Glucose toxicity dosing

Usual dose schedules of streptozotocin involve 500 mg/m2 i.v. during five consecutive days. The major toxicity is renal tubular damage. Treatment of metastatic insulinomas may result in the release of insulin from the tumor and subsequent hypoglycemic coma. Less severe toxicities include diarrhea, anemia, and mild alterations in glucose tolerance or liver function tests. 

Acetaminophen may alter blood glucose test results, causing falsely lower blood glucose values. Use with the barbiturates, hydantoins, isoniazid, and rifampin may increase the toxic effects and possibly decrease the therapeutic effects of acetaminophen. The effects of the loop diuretics may be decreased when administered with acetaminophen. Hepatotoxicity has occurred in chronic alcoholics who are taking moderate doses of acetaminophen. 

Intravenous doses of miconazole have ranged from 0.2 g daily to 1.2 g three times daily, depending on the sensitivity and severity of the infection. It should be diluted in sodium chloride 0.9% or glucose 5% and given by slow infusion the manufacturers recommend that daily dose up to 2.4 g should be diluted to a concentration of 1 mg/mL and infused at a rate of 100 mg/h, in order to reduce toxicity. Children over 1 year of age may be given 20-40 mg/kg body weight daily but not more than 15 mg/kg of miconazole should be given at each infusion [3]. 

It was discovered nearly 20 years ago that V(V) as vanadate and V(IV) as vanadyl can mimic some of the effects of insulin (stimulate glucose uptake and oxidation and glycogen synthesis) (512, 513). Vanadate is an effective insulin mimetic in the diabetic rat (514), but has proved to be too toxic for human use. Vanadyl, as VOS04, is also unsuitable because high doses are needed on account of its poor oral absorption. Vanadium complexes with organic ligands have proved to be less toxic and can have improved aqueous solubility and lipophil-icity. 

Albendazole selectively blocks glucose uptake and depletes glycogen stores. ATP formation is thus inhibited. It should be administered on an empty stomach for intraluminal parasites and with a fatty meal for tissue parasites. It is metabolized to an active sulfoxide metabolite resulting in very low Albendazole blood levels. Albendazole sulfoxide is excreted in the urine with an elimination half-life of about 8 h. Used for 1-3 days in doses recommended for intestinal worms the incidence of adverse effects is similar in treatment and control groups. Hepato-toxicity may occur, especially after the higher doses that are needed for hydatid disease. Also alopecia has been reported. 

Decreases catabolism of apo AI treduces VLDL secretion from liver Increases HDL decreases lipoprotein(a) [Lp(a)], LDL, and triglycerides Low HDL elevated VLDL, LDL, Lp(a) Oral large doses Toxicity Gastric irritation, flushing, low incidence of hepatic toxicity may reduce glucose tolerance... 

---