Disease, metabolic effects

The low incidence of ischemic heart disease in the black population of Africa may mitigate the seriousness of the consequence of the metabolic effects of thiazide diuretics, for example hyperlipidemia and hypo-kalemia. 

Mechanism of Action. The mechanisms by which antibiotic administration at subtherapeutic levels enhance growth rate and efficiency of gain in growing animals have not been clarified. Possible modes of action include disease control, nutrient sparing, and metabolic effects. There is extensive evidence that the principal benefit from subtherapeutic use of antibiotics results from the control of harmful microoiganisms. 

Olsson AG, Carlson LA. Clinical, hemodynamic and metabolic effects of intraarterial infusions of prostaglandin El in patients with peripheral vascular disease. Adv Prostaglandin Thromboxane Res 1976 1 429-32. 

Godsland IF, Crook D. Update on the metabolic effects of steroidal contraceptives and their relationship to cardiovascular disease risk. Am J Obstet Gynecol 1994 170(5 Pt 2) 1528-36. 

Workers are potentially exposed to a variety of substances during daily industrial operations. The OSHA estimates that a large segment of workers are simultaneously exposed to more than one substance and suffer from adverse effects. Adverse effects include many acute and chronic diseases (e.g., allergic sensitization, cancer, cardiovascular diseases, dermatitis, erythema, edema, irritation of the mucous membrane, irritation of the skin, kidney disease, liver disease, metabolic interferences, narcosis, neuropathy, ocular effects, odor effects, respiratory diseases, systemic toxicity). These should be properly addressed by concerned management and the individual worker to improve chemical safety. Workers come in contact directly or indirectly during different work conditions hence it is important to understand the possible adverse effects that these chemicals may cause vis-a-vis chemical safety. 

As discussed above, aerobic exercise produces numerous physiologic and metabolic changes in the body. Many of these changes are believed to be beneficial for prevention of heart disease. The effects on cardiopulmonary function were mentioned earlier and are clearly beneficial, as are the changes in body composition described in Chapter 9. Further, aerobic exercise appears to have positive effects on blood oholesterol and other lipids. These effects of exercise on the metabolism of lipids and the important transport particles called lipoproteins are discussed in Chapter 5. 

More recently, it has been shown that hypokalemia and other dose-related adverse metabolic effects of thiazide diuretics increase the risk of sudden death and negate the cardiovascular benefit of blood pressure lowering when high doses these drugs are prescribed (21). Hence, another explanation for the apparent inability of antihypertensive therapy to lower mortality in patients with coronary heart disease is that high thiazide doses were used in many of the trials that were analyzed. As pointed out by Temple (2), this explanation is supported by the results of a trial of antihypertensive therapy in elderly patients with isolated systolic hypertension (22). In this study, only low doses of a thiazide diuretic were prescribed and a 4-mm Hg average decrease in diastolic blood pressure was associated with a 36% reduction in the... 

Koroslretz WJ, Jerrkirrs BG, Roserr BR, Beal MF (1997) Errergy metabolism defects irr Hurrdrrgtorr s disease arrd effects of coerr-zyme QIO. Arrrr Neur ol 41 160—165. 

Quick relief can be obtained with a p-adrenoceptor blocking drug (judge dose by heart rate) though these do not block all the metabolic effects of the hormone, e.g. on the myocardium, and the basal metabolic rate is unchanged. For this reason they should not be used as sole therapy except in mild thyrotoxicosis in preparation for radioiodine treatment, and should be continued in these patients until the radioiodine has taken effect. They do not alter the course of the disease, nor biochemical tests of thyroid function. Any effect on thyroid hormonal action on peripheral tissues is clinically unimportant. It is desirable to choose a drug that is nonselective for pj and p2 receptors and lacks partial agonist effect (e.g. propranolol 20-80 mg 6-8-hourly, or timolol 5 mg once daily). Usual contraindications to P-blockade (see p. 478) should be observed, especially asthma. 

Lieber, C.S. Hepatic and metabolic effects of ethanol pathogenesis and prevention. Ann. Med. 1994 26 325-330 Ethanol metabolism, cirrhosis and alcoholism. Clin. Chim. Acta 1997 257 59-84 Role of oxidative stress and antioxidant therapy in alcoholic and non-alcoholic liver diseases. Adv. Pharmacol. 1997 38 601-628... 

Modes of action The mechanisms of UDCA and its effects in cholestatic liver diseases are not yet fully understood - even though a number of different effects have been demonstrated. These include (i.) hepatopro-tective (92, 97, 98), (2.) cytoprotective (89), and (3.) biliary-metabolic effects (84, 93, 104, 105), as well as (4.) an influence on the immune system. In ligature of the bile duct in rats, UDCA was found to reduce the occurrence of histological changes and biliary cirrhosis as well as of portal hypertension. (98) (s. tab. 40.7)... 

Koroshetz WJ, Jenkins BG, Rosen BR, Beal MF (1997) Energy metabolism defects in Huntington s disease and effects of coenzyme QIO. Ann Neurol 41 160-165. 

Because of the cardiac and metabolic effects of salbutamol, it should be given cautiously with appropriate monitoring in patients with cardiovascular disease, diabetes, and hyperthyroidism. 

Vincamine is an alkaloid extracted from the plant Vinca minor. Ethyl apovincaminate is a related synthetic ethyl ester of vincaminic acid. These drugs have spasmolytic effects similar to those of reserpine, but also have metabolic effects, including, in high doses, inhibition of phosphodiesterase. Although increased cerebral blood flow has been reported after the intravenous administration of vincamine, there have been no reliable studies of blood flow after oral medication. Improvement in scores on some psychometric tests have been obtained in some patients with cerebrovascular disease, but no clear-cut practical benefit has been demonstrated. 

Bjerneroth G, Sammeli 0, Li Y-C et al 1994 Effects of alkaline buffers on cytoplasmic pH in lymphocytes. Critical Care Medicine 22 1550-1556 Boilaert P E, Levy B, Nace L et al 1995 Hemodynamic and metabolic effects of rapid correction of hypophosphatemia in patients with septic shock. Chest 107 1698-1701 Bonagura J D, Reef V B 1998 Cardiovascular diseases. In Reed S M, Bayly W M (eds) Equine internal medicine. Saunders, Philadelphia, PA, pp. 290-370 Bonventre J V, Cheung J Y 1985 Effects of metabolic acidosis on viability of cells exposed to anoxia. 

---