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Allopathic Medicines
Published in Varma H. Rambaran, Nalini K. Singh, Alternative Medicines for Diabetes Management, 2023
Varma H. Rambaran, Nalini K. Singh
It is known that renal tubular reabsorption undergoes adaptations in uncontrolled diabetes, particularly as it relates to the upregulation of renal GLUT vesicles. The increase in extracellular glucose concentration in diabetes lowers its outward-directed gradient from the tubular cells into the interstitium. As a natural response to maintain homeostasis, an upregulation of SGLT-2 is stimulated in an attempt to maintain renal tubular glucose reabsorption. This now manifests itself as a problem, as there is already a high BG level in the body. This situation (as illustrated in Figure 2.16) now presents itself as the ideal stage for the action of the SGLT2 inhibitors (SGLTi), where the drug's action results in the retardation of the rate of glucose reabsorption, consequently leading to a drop in the hyperglycaemic state (Nair and Wilding 2010).
Micronutrients
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Chloride is primarily excreted by the kidney. Cl− undergoes free glomerular filtration with 99% being reabsorbed and about 180 mmol of Cl− excreted per day (15–16). Most of the reabsorption occurs in the proximal tubule of the kidney, by passive reabsorption, ion conductance or active coupled transport with other ions. Cl− excretion is an important mechanism in the kidney’s adaptation to metabolic acidosis and chronic respiratory acid-base disturbances (15–16). Several preclinical studies showed that Cl− depletion induced stimulation of renin secretion resulting in increased systemic blood pressure. In addition, Cl− concentrations may exert direct effects on smooth muscle cells resulting in vasoconstriction (15–16).
Urolithiasis
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Absorbed oxalate is not metabolised any further.Excreted predominantly within proximal tubules.Renal reabsorption is negligible.
In silico models to predict tubular secretion or reabsorption clearance pathway using physicochemical properties and structural characteristics
Published in Xenobiotica, 2022
Navid Kaboudi, Ali Akbar Alizadeh, Ali Shayanfar
Based on the obtained data, logD7.4, AUS7.4, and the number of hydrogen bond donors have a significant role in the estimating renal clearance pathway of drugs. All developed models have acceptable accuracies, and the difference in prediction power is not considerable. Previous studies (Varma et al. 2009; Chen et al. 2020) showed that higher lipophilicity may lead to appropriate reabsorption, which is a passive process. The classification systems in this study are mainly based on lipophilicity, ionisation indexes (logD7.4, and AUS7.4), and hydrogen bond formation ability of drugs in order to establish a mechanistic model (as an essential principle in developing QSPR models (Dearden et al. 2009) to predict, and justification of renal clearance pathway of drugs in human.
Different outcomes of methadone maintenance therapy in rehabilitated and relapsed drug addicts: significance of liver and renal biomarkers
Published in Drug and Chemical Toxicology, 2022
Damir Suljević, Amra Šiljak, Muhamed Fočak
MT is metabolized almost exclusively in the liver. CYP3A4 enzyme is involved in major biotransformation pathways. This enzyme is found in the small intestine and in the liver, where it affects the intestinal and hepatic metabolism of MT (Gerber et al.2004). Urine is the primary route of MT elimination if administered at doses greater than 55 mg/day, otherwise, it is excreted by feces. The process of glomerular filtration and tubular reabsorption in the kidneys is a significant part of the elimination process (Nilsson et al.1982). The liver is the most important organ for MT metabolism and most metabolic products are excreted in the urine. The aim of the study is to analyze specific renal and hepatic markers during long-term and short-term MT treatment of heroin addicts.
Safety of treatment options available for postoperative pain
Published in Expert Opinion on Drug Safety, 2021
Zhaosheng Jin, Christopher Lee, Kalissa Zhang, Tong J Gan, Sergio D Bergese
When used as a regional anesthesia adjunct, the α-2 adrenergic agonists are delivered to the perineural space or into the fascial spaces. However, as discussed above, systemic reabsorption can still occur. Popping et al. conducted a meta-analysis of patients who underwent shoulder surgery with brachial plexus block, and reported that 50 to 150 mcg of clonidine added to local anesthetics was associated with significantly higher incidence of hypotension and bradycardia [109]. Similarly, Vorobeichik et al. reported that 30 to 150 mcg of dexmedetomidine was associated with a significantly higher risk of hypertension and bradycardia [115]. Another factor to consider is that perineural dexmedetomidine has been shown to prolong the duration of motor blockade. Hussain et al. conducted a meta-analysis of perineural dexmedetomidine administration in brachial plexus block, and reported that dexmedetomidine prolonged motor block by 200 minutes [116].