Medication accumulation

Ruhoya ISR, Daughton CG (2008) Beyond the medicine cabinet an analysis of where and why medications accumulate. Environ Int 34 1157-1169... 

Medication accumulates and forms a reservoir called pooling. There are two types of pooling. These are ... 

AH x-ray equipment must be periodically inspected and the output monitored and caUbrated to minimize the chance of accidental overexposure. Another concern involves radiation accumulation by medical personnel operating x-ray equipment. Although the dose to any one patient may be low, the accumulated dose to a clinician performing multiple exams each day over the course of a year is great. Therefore, personnel working with x-ray equipment must take precautions constandy to minimize and monitor exposure. Lead aprons and film badges are used to minimize exposure and to monitor accumulated dose, respectively. 

ATPase inhibitor. In such patients, inhibition of the sodium pump in the cells lining the blood vessel wall results in accumulation of sodium and calcium in these cells and the narrowing of the vessels to create hypertension. An 8-year study aimed at the isolation and identification of the agent responsible for these effects by researchers at the University of Maryland Medical School and the Upjohn Laboratories in Michigan recently yielded a surprising result. Mass spectrometric analysis of compounds isolated from many hundreds of gallons of blood plasma has revealed that the hypertensive agent is ouabain itself or a closely related molecule ... 

As evidence accumulates showing that a number of medications are efficacious for the treatment of co-occurring psychopathology and/or the prevention of relapse in alcoholic patients, the therapeutic options available to physicians in treating these patients will increase. As these developments unfold, it is crucial that efforts be directed to enhancing the acceptability of pharmacotherapy to the alcoholism treatment community as a standard ingredient in alcoholism rehabilitation. 

Although the occurrence of product contamination has been well documented in medical literature, the significance for the patient has not always been clear. Evidence accumulated in the past 30 years or so has, however, enabled a better understanding of why and how contamination occurs, its extent and fiequency, the factors determining the outcome for the patient and finally what preventive steps may be taken to control the problems. 

H, MATSUURA D, MIYAKE M, UENO M, TAKAI I, YAMAMOTO T, KUBO M, MOSS J, NODA M (2002) Identification in traditional herbal medications and confirmation by synthesis of factors that inhibit cholera toxin-induced fluid accumulation. Proc Natl Acad Sci U S A. 99 3042-6. 

Propofol 5-20 mcg/kg/min continuous IV infusion (in patients who require frequent neurological assessment) Reassess goals daily and titrate/taper dose to desired response (as patients may accumulate the medication or become tolerant)... 

Medication use must be monitored carefully for potential hepatotoxicity. Hepatically metabolized medications have the potential to accumulate in patients with liver disease. Little guidance is available on drug dosing in hepatic impairment because these patients are often excluded from drug trials. Daily acetaminophen use should not exceed 2 g. Dietary supplements have not been well studied in hepatic impairment and cannot be recommended. 

Question the patient about adverse effects, since hepati-cally metabolized medications may accumulate and cause adverse effects. 

P-glycoprotein, a plasma membrane transport protein, is present in the gut, brain, liver, and kidneys 42 This protein provides a biologic barrier by eliminating toxic substances and xenobiotics that may accumulate in these organs. P-glycoprotein plays an important role in the absorption and distribution of many medications. Medications that are CYP3A4 substrates, inhibitors, or inducers are also often affected by P-glycoprotein therefore, the potential for even more DDIs exists in transplant recipients.42... 

Adsorption of (bio)polymers occurs ubiquitously, and among the biopolymers, proteins are most surface active. Wherever and whenever a protein-containing (aqueous) solution is exposed to a (solid) surface, it results in the spontaneous accumulation of protein molecules at the solid-water interface, thereby altering the characteristics of the sorbent surface and, in most cases, of the protein molecules as well (Malmsten 2003). Therefore, the interaction between proteins and interfaces attracts attention from a wide variety of disciplines, ranging from environmental sciences to food processing and medical sciences. 

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