Liver exercise

Erythromycin - Erythromycin is principally excreted by the liver. Exercise caution in administering to patients with impaired hepatic function. 

Hepatic function impairment Ritonavir is principally metabolized by the liver. Exercise caution when administering this drug to patients with pre-existing liver diseases, liver enzyme abnormalities, or hepatitis. 

The lactic acid (C3H603(flg), AG = —559 kj) produced in muscle cells by vigorous exercise eventually is absorbed into the bloodstream, where it is metabolized back to glucose (AG = —919 kj) in the liver. The reaction is... 

Hultman, E. Nilsson, L.H. (1971). Liver glycogen in man. Effect of different diet and muscular exercise. In Muscle Metabolism During Exercise (Pemow, B. Saltm, B., eds.), pp. 143-151, Plenum Press, New York. 

Salo, D.C., Donovan, C.M., Davies, K.J, (1991). Hsp70 and other possible heat shock or oxidative stress proteins are induced in skeletal muscle, heart, and liver during exercise. Free Radic. Biol. Med 11,239-246. 

Black cohosh has been one of the most studied herbal remedies for vasomotor symptoms, and it has not demonstrated a substantial benefit over placebo. The mechanism of action, safety profile, drug-drug interactions, and adverse effects of black cohosh remain unknown. In non-placebo-controlled trials conducted for 6 months or less, black cohosh demonstrated a small reduction in vasomotor symptoms. It has not been shown to be effective for vasomotor symptoms in women with breast cancer.33 There have been case reports of hepatotoxicity with the use of black cohosh.36 Caution should be exercised when considering the use of this product, especially in patients with liver dysfunction. 

During the recovery period from exercise, ATP (newly produced by way of oxidative phosphorylation) is needed to replace the creatine phosphate reserves — a process that may be completed within a few minutes. Next, the lactic acid produced during glycolysis must be metabolized. In the muscle, lactic acid is converted into pyruvic acid, some of which is then used as a substrate in the oxidative phosphorylation pathway to produce ATP. The remainder of the pyruvic acid is converted into glucose in the liver that is then stored in the form of glycogen in the liver and skeletal muscles. These later metabolic processes require several hours for completion. 

Rare painless hematuria normal Hb level heavy exercise under extreme conditions may provoke gross hematuria and complications Pain crises, microvascular disruption of organs (spleen, liver, bone marrow, kidney, brain, and lung), gallstone, priapism, leg ulcers, anemia (Hb 7-10 g/dL) Painless hematuria and rare aseptic necrosis of bone vasoocclusive crises are less common and occur later in life other complications are ocular disease and pregnancy-related problems mild anemia (Hb 10-12 g/dL)... 

The calorific capacity of amino acids is comparable to that of carbohydrates so despite their prime importance in maintaining structural integrity of cells as proteins, amino acids may be used as fuels especially during times when carbohydrate metabolism is compromised, for example, starvation or prolonged vigorous exercise. Muscle and liver are particularly important in the metabolism of amino acids as both have transaminase enzymes (see Figures 6.2 and 6.3 and Section 6.4.2) which convert the carbon skeletons of several different amino acids into intermediates of glycolysis (e.g. pyruvate) or the TCA cycle (e.g. oxaloacetate). Not all amino acids are catabolized to the same extent... 

In a muscle at rest, most of the 2-oxo acids produced from transamination of branched chain amino acids are transported to the liver and become subject to oxidation in reactions catalysed by branched-chain 2-oxo acid dehydrogenase complex. During periods of exercise, however, the skeletal muscle itself is able to utilize the oxo-acids by conversion into either acetyl-CoA (leucine and isoleucine) or succinyl-CoA (valine and isoleucine). 

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