Multi drug resistance

Szakacs G, Paterson JK, Ludwig JA et al (2006) Targeting multi drug resistance in cancer. Nat Rev Drag Discov 5 219-234... 

Kioka, N., Hosokawa, N., Komano, T., Hiiayoshi, H., Nagat, K., Ueda, K. (1992). Quercetin, a bioflavonoid, inhibits the increase of human multi-drug resistance gene (MDRI) expression caused by arsenite. FEES Lett. 301, 307-309. 

King NM, Melnick L, Prabu-Jeyabalan M, NalivaikaEA, Yang SS, Gao Y, NieX, Zepp C, Heefner DL, Schiffer CA (2002) Lack of synergy for inhibitors targeting a multi-drug-resistant HIV-1 protease. Protein Sci 11 418 29... 

In recent years multi-drug resistance has increased among certain pathogens. These include aureus, enterococci andM. tuberculosis. Staphylococcus aureus... 

The GIT supplements the kidney in the elimination of wastes and toxins. The P-glycoprotein of enterocytes, which is implicated in multi-drug resistance, plays a critical role. This export carrier exhibits varying responses to the different polyphenols present in green tea (Wang et al, 2002), and is inhibited by one or more components of grapefruit juice (Wagner et al, 2001). It is... 

PETERSON G and BARNES s (1991) Genistein inhibition of the growth of hiunan hreast cancer cells independence from estrogen receptors and the multi-drug resistance gene. Biochem Biophys Res Commun. 179 (1) 661-7. 

Gentamicin and tobramycin are equally effective. Tobramycin has slightly better MICs to Pseudomonas. Amikacin generally is reserved for multi-drug resistant bacteria. Typically used as a short course of therapy followed by a switch to an oral agent. 

Treatment for septic patients with hospital-acquired, ventilator-acquired, and health care-associated pneumonia is dependent on risk factors for multi-drug resistant (MDR) organisms (Fig. 79-2). Recommended treatment for patients with no MDR risk factors are third-generation cephalosporins, fluoroquinolones, ampicillin-sulbactam, or ertapenem (see Table 79-3).35 Recommended treatment for patients with MDR risk factors are P-lactam/p-lactamase inhibitors (piperacillin-tazobactam), antipseudomonal cephalosporin, or carbapenem, plus an aminoglycoside, plus vancomycin or linezolid (see Table 79-3).35 If an aminoglycoside is undesirable, a antipseudomonal fluoroquinolone may be utilized with a P-lactam/p-lactamase inhibitor. 

Risk Factors for Multi-drug Resistant (MDR) Pathogens... 

Huang L, Vore M. Multi drug resistance p-glycoprotein 2 is essential for the biliary excretion of indocyanine green. Dmg Metab Dispos 2001 29(5) 634-637. 

Cordon-Cardo C, O Brien JP, Casals D, Rittman-Grauer L, Biedler JL, Melamed MR et al. Multi-drug resistance (P-glycoprotein) is expressed by endothelial cells at blood-brain barrier sites. Proc Natl Acad Sci USA 1989 86 695-698. 

Hoffmeyer S, Burk O, Von Richter O, Arnold HP, Brockmoller J, Johne A et al. Functional polymorphisms of the human multi-drug resistance gene multiple sequence variations and correlation of one allele with P-glycoprotein expression and activity in vivo. Proc Natl Acad Sci USA 2000 97 3473-3478. 

Huai-Yun H, Secrest DT, Mark KS, Carney D, Elmquist WF, Miller W. Expression of multi-drug resistance-associated protein (MRP) in brain microvessel endothelial cells. Biochem Biophys Res Commun 1998 243 816-820. 

Keywords Pyrrole Natural products Antitumor agents Multi-drug resistance... 

---