholestatic liver diseases. These transport defects result in the
accumulation of toxic levels of bile salts within the hepatocytes resulting in liver failure.

Structure of a liver lobule

Structure of a liver lobule. Lobules in the liver represent histologically and functionally distinct domains within the liver. They are
not to be confused with the anatomical lobes of the liver which are defined as the right and left lobes and the median and
quadrate lobes. Lobules are histologically defined as classical, portal, and acinus lobules. Lobules contain hepatocytes, and are
vascularized by the hepatic portal vein, the hepatic artery, and the central vein. In addition, the bile cannaliculi run through the
lobules allowing hepatic products such as bile acids to be delivered to the bile ducts and ultimately to the gallbladder. Kuppfer
cells are liver resident macrophages.ssive neuropathies in adults.

Reference/s:
https://themedicalbiochemistrypage.org/bileacids.php