Ursodeoxycholic acid (Ursodiol)

Ursodeoxycholic acid (UDCA), also known as ursodiol, is a relatively hydrophilic bile acid used primarily for its cytoprotective effects in the biliary system. It protects hepatocytes from toxic hydrophobic bile acids, stimulates bile flow (choleretic), and has immunomodulatory and anti-apoptotic properties. **Clinical Pearl:** Highly effective in the management of chronic hepatitis, cholangitis, and gallbladder sludge. > **Warning:** Contraindicated in patients with complete biliary obstruction.

กลไกการออกฤทธิ์: UDCA is a hydrophilic bile acid that **inhibits ileal absorption** of toxic, hydrophobic bile acids → reduces their concentration in the systemic bile acid pool. Hydrophobic bile acids are toxic to hepatobiliary cell membranes and potentiate cholestasis. UDCA also stimulates **biliary secretion** (choleretic effect), protects hepatocyte membranes from detergent effects, and exerts **immunomodulatory** and **anti-apoptotic** effects on liver cells.

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