Insulin caffeine

Pharmacology Histamine H2 antagonists are reversible competitive blockers of histamine at the H2receptors. They also inhibit fasting and nocturnal secretions, and secretions stimulated by food, insulin, caffeine, pentagastrin, and betazole. 

Horinaka, N., Kuang, T. Y., Pak, H. etal. Blockade of cerebral blood flow response to insulin-induced hypoglycemia by caffeine and glibenclamide in conscious rats. /. Cereb. Blood Flow Metab. 17 1309-1318,1997. 

Metabolism. The nucleotide cAMP (adenosine 3, 5 -cyclic monophosphate) is synthesized by membrane-bound adenylate cyclases [1] on the inside of the plasma membrane. The adenylate cyclases are a family of enzymes that cyclize ATP to cAMP by cleaving diphosphate (PPi). The degradation of cAMP to AMP is catalyzed by phosphodiesterases [2], which are inhibited by methylxanthines such as caffeine, for example. By contrast, insulin activates the esterase and thereby reduces the cAMP level (see p. 388). 

Smoking cessation, with or without nicotine substitutes, may alter response to concomitant medication in ex-smokers. Smoking may affect alcohol, benzodiazepines, beta-adrenergic blockers, caffeine, clozapine, fluvoxamine, olanzapine, tacrine, theophylline, clorazepate, lidocaine (oral), estradiol, flecanide, imipramine, heparin, insulin, mexiletine, opioids, propranolol, catecholamines, and cortisol. 

Mecftanism of Action AGI Hj-blocker and gastric acid secretion inhibitor that inhibits histamine action at histamine 2 receptors of parietal cells Therapeutic Effect Inhibits gastric acid secretion when fasting, at night, or when stimulated by food, caffeine, or insulin. 

Drugs that may require dosage reduction with smoking cessation acetaminophen, caffeine, imipramine, oxazepam, penfazocine, propranolol, fheophylline, insulin, prazocin, labetalol... 

A 73-year-old man with diabetic gangrene who had used insulin and acarbose 300 mg/day for 15 months developed ileus with abdominal pain and vomiting after he took PL granules (containing salicylamide, paracetamol, anhydrous caffeine, and promethazine methylene disalicylate) for a common cold (51). The ileus subsided after acarbose and the other drugs were withdrawn. 

Drugs that show extensive tissue binding are said to have an apparent volume of distribution many times the total body size. For example, digoxin (see Chapter 35), which binds to plasma protein to the extent of 23%, has an apparent volume of distribution of 8 1/kg. The volume of distribution of drugs that do not bind to plasma or tissue proteins varies between the extracellular fluid volume (16 liters) and the total body water (42 liters). Insulin, sodium, and iodine are confined to the extracellular water, whereas caffeine and ethanol are distributed in the total body water. 

Frankly toxic effects, such as persistent insomnia and anxiety, only become evident when people drink more than eight or nine cups of coffee or tea a day. Convulsions and delirium can follow enormous doses, and a near-fatal dose can induce a state similar to that of a diabetic lacking insulin. Blood sugar surges, and ketones appear in the urine. The lowest recorded fatal dose of caffeine was 3200 mg, which was given by accident directly into the bloodstream. It takes the equivalent of 40 cups of coffee consumed by mouth in a short interval for caffeine to kill a person. 

ASA = aspirin NSAIDs = non-steroidal anti-inflammatory drugs, such as ibuprofen, naproxen, and diclofenac CNS stimulants include drugs such as pseudoephedrine, dextroamphetamine, theophylline, and caffeine MAO = monoamine oxidase CNS depressants include drugs such as benzodiazepines, barbiturates, and ethanol SSRIs = selective serotonin reuptake inhibitors, such as fluoxetine, sertraline, and paroxetine. Antidiabetic agents include drugs such as insulin, glipizide, glyburide, and metformin. 

Clinically important, potentially hazardous interactions with caffeine, carbamazepine, cocoa, fluoxetine, guarana, insulin glulisine, risperidone, ritonavir, selenium, uracil/tegafur... 

Aside from inorganic ions, amino acids and other small organic molecules have transport systems to move them across membranes. Human erythrocytes have two different amino acid transporters, and both of them are affected by harmaline, though in different ways [529]. Caffeine and theophylline both inhibit glucose uptake by insulin-treated adipocytes [530],... 

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