Medications in the kidney.

Patients with chronic kidney disease (CKD) constitute a population at high risk for adverse drug reactions and/or drug-drug interactions. Renal dysfunction-induced pathophysiological changes may alter both medication pharmacodynamics and handling. Most pharmacokinetic parameters are adversely affected by impaired kidney function, among which reduced glomerular filtration and altered tubular secretion and reabsorption lead to the most specific alterations. Dosages of drugs cleared by the kidney should usually be adjusted according to creatinine clearance. Recommended methods for maintenance dosing adjustments are dose reductions, lengthening the dosing interval, or both. Appropriate drug selection and dosing in patients with CKD is imperative to avoid drug adverse events and to ensure optimal patient outcomes

Pharmacokinetic evaluation of atorvastatin and sitagliptin in combination for the treatment of type 2 diabetes.

peer reviewedINTRODUCTION: Patients with type 2 diabetes (T2DM) are exposed to a high risk of cardiovascular disease (CVD) requiring a global therapeutic approach. Statin therapy has proven its efficacy in reducing CVD events in T2DM patients. Dipeptidylpeptidase-4 inhibitors (gliptins), which are increasingly used to target hyperglycemia, also offer promising preliminary results regarding a possible reduction in CVD events. As most patients with T2DM may be treated with both a statin and a gliptin, dual pharmacological therapy, possibly as a fixed-dose combination (FDC), deserves further consideration. AREAS COVERED: The reader is provided with an update of information on the pharmacokinetics (PK) and pharmacodynamics (PD) of atorvastatin and sitagliptin . The article provides an analysis of the potential PK/PD interactions between the two compounds and puts into perspective the potential cardiovascular protection that such a dual therapy may offer in patients with T2DM. EXPERT OPINION: Atorvastatin and sitagliptin are not prone to PK drug-drug interactions. Their coadministration, either separately or in an FDC, improves both blood glucose levels and cholesterol concentrations, without clinically relevant adverse events. The atorvastatin plus sitagliptin combination may be used to reduce LDL cholesterol and hyperglycemia in patients with T2DM, with the aim to improve CVD prognosis and adherence to therapy

The social construction of the Norwegian Viking Age: An analysis of the national identity discourse in Norwegian Viking Age research.

The overall theme of this thesis is how everyday words and formulations can be effective components in the creation and maintenance of national identities. The thesis explores the everyday and almost invisible markers of the national, i.e. statements and formulations which function as constant reminders of a nation, and a national identity. This is done through an analysis of Norwegian archaeological texts examining the Viking Age written between the beginning of the 20th century and the present day. The aim of the thesis is to analyse if a connection between the Viking Age and a Norwegian national identity can be traced in Norwegian archaeological literature. More specifically, the thesis examines if, and in what way, Norwegian archaeological texts assign the Vikings and elements from the Viking Age a Norwegian identity. With the theoretical viewpoint of social constructivism, the thesis argues that our perceptions of identity and the nation are social constructions, and that our perceptions of reality only receive meaning through discourse. On this background, it is emphasised how knowledge is conveyed through language, and how some statements get accepted as meaningful and true in a given historical period. Hence, the thesis examines how some statements continuously get reproduced in the discourse, and in this way are regarded as truths. The aim is thus to analyse how a national identity discourse is created and maintained in archaeological texts examining the Viking Age