Enzymes clinical problems/solutions

Information is limited, but the interaction between doxycycline and alcohol appears to be established and of clinical significance in alcoholics but not in non-alcoholic individuals. One possible solution to the problem of enzyme induction is to give alcoholic subjects double the dose of doxycy-cline. Alternatively tetracycline may be a suitable non-interacting alternative. There is nothing to suggest that moderate or even occasional heavy drinking has a clinically relevant effect on any of the tetracyclines in non-alcoholic subjects. 

The concentration of heparin in tissues from which it is isolated is about 10-50 ppm. Hence, it is a trace substance. Further it combines easily with protein. Hence, its extraction from tissue economically has required considerable ingenuity. Methods for this involve the use of concentrated electrolyte solutions and proteolytic enzymes. Standards set for this compound do not appear to meet the problem presented in identifying this compound and this is responsible for the variability that occurs. This variability is important in standardizing heparin for clinical use [7, 8]. The variations seen in activity values by different tests indicate there are probably similar variations in activity of the preparations for different clinical uses - e.g. prevention of postoperative thrombosis, prevention of clotting in the heart-lung machine, etc. 

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