Lactate clearance

The reasons for the raised blood lactate levels seen during the concurrent use of phenformin and alcohol are not clear, but one suggestion is that it may possibly be related to the competitive demands for isoenzymes by the reactions that convert alcohol to acetaldehyde, and lactate to pyruvate. A study in healthy subjects found that moderate alcohol consumption both improves insulin action, without affecting non-insulin mediated glucose uptake, and decreases lactate clearance. The increase in blood lactate with alcohol is therefore mainly due to inhibition of clearance. Alcohol did not appear to significantly affect beta-cell function. ... 

Abramson D, Scalea TM et al. (1993) Lactate clearance and survival following injury. J Trauma Injury Infect Crit Care 35 584-588... 

Cardiac index and blood pressure must be sufficient to ensure adequate organ perfusion, as assessed by alert mental status, creatinine clearance sufficient to prevent metabolic azotemic complications, hepatic function adequate to maintain synthetic and excretory functions, a stable heart rate and rhythm, absence of ongoing myocardial ischemia or infarction, skeletal muscle and skin blood flow sufficient to prevent ischemic injury, and normal arterial pH (7.34 to 7.47) with a normal serum lactate concentration. These goals are most often achieved with a cardiac index greater than 2.2 L/min/m2, a mean arterial blood pressure greater than 60 mm Hg, and PAOP of 25 mm Hg or greater. 

Lactation It is not known whether linezolid is excreted in human breast milk. Children Clearance is most rapid in the youngest age groups ranging from older than 1 week to 11 years of age, resulting in lower single-dose AUC and shorter... 

A 65-year-old man with a creatinine clearance of 67 ml/minute taking metformin 850 mg bd developed lactic acidosis (lactate 25 mmol/1, pH 7.13, bicarbonate 5 mmol/1) (48). Despite the relatively small dosage of metformin, he had unexplained very high metformin concentrations (61 ig/ml). 

Bile excretion was >0. 1% of the aluminum load. When aluminum was administered via the external jugular vein, aluminum excretion was found to occur in the distal tubule of the kidney in pigs (Monteagudo et al. 1988). Yokel and McNamara (1985) did not find any age-related differences in the systemic clearance or half-time of aluminum in rabbits following parenteral administration of aluminum lactate. 

The fate of peptide amphiphiles will be critical to their development as materials for in vivo use. Studies by Beniash and colleagues found that cells entrapped within a network of peptide amphiphiles internalize fibers by endocytosis and store these fibers in the lysosome. In this case the fibers displayed a KGE motif, with similar charge properties to RGD, and the cells could proliferate within these scaffolds for at least 3 weeks. Studies of glucose and lactate concentrations suggest the cell may metabolize the peptide amphiphiles (Beniash et al., 2005), indicating that clearance of these peptides from the site of application is unlikely to be an issue for these structures. 

Hetherington HP, Tan MJ, Luo KL, Pohost GM, Halsey JH, Conger KA (1994) Evaluation of lactate production and clearance kinetics by 1H NMR in a model of brief repetitive cerebral ischemia. J.Cereb.Blood Flow Metab 14 591-596... 

Another aspect of non-steady-state behaviour that is occasionally of interest is the clearance of a chemical from a contaminated animal. Feeding studies have shown the clearance from non-lactating cattle to be very slow, with half-lives in the order of several hundred days.70,71 It is not known if the disappearance is due to metabolism or other mechanisms. While the loss from the animal is very slow, the concentrations can decrease as a result of growth dilution.72... 

Clearance from lactating cows has been studied much more intensively. Half-lives in the order of 30-60 days have generally been found.60 66 73 74 The half-life can be expected to increase with increasing body lipid weight and decreasing lactation rate of the contaminated animal.65 There is evidence of a rapid initial drop in milk fat concentrations following removal of the contaminant source from the diet, and this has been described using a pharmacokinetic model.75... 

The clearance of lactate may be reduced in liver impairment, leading to the possibility of accumulation and increased potential for lactic acidosis. Concurrent renal impairment with liver impairment could further increase the risk with drugs known to cause lactic acidosis, e.g. metformin and nucleoside reverse transcriptase inhibitors [2]. 

Doucette et al. 2000). At lower doses neonates show delayed effects on eye opening and olfactory conditioned place preference (Doucette et al. 2003). The latter supports the high sensitivity of the mitral-granule cells to domoic acid as described earlier. Evidence indicates that the sensitivity of the neonates results from insufficient renal clearance of toxin, allowing increased bioavailability in the blood (Xi et al. 1997). Domoic acid has been detected in the blood of neonates, transmitted via milk from lactating mother rats previously exposed to domoic acid but at levels appearing to be well below symptomatic doses (Maucher and Ramsdell 2005). 

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