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The bromelain gel is contraindicated in persons allergic to pineapple or the enzyme papain. [3] The most common side-effects are fever (19% of patients in studies) and local pain (3.6%). Wound infections occur no more frequently than under standard treatment. [3]
Bromelain extract is a mixture of protein-digesting (proteolytic) enzymes and several other substances in smaller quantities. The proteolytic enzymes are sulfhydryl proteases; a free sulfhydryl group of a cysteine amino acid side chain is required for function. The two main enzymes are: Stem bromelain – EC 3.4.22.32; Fruit bromelain – EC 3 ...
Very rarely Stevens–Johnson syndrome, liver damage, severe allergy has been reported [17] May lower blood sugar excessively in combination with diabetes medication. [17] Contains a chemical linked to possible birth defects. [ 17 ]
A group of enzymes located in the endoplasmic reticulum, known as cytochrome P-450, is the most important family of metabolizing enzymes in the liver. Cytochrome P-450 is not a single enzyme, but rather consists of a closely related family of 50 isoforms; six of them metabolize 90% of drugs.
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.
To make the distinction, abnormal liver function tests and/or ultrasound suggesting liver disease are required, and ideally a liver biopsy. [ 4 ] [ 9 ] The symptoms of hepatic encephalopathy may also arise from other conditions, such as bleeding in the brain and seizures (both of which are more common in chronic liver disease).
Pharmacologic treatment in acute situations consists of replacing the enzyme concentrate that is deficient or dysfunctional in this disease process. [20] In life-threatening situations, including cases of oral and pharyngeal swelling, it is important to manage these symptoms and to protect the airways to lower the risk of mortality. [20]
The LCAT glycoprotein produces lysophosphatidylcholine and cholesterol ester and binds to lipoproteins after being secreted by the liver. [5] Usually the enzyme produced is responsible for cholesterol ester formation and high density lipoprotein (HDL) metabolism, but in fish-eye disease the enzyme cannot esterify, or make the acid into an alkyl ...