Metabolism renal

Steady state Css Infusion rate Metabolism, renal excretion... 

Drug metabolism, renal tubular secretion, and biliary secretion are usually mediated by metabolizing enzymes or transporter proteins. These protein systems usually possess good substrate selectivity with finite capacities, which are described by the Michaelis-Menten equation,... 

For many drugs that do not undergo metabolism, renal clearance is the primary route of elimination from the body. At a simplistic level drugs may be categorized into those that are extensively metabolized or those that are primarily excreted unchanged in the urine (i.e., nonextensively... 

Physiological actions of PTH include regulation of bone metabolism, renal tubular reabsorption of calcium and phosphate, and intestinal calcium absorption... 

Lipophilicity Frotein binding (%) Metabolism Renal excretion (%) Faecal excretion (%)... 

Mechanism uncertain. Metformin does not undergo hepatic metabolism. Renal tubular secretion is the major route of metformin elimination. Aminoglycosides are also principally excreted via the kidney, and nephrotoxicity is an important side-effect Watch and monitor for hypoglycaemia, and warn patients about it - For signs and symptoms of hypoglycaemia, see Clinical Features of Some Adverse Drug Interactions, Hypoglycaemia... 

Pharmacokinetics. Quinolones are well absorbed from the gut, and widely distributed in body tissue. Mechanisms of inactivation (hepatic metabolism, renal and biliary excretion) are detailed below for individual members. There is substantial excretion and re-absorption via the colonic mucosa, and patients with renal failure or intestinal malfunction, e.g. ileus, are prone to accumulate quinolones. 

Hyperuricaemia and gout from whatever cause (e.g. metabolic, renal disease, neoplasia) depends essentially on two processes, (1) overproduction and (2) underexcretion of urate. Both mechanisms may operate in the same patient but decreased renal clearance contributes to hyperuricaemia in most patients with gout. Drugs may influence these processes as follows ... 

Low-molecular-weight heparins, such as enoxaparin, dal-teparin, and tinzaparin, were introduced in 1982. These are parenteral agents that have fixed or weight-adjusted dosing, involve less monitoring, and are easier to administer. The half-lives of LMWHs are longer than that of UFH. Because LMWHs are metabolized renally and due to a 90% cross-reactivity to HIT antibodies, they are contraindicated in patients with poor renal function and patients with HIT. In rare instances, antifactor Xa levels are measured. This peak level is drawn 4 hours after the third dose (prophylaxis 0.2-0.4 units/mL treatment 0.5-1.0 units/mL). 

Acute, and sometimes fatal, complications of pulmonary, metabolic, renal, and hepatic functions result from formaldehyde intoxication (Feinman 1988b Gosselin et al. 1984). No strong evidence links formaldehyde to significant and consistent neurotoxicity (Bar-dana and Montanaro 1987). 

Teriparatide is a parathyroid hormone, which regulates bone metabolism, renal tubular reabsorption of calcium and phosphate, and intestinal calcium reabsorption. It is indicated in the treatment of postmenopausal women with osteoporosis who are at high risk for fracture (e.g., history of osteoporotic fracture) and to increase bone mass in men with primary or hypogonadal osteoporosis who are at high risk of fracture (e.g., history of osteoporotic fracture). 

Adler AJ and Berlyne GM (1986) Silicon metabolism. Renal handling in chronic renal failure patients. Nephron 44 36-39. 

Fig. 42.6. Renal glutamine metabolism. Renal tubule cells preferentially oxidize glutamine. During metabolic acidosis, it is the major fuel for the kidney. Conversion of glutamine to a-ketoglutarate generates NH4. Ammonium ion excretion helps to buffer systemic acidemia.

S u a liver metabolism, renal excretion. Hypotension, tachycardia, respiratory depression, bronchospasm, anaphylaxis. Most commonly used druc for induction of anesthesia. 

Drug elimination occurs by renal excretion and an extrarenal pathway, usually hepatic metabolism. Renal clearance Is defined as the proportionality constant between the urinary excretion rate and the plasma concentration ... 

Age. Absorption and first-pass metabolism of phytochemicals may be age-dependent, thus neonates exhibit reduced hepatic metabolism and renal excretion as a direct consequence of the immaturity of liver and kidney function. The susceptibility of the elderly to xenobiotics may be affected by age-related alterations in absorption, intestinal and hepatic metabolism, renal clearance, or volume of distribution [27]. 

From the above succinct review of the mechanism regulating blood pH, it is clear that acidosis or alkalosis may result from metabolic, renal, or pulmonary dysfunctions. Depending upon the severity of the dysfunction, the electrolyte imbalance will not be associated with severe changes in blood pH (compensated acidosis or alkalosis), or the blood pH may reach values incompatible with survival. 

---