Serum aspartate aminotransferase

Myocardial infarction occurs when the blood supply to the heart muscle is blocked for an extended time. If this lack of blood supply, called ischemia, is prolonged, the myocardium suffers irreversible cell damage and muscle death, or infarction. When this happens, the concentration of cardiac enzymes in the blood rises dramatically as the dead cells release their contents into the bloodstream. Although many enzymes are liberated, three are of prime importance. These three enzymes, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and aspartate aminotransferase/serum glutamate-oxaloacetate transaminase (AST/SGOT), show a characteristic sequential rise in blood serum level following myocardial infarction and then return to normal. This enzyme profile, shown in the ac-... 

In postmenopausal women taking 40 mg black cohosh extract daily for 4 months, no changes in total hepatic blood flow, bilirubin, y-glutamyltransferase, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, serum albumin, or prothrombin time and concentration were observed (Nasr and Nafeh 2009). No changes in liver enzyme levels were observed in other studies with women taking 40 mg black cohosh daily for 3 or 4 months, or in women given single doses up to 128 mg (Bai et al. 2007 Osmers et al. 2005 van Breemen et al. 2009). 

When administering the HMG-CoA reductase inhibitors and the fibric acid derivatives, the nurse monitors the patient s fiver function by obtaining serum transaminase levels before the drug regimen is started, at 6 and 12 weeks, then periodically thereafter because of the possibility of liver dysfunction with the drugs. If aspartate aminotransferase (AST) levels increase to three times normal, the primary care provider in notified immediately because the HMG-CoA reductase inhibitor therapy may be discontinued. 

Serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, y-glutamyl transferase, and bilirubin may be elevated in patients with hepatobiliary disease. 

Hepatocellular damage manifests as elevated serum aminotransferases [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)]. The degree of transaminase elevation does not correlate with the remaining functional metabolic capacity of the liver. An AST level two-fold higher than ALT is indicative of alcoholic liver damage. 

Tolcapone has been associated with several cases of severe liver failure, including fatalities, and has been removed from the market in some countries. Thus, it should only be used in patients who cannot take or do not respond to entacapone. Serum alanine aminotransferase and aspartate aminotransferase concentrations should be monitored at baseline, then every 2 to 4 weeks for 6 months, and then periodically for the remainder of therapy. Patients who fail to show symptomatic benefit after 3 weeks should discontinue tolcapone. Entacapone has not been associated with liver damage, so monitoring of liver enzymes is not currently recommended.24,25,29... 

The patient is started on fluconazole 400 mg/day, but 3 days later has persistent fever and develops hypotension and decreased urine output. Blood cultures reveal a germ tube-negative yeast growing in the blood. Laboratory studies revealed a white blood cell count of 12,300/mm3 (12x109/L), aspartate aminotransferase 68 IU/L (1.13 pKat/L), alanine aminotransferase 75 IU/L (1.25 pKat/L), alkaline phosphatase 168 IU/L (2.8 pKat/L), and normal bilirubin. Serum creatinine is 1.8 mg/dL (159 pmol/L). 

ALK-P, alkaline phosphatase ALT, alanine aminotransferase AST, aspartate aminotransferase BUN, blood urea nitrogen CBC, complete blood cell count IA, intraarticular NSAIDs, nonsteroidal antiinflammatory drugs Sa, serum creatinine UA, urinalysis. ... 

Current nutritional intake Complete blood cell count Serum electrolytes Sodium Potassium Chloride Bicarbonate Magnesium Phosphorous Calcium Serum glucose Serum albumin Markers for organ function Liver function tests Alkaline phosphatase Aspartate aminotransferase Alanine aminotransferase Total bilirubin Prothrombin time or International normalized ratio Renal function tests Blood urea nitrogen Creatinine Fluid balance Input Oral... 

Hepatic Effects. Liver function tests (serum bilirubin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase) completed in 11 hexachloroethane workers were within the normal range (Selden et al. 1994). Plasma hexachloroethane levels in these workers, who wore protective equipment, were 7.3 + 6.04 pg/L at the time of the tests (Selden et al. 1993). Mild skin and mucous membrane irritation were reported in the exposed group, suggesting that exposure may have been through either the inhalation or dermal routes of exposure. 

The liver appeared to be a target organ for hexachloroethane following oral administration. When one dose of 500 mg/kg was administered in an olive oil aqueous emulsion to male sheep, the levels of glutamate dehydrogenase, sorbitol dehydrogenase, ornithine carbamyl transferase, and aspartate aminotransferase in serum increased in the 2-day period after compound administration and then normalized (Fowler 1969b). Hexachloroethane had no effect on bromsulphthalein uptake from the blood by liver cells, but the transfer of this dye to bile was reduced in sheep exposed to doses of 500-1,000 mg/kg/day. 

Hepatic Effects. Liver function tests (serum bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase) were not affected in 11 hexachloroethane-exposed workers who wore protective clothing (Selden et al. 1993). 

Hepatic Effects. Enlarged liver and elevated serum levels of hepatic enzymes indicative of liver injury (lactate dehydrogenase, 2 times above normal aspartate aminotransferase, 21 times above normal alanine aminotransferase, 100 times above normal) were observed in an individual following chronic daily exposure to vapors and spills of phenol (Merliss 1972). The symptoms lessened when the... 

Elevated activities of liver enzymes (lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, glutamate dehydrogenase) were found in the serum of rats exposed continuously to 26 ppm phenol vapor for 15 days (Dalin and Kristoffersson 1974). Increased concentration of these enzymes in serum is often associated with liver injury but is not conclusive evidence for the type or severity of injury. Therefore, 26 ppm can be considered a less serious LOAEL in rats. Serum levels of... 

Hepatic Effects. Serum markers of liver effects, bilirubin, glucose, cholesterol, and aspartate aminotransferase were not affected in 39 persons exposed to phenol in the drinking water at an estimated dose of 0.14-3.4 mg/kg/day for several weeks (Baker et al. 1978). Because these examinations were completed 7 months after the spill, this study does not provide conclusive evidence that there was no reversible liver damage. 

Hepatic Effects. Two days after a man was splashed with a phenol-water solution over his face, chest wall, hand, and both arms, serum bilirubin increased 2-fold (Horch et al. 1994). After 5 days, serum bilirubin returned to normal. An enlarged and tender liver and increased liver enzymes in the serum were reported in a case of chronic phenol poisoning (Merliss 1972). Lactate dehydrogenase was about 2-fold greater than normal, aspartate aminotransferase was about 21-fold greater than normal, and alanine aminotransferase was about 100-fold greater than normal. The man worked in a laboratory for 13.5 years where he distilled phenol several times a day. During the process, heavy odors were detectable, phenol was often spilled on his clothes, and he noted skin irritation. 

Hepatic Effects. Both patients described by Letz et al. (1984) (see Section 2.2.3.1) had elevated serum aspartate aminotransferase and lactic dehydrogenase, indicating severe hepatic damage. 

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