Predicting Medication Effects

DNP can be measured in blood, urine, and several body tissues. The main breakdown product of DNP in people, 2-amino-4-nitrophenol, can also be measured in the blood, urine, and tissues. The Derrien test is routinely used to measure this breakdown product in urine. This test produces a purple color if 2-amino-4-nitrophenol is present, but similar chemicals can also produce a purple color with this test. The total amount or concentration of DNP and its main breakdown products in urine or blood is a better indicator of DNP exposure. More modern tests can now identify and measure total DNP and breakdown products in blood or urine. However, these tests are not routinely available at your doctor s office, but can be performed at special laboratories or hospitals. These tests have not been used to tell exactly how much DNP people were exposed to or for how long. They also have not been used to predict harmful effects. More information on medical tests can be found in Chapters 2 and 6. 

The ability to predict the effects of even simple structural modifications on the aqueous solubility of an organic molecule could be of great value in the development of new molecules in various fields, e.g., medical or industrial. There exist theoretical procedures to predict solubilities of nonpolar molecules in nonpolar solvents and for salts or other highly polar solutes in polar solvents, such as water or similar substances. However, the prediction of solubility of a nonpolar solute in water has been found to require some different molecular considerations. 

Mitochondria-associated toxicities, such as pancreatitis, are frequently demonstrated in HlV/HCV-coinfected individuals, and may significantly influence treatment options (de Mendoza and Soriano 2005). Yet, no cell culture or animal models have been developed to predict nucleoside-induced pancreatitis. Nevertheless, an association of HCV replication and mitochondrial DNA depletion in primary human lymphocytes obtained from HIV/HCV-coinfected individuals under concomitant administration of HCV and HIV medications was demonstrated by de Mendoza and coworkers (de Mendoza et al. 2007). They claimed that the use of HCV medication together with certain antiretroviral agents seemed to enhance mitochondrial damage due to a synergistic deleterious interaction between the anti-HCV and anti-HIV drugs. In contrast, an improvement in mitochondrial content with effective... 

Pharmacotherapy has an important role in managing AR symptoms (Table 59-2). Intranasal corticosteroids, systemic and topical antihistamines and decongestants, mast cell stabilizers, and immunotherapy all are beneficial in treating symptoms of AR.9 Antihistamines and intranasal corticosteroids are considered first-line therapy for AR, whereas decongestants, mast cell stabilizers, leukotriene modifiers, and systemic corticosteroids are secondary treatment options10-12 (Fig. 59-2). Whenever exposure to allergens can be predicted (e.g., SAR or visiting homes with a pet), medications should be used pro-phylactically to maximize effectiveness.11... 

Parenteral administration of drugs by intravenous (IV), intramuscular (IM), or subcutaneous (SC) routes is now an established and essential part of medical practice. Advantages for parenterally administered drugs include the following rapid onset, predictable effect, predictable and nearly complete bioavailability, and avoidance of the gastrointestinal (GI) tract and, hence, the problems of variable absorption, drug inactivation, and GI distress. In addition, the parenteral route provides reliable drug administration in very ill or comatose patients. 

Intravenous medication is injected directly into a vein either to obtain an extremely rapid and predictable response or to avoid irritation of other tissues. This route of administration also provides maximum availability and assurance in delivering the drug to the site of action. However, a major danger of this route of administration is that the rapidity of absorption makes effective administration of an antidote very difficult, if not impossible, in most instances. Care must often be... 

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