Renal system study

The answer is a. (Hardman, pp 885-8870 Lovastatin should not be used in patients with severe liver disease. With routine use of lovastatin, serum transaminase values may rise, and in such patients the drug may be continued only with great caution. Lovastatin has also been associated with lenticular opacities, and slit-lamp studies should be done before and one year after the start of therapy There is no effect on the otic nerve. The drug is not toxic to the renal system, and reports of bone marrow depression are very rare There is a small incidence of myopathy, and levels of creatinine kinase should be measured when unexplained muscle pain occurs. Combination with cyclosporine or clofibrate has led to myopathy There is no danger in use with bile acid sequestrants. 

In an epidemiological study at a munitions plant where workers were exposed to 0.28 mg/m time-weighted average (TWA), there were no abnormalities of the hematologic, hepatic, or renal systems. ... 

Memantine is not a major substrate for hepatic cytochrome P450 isoenzymes and has not been shown to significantly inhibit or induce these enzymes. However, memantine is partially excreted by renal tubular secretion. Thus, concomitant use of other medications that use the same renal system (i.e., triampterene, hydrochlorothiazide, digoxin, cimetidine, ranitidine, metformin, and quinidine) may affect plasma levels of both drugs (Namenda 2005). Memantine should not be used in combination with other NMDA receptor antagonists, such as amantadine or dextromethorphan, because these combinations have not been formally studied. The clearance of memantine can be reduced when the urine is alkalinized, such as with the concomitant use of sodium bicarbonate or carbonic anhy-... 

Whole animal studies are generally necessary to determine the effect of the drug on organ systems and disease models. Cardiovascular and renal function studies of all new drugs are generally first performed in normal animals. Where appropriate, studies on disease models are performed. For a candidate antihypertensive drug, animals with hypertension would be treated to see whether blood pressure was lowered in a dose-related manner and to characterize other effects of the compound. Evidence would be collected on duration of action and efficacy after oral and parenteral administration. 

No studies were located regarding health effects in humans or animals after chronic inhalation, oral, or dermal exposure or in animals after chronic inhalation exposure to 2-butoxyethanol or 2-butoxyethanol acetate. The primary targets for adverse systemic effects of 2-butoxyethanol following acute- and intermediate-duration exposure are the hematological and renal systems. Since chronic low-level... 

Liano F, Junco E, Pascual J, Madero R, Verde E The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid Acute Renal Failure Study Group. Kidney Int SuppI 66 S16-S24, 1998 Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. JAMA 273 117-123, 1995... 

With the possibihty of new drugs targeting NC and its receptor, one must consider the potential systemic effects with such administration. NC has the potential to effect systems such as the cardiovascular and renal systems. IV administration of NC resulted in species-based cardiovascular changes in test animals, showing transient hypotension and bradycardia in test rats, but an increase in both heart rate and blood pressure in sheep [1]. With regard to renal function, IV administration of NC resulted in increased water excretion and decreased urinary sodium excretion according to one study. This effect is probably due to the inhibition of oxytocin and vasopressin by NC. ICV injection of NC in test animals led to an increase in food consumption [1]. However, unlike other effects, this one was shown to be antagonized by naloxone. 

Cardiovascular effects of Pb in humans are the subject of Chapter 13, particularly with respect to effect potency in older exposure subjects but with inclusion of other risk groups. Cardiovascular effects, while inconsistently quantified across human populations, have been identified in multiple epidemiological studies, supported by a number of experimental data sets appearing in the global literature. Chapter 14 on human reproductive and developmental impacts of lead exposures presents the more useful data across several risk groups within human populations. Chapter 15 discusses adverse effects of lead on the renal system as nephrotoxicity is considered to occur across both occupational and nonoccupational subsets of human populations and subsets within nonoccupational categories. Discussions in Chapter 15, much like those in Chapter 18 on immunotoxicity, have benefited from quite recent findings. 

Long-lasting vasoconstriction is produced by the ETs in almost all arteries and veins and several studies have shown that ET-1 causes a reduction in renal blood flow and urinary sodium excretion. ET-1 has been reported to be a potent mitogen in fibroblasts and aortic smooth muscle cells and to cause contraction of rat stomach strips, rat colon and guinea pig ileum. In the central nervous system, ETs have been shown to modulate neurotransmitter release. 

In the treatment of diseases where the metaboUtes are not being deUvered to the system, synthetic metaboUtes or active analogues have been successfully adrninistered. Vitamin metaboUtes have been successfully used for treatment of milk fever ia catde, turkey leg weakness, plaque psoriasis, and osteoporosis and renal osteodystrophy ia humans. Many of these clinical studies are outlined ia References 6, 16, 40, 51, and 141. The vitamin D receptor complex is a member of the gene superfamily of transcriptional activators, and 1,25 dihydroxy vitamin D is thus supportive of selective cell differentiation. In addition to mineral homeostasis mediated ia the iatestiae, kidney, and bone, the metaboUte acts on the immune system, P-ceUs of the pancreas (iasulin secretion), cerebellum, and hypothalamus. 

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