Electrolyte balance, changes

It does not matter that essentiality of some other elements (Na, K, Ca, Sr, Si) - if it actually refers to a certain element which cannot be replaced - will be unrelated to biocatalysis e.g., K can be fully replaced by Rb in many organisms (Scott and DeVoe 1954 Lwoff and Ionesco 1947), Ca roles, e.g. in control of cell budding can likewise be fulfilled by Sr and by various REE ions as a rule, while there are specific functions (unknown up to now) for Sr in corals and certain algae and for Ba in desmides, biocatalytic or not. Thus, neither K nor Ca are fundamental as single elements in such organisms. Examples for such different reasons of essentiality include electrolyte balances, changes of membrane permeability or protein shapes... 

From the above, derives the fundamental concept that the newborn infant must be maintained in an adequate degree of hydration and in electrolyte balance in order for the infant to thrive. In some cases, where for one reason or other, the infant is not able to take fluids by mouth in the normal manner, one may need to resort to supplementary fluid therapy by vein. For a rational approach to this problem one needs to have available from the clinical chemical laboratory> rapid response in order to continuously monitor changes in electrolyte levels so that fluids can be modified so as to correct these abnormal-ities. 

Provide a plan to assess the effectiveness and safety of therapy. Follow-up in 2 to 4 weeks if the medication regimen has changed, otherwise semi-annual or annual clinic visits to assess blood pressure, electrolyte balance, and renal function should occur. 

Aldosterone influences electrolyte balance in the body. Specifically, aldosterone increases the excretion of potassium by the kidney but decreases the excretion of sodium by this organ. One result is the net retention of water. The action of mineralocorticoids tends to increase blood pressure. Basically, the more sodium you retain, the more water you retain. Retaining water tends to increase the fluid level in the vascular system and that increases blood pressure. Think about the pressure changes that happen when you continue to fill a flexible container such as a balloon with water the more water, the greater the pressure in the balloon. You might well imagine that an... 

Monitoring Monitor initially and periodically thereafter body weight, blood pressure, fluid, and electrolyte balance signs and symptoms of pericardial effusion ECG changes CBC alkaline phosphatase renal function tests. 

Certain foreign compounds may cause the retention or excretion of water. Some compounds, such as the drug furosemide, are used therapeutically as diuretics. Other compounds causing diuresis are ethanol, caffeine, and certain mercury compounds such as mersalyl. Diuresis can be the result of a direct effect on the kidney, as with mercury compounds, which inhibit the reabsorption of chloride, whereas other diuretics such as ethanol influence the production of antidiuretic hormone by the pituitary. Changes in electrolyte balance may occur as a result of excessive excretion of an anion or cation. For example, salicylate-induced alkalosis leads to excretion of Na+, and ethylene glycol causes the depletion of calcium, excreted as calcium oxalate. 

Physiological, pharmacological, and biochemical responses do not usually lead to a tissue lesion, although there may be organ failure as a result. They may result from interactions of chemicals with receptors or specific enzymes leading to anoxia, inhibition of cellular respiration, respiratory failure, changes in pH, temperature, blood pressure or electrolyte balance, for example. 

In addition to its normal role in controlling fluid and electrolyte balance, aldosterone can have detrimental effects on the heart and vasculature. Excess or prolonged aldosterone production can cause hypertrophy and fibrosis of cardiac and vascular tissues and lead to detrimental changes in these tissues.30,78 Moreover, it is now apparent that aldosterone can be produced locally within certain tissues including the heart and vascular endothelium.78,83 That is, these tissues may produce their own supply of aldosterone as well as receive circulating levels of aldosterone from the... 

What is clear, however, is that the consequences of hormone imbalance result in profound aberrations in homeostasis. For instance, changes in water, acid-base, and electrolyte balance in the human organism have far-reaching medical implications. The clinical biochemistry laboratory performs numerous acid-base, electrolyte, and osmolarity determinations every day, and the management of the patient depends in a major way on such clinical-chemical data. For this reason, this chapter contains a discourse on water and electrolyte balance, presented from a clinical and biochemical point of view. 

Four general pathophysiologic mechanisms disrupt water and electrolyte balance, leading to diarrhea. These four mechanisms are the basis of diagnosis and therapy. They are (1) a change in active ion transport by either decreased sodium absorption or increased chloride secretion (2) a change in intestinal motility (3) an increase in luminal osmolarity and (4) an increase in tissue hydrostatic pressure. These mechanisms have been related to four broad clinical diarrheal groups secretory, osmotic, exudative, and altered intestinal transit. 

Age-linked alterations in electrolyte distribution, such as loss of potassium and increased retention of sodium, was attributed to vasopressin activity (111)- When vasopressin was given alone or in combination with hydrocortisone, the life span of rats was significantly increased and the mortality rate was decreased during the early months of treatment, but when it was administered to older rats, there was no effect on survival rate in spite of an improvement in electrolyte balance. Electrolyte changes with age recently have been studied by Korkusko et al. (112), Plasma, potassium, calcium, and magnesium were significantly decreased with age. 

Glucocorticoids also have weak mineralocorti-coid effects as they have some affinity for miner-alocorticoid receptors. The laminitis-producing effects of the glucocorticoids have recently been linked to their ability to stimulate mineralocorti-coid receptors and produce changes in blood flow and electrolyte balance. 

The adrenocortical steroids permit the bexly to adjust to environmental changes, to. stress, and to changes in the diet. Aldosterone and. to a lesser extent, other mincralocortieoids maintain a constant electrolyte balance and blood volume, and the glucocorticoids have key roles in controlling carbohydrate. protein, and lipid metabolism. 

Several children who were treated with mercurous chloride for constipation, worms, or teething discomfort had swollen red gums, excessive salivation, anorexia, diarrhea, and/or abdominal pain (Warkany and Hubbard 1953). They also experienced muscle twitching or cramping in the legs and/or arms, but these muscular effects were probably secondary to changes in electrolyte balance (i.e., potassium imbalance due to fluid loss or renal wasting). 

Maintenance of fluid volume, osmolarity, electrolyte balance, and acid-base status are aU regulated in large part by the kidney. Homeostasis of sodium, potassium, chloride, calcium, magnesium, and phosphorus is altered due to changes in urinary excretion that occur in patients with impaired kidney function. A comprehensive discussion... 

Budde RA and Crenshaw TD (2003) Chronic metabolic acid load induced by changes in dietary electrolyte balance increased chloride retention but did not compromise bone in growing swine. J Anim Sci 81 197-208. 

Discuss the changes in electrolyte balance seen with penicillin administration. 

Penicillin is often administered as a sodium or potassium salt. The introduction of potentially large numbers on sodium or potassium ions along with the drug can result in changes in electrolyte balance. This is of particular occurrence with ticarcillin and carbenicillin salts. 

The kidneys play important roles in regulating acid-base balance, water and electrolyte balance, blood volume, and blood pressure by interacting with blood hormones. For example, any major change of plasma osmolality is detected by the hypothalamus, which relays messages to the posterior pituitary gland, which then alters the secretion of antidiuretic hormones. Some metabolites (e.g., amino acids and glucose, which are filtered by the glomeruli) are reabsorbed by the tubules and conserved for recirculation. 

---