Drug-induced impairment of renal function

George Sunny Pazhayattil, Anushree C Shirali Section of Nephrology, Yale University School of Medicine, New Haven, CT, USA Abstract: Pharmaceutical agents provide diagnostic and therapeutic utility that are central to patient care. However, all agents also carry adverse drug effect profiles. While most of these are clinically insignificant, some drugs may cause unacceptable toxicity that impacts negatively on patient morbidity and mortality. Recognizing adverse effects is important for administering appropriate drug doses, instituting preventive strategies, and withdrawing the offending agent due to toxicity. In the present article, we will review those drugs that are associated with impaired renal function. By focusing on pharmaceutical agents that are currently in clinical practice, we will provide an overview of nephrotoxic drugs that a treating physician is most likely to encounter. In doing so, we will summarize risk factors for nephrotoxicity, describe clinical manifestations, and address preventive and treatment strategies. Keywords: acute kidney injury, chronic kidney disease, drug nephrotoxicity, chemotherapy, NSAID

Drug Excretion

Absorption, Distribution, Metabolism and Excretion (ADME) processes and their relationship with the design of dosage forms and the success of pharmacotherapy form the basis of this upper level undergraduate/graduate textbook. As an introduction oriented to pharmacy students, it is also written for scientist from different fields outside of pharmaceutics. (e.g. material scientist, material engineers, medicinal chemists) who might be working in a positions in pharmaceutical companies or whose work might benefit from basic training in the ADME concepts and some biological background. Pedagogical features such as objectives, keywords, discussion questions, summaries and case studies add valuable teaching tools. This book will provide not only general knowledge on ADME processes but also an updated insight on some hot topics such as drug transporters, multi-drug resistance related to pharmacokinetic phenomena, last generation pharmaceutical carriers (nanopharmaceuticals), in vitro and in vivo bioequivalence studies, biopharmaceuticals, pharmacogenomics, drug-drug and food-drug interactions, and in silico and in vitro prediction of ADME properties. In comparison with other similar textbooks, around half of the volume would be focused on the relationship between expanding scientific fields and ADME processes. Each of these burgeoning fields has a separate chapter in the second part of the volume, and was written with leading experts on the correspondent topic, including scientists and academics from USA and UK (Duquesne University School of Pharmacy, Indiana University School of Medicine, University of Utah College of Pharmacy, University of Maryland, University of Bath).Additionally, each of the initial chapters dealing with the generalities of drug absorption, distribution, metabolism and excretion would include relevant, classic examples related to each topic with appropriate illustrations (e.g. importance of active absorption of levodopa, implications in levodopa administration, drug drug interactions and food drug interactions emerging from the active uptake; intoxication with paracetamol as a result of glutathione depletion, CYP induction and its relationship with acute liver failure caused by paracetamol, etc).ADME Processes and Pharmaceutical Sciences is written as a core textbook for ADME processes, pharmacy, pharmacokinetics, drug delivery, biopharmaceutics, drug disposition, drug design and medicinal chemistry courses.Fil: Talevi, Alan. Universidad Nacional de La Plata. Facultad de Ciencas Exactas. Laboratorio de Investigación y Desarrollo de Bioactivos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas. Cátedra de Química Medicinal; ArgentinaFil: Bellera, Carolina Leticia. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biológicas. Cátedra de Química Medicinal; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata. Facultad de Ciencas Exactas. Laboratorio de Investigación y Desarrollo de Bioactivos; Argentin

The Heavenly Sanctuary/Temple Motif in the Hebrew Bible : Function and Relationship to the Earthly Counterparts

The present dissertation investigates the function of the heavenly sanctuary/temple and its relationship to the earthly counterparts, as reflected in forty-three passages of Hebrew Bible. Following an introductory chapter, the second chapter of this dissertation is devoted to a survey of the heavenly sanctuary/temple motif in the ANE literature, as represented by Sumerian, Akkadian, Hittite, Ugaritic, and Egyptian texts. The investigation of these texts reveals that the heavenly sanctuary/temple motif was part of the worldview of the ANE, where the heavenly sanctuary was not only assumed as existing in heaven, but also as functioning in close relationship to the earthly counterparts. Chapters 3, 4, and 5 are devoted to the exegesis of heavenly sanctuary/temple passages in the Hebrew Scriptures, according to the canonical divisions of the Hebrew Bible (namely Torah, Prophets, and Writings). This investigation reveals the pervasive presence of the heavenly sanctuary/temple motif in the Hebrew Bible and provides a broad delineation of its function and relationship to the earthly counterparts. It has been found that the heavenly sanctuary temple functions as a place of divine activities where YHWH supervises the cosmos, performs acts of judgment (sometimes conceived as a two-stage activity in which the execution of the sentence was preceded by an investigative phase), hears the prayers of the needy, and bestows atonement and forgiveness upon the sinners. The perception also emerged of the heavenly sanctuary/temple as a place of worship, a meeting place for the heavenly council, and an object of attack by anti-YHWH forces, thus playing a pivotal role in the cosmic battle between good and evil. In terms of its relationship to the earthly counterparts, it becomes apparent that the heavenly sanctuary/temple was understood to operate in structural and functional correspondence to the earthly counterparts. Moreover, some texts reveal a dynamic interaction between heavenly and earthly sanctuaries/temples, inasmuch as the activities of one could affect the other. Chapter 6 presents a theological synthesis of the heavenly sanctuary/temple motif based on the previous chapters. Some consideration is given to the similarities and differences between the heavenly sanctuary/temple motif as found in the Hebrew Bible and in its ANE background. Next, attention is devoted to some theological implications of the heavenly sanctuary/temple motif for the notions of judgment, cosmic battle, and covenant. To conclude, the Hebrew Bible conceives of the heavenly sanctuary/temple in functional and structural correspondence with its earthly counterpart with both sanctuaries/temples operating in dynamic interaction