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First-pass metabolism may occur in the liver (for propranolol, lidocaine, clomethiazole, and nitroglycerin) or in the gut (for benzylpenicillin and insulin). [4] The four primary systems that affect the first pass effect of a drug are the enzymes of the gastrointestinal lumen, [5] gastrointestinal wall enzymes, [6] [7] [8] bacterial enzymes [5] and hepatic enzymes.
Oxidative damage may occur in any cell in the body but the effects on the three most susceptible organs will be the primary concern. It may also be implicated in damage to red blood cells , [7] [8] the liver, [9] heart, [10] endocrine glands (adrenal glands, gonads, and thyroid), [11] [12] [13] or kidneys, [14] and general damage to cells. [2] [15]
Cardiotoxicity is the occurrence of heart dysfunction as electric or muscle damage, resulting in heart toxicity. [1] This can cause heart failure, arrhythmia, myocarditis, and cardiomyopathy in patients. [2] Some effects are reversible, while in others, permanent damage requiring further treatment may arise.
Chronic alcohol consumption leads to the accumulation of toxic metabolites, such as acetaldehyde and reactive oxygen species, in the heart muscle cells. [2] These toxic substances can cause oxidative stress, inflammation, and damage to the cardiomyocytes, leading to the development of ACM. [3]
Oxidative stress mechanisms in tissue injury. Free radical toxicity induced by xenobiotics and the subsequent detoxification by cellular enzymes (termination).. Oxidative stress reflects an imbalance between the systemic manifestation of reactive oxygen species and a biological system's ability to readily detoxify the reactive intermediates or to repair the resulting damage. [1]
Coronary arteries deliver oxygen-rich blood to the heart muscle. [5] Reduced blood flow to the heart associated with coronary ischemia can result in inadequate oxygen supply to the heart muscle. [6] When oxygen supply to the heart is unable to keep up with oxygen demand from the muscle, the result is the characteristic symptoms of coronary ...
Drug-induced liver injury (DILI) is a cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn from the market after approval. The liver plays a central role in transforming and clearing chemicals and is susceptible to the toxicity from these agents.
Lactic acidosis is commonly found in people who are unwell, such as those with severe heart and/or lung disease, a severe infection with sepsis, the systemic inflammatory response syndrome due to another cause, severe physical trauma, or severe depletion of body fluids. [3]