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Refers to drug biotransformation metabolism that takes place in tissues other than the liver

Extrahepatic metabolism

The most common sites of extrahepatic metabolism include the ____

Portals of entry and exit of excretion

5 extrahepatic sites

Plasma


Intestinal mucosa


Intestinal bacterial flora


Stomach


Nasal mucosa

PIISN

Main purpose of plasma

Activate prodrugs

The plasma contains ____ which is responsible primarily for the ____

Esterase enzymes


Hydrolysis of esters

2 examples of simple esters

Procaine


Succinylcholine

PS

Use of succinylcholine

Neuromuscular blocking agent

2 main purpose of intestinal mucosa

Site of absorption


Site of metabolism

SS

Secrete a number of enzymes capable of metabolizing drugs and other xenobiotics

Intestinal bacterial flora

2 enzymes secrete by the intestinal bacterial flora

Beta-glucoronidase enzyme


Azoreductase enzyme

BA

2 functions of bacterial flora

Convert vitamin precursor to their active forms


Convert substances to their toxic form

CC

9 vitamins that can be converted by the bacterial flora (5)

K


B7


B12


B9


B3

KBB BB

9 vitamins that can be converted by bacterial flora (4)

B5


B1


B2


B6

2 other names of vitamin K

Phytonadione


Menaquinone

PM

Vitamin B7

Biotin

Vitamin B12

Cobalamin

Vitamin B9

Folate

Vitamin B3

Nicotinic acid

Vitamin B5

Panthotenic acid

Vitamin B1

Thiamine

Vitamin B2

Riboflavin

Vitamin B6

Pyridoxine

Precursor of Thiamine

Thiamine diphosphate

2 precursor of riboflavin

Flavin mononucleotide


Flavin adenine dinucleotide

FF

Precursor of pyridoxine

Pyridoxal phosphate

2 precursor of biotin

Alanine


Pimeloyl CoA

AP

Precursor of cobalamine

Uroporphyrinogen III

Precursor of folate

Dihydropteroic acid

Precursor of nicotinic acid

Tryptophan

Precursor of panthotenic acid

Coenzyme A