Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:3.1.1.7 (acetylcholinesterase)
28,390 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present 3 patients with chronic renal failure who had postoperative paralysis due to the administration muscle relaxants. One of them received gallamine, a non-depolarizing blocking agent that is mainly excreted by the kidney (70--90%). Two of them received pancuronium bromide, also a non-depolarizing blocking agent which is partially excreted by the kidneys (37--44%). All of them received succinylcholine. Succinylcholine is hydrolyzed by the serum cholinesterase into succinylmonocholine and choline. These active metabolites are excreted by the kidney. These patients serve as examples of the importance of considering the route of excretion of drugs and their metabolites in clinical situations involving the renal failure patient. The pharmacology of drugs administered relative to surgical procedures is reviewed.
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PMID:Anesthesia related muscle paralysis in renal failure. 35 7

The practice of dietetic therapy is unusual today for patients suffering from renal failure without hypertension and reduction of glomerular filtration rate. Specific treatment is needed, however, for arterial hypertension, uremia, calculus and uralith disease. Experiments in rats showed, that a lot of uremic symptoms following poorly functioning kidneys are partly at least caused by disturbances in amino acid metabolism. Uremia patients with dysfunctioning plasma protein metabolism (transferrin, complement, cholinesterase, prealbumin and retinolbinding protein) need oral, respectively parenteral substitution of essential amino acids. This substitution is very important under catabolic stress conditions in uremic syndrome with and without vividialysis treatment.
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PMID:[Nutrition problems in kidney diseases]. 96 82

We have determined the pharmacokinetics and duration of action of a bolus dose of mivacurium (0.15 mg kg-1) during isoflurane and nitrous oxide anaesthesia in nine patients with normal renal and liver function, nine patients undergoing cadaveric kidney transplantation and nine patients undergoing cadaveric liver transplantation. Total plasma concentrations of mivacurium were measured for 2.5 h after administration using a high-pressure liquid chromatographic assay. Plasma concentration vs time data for what were presumed to be the two active mivacurium isomers were analysed by a non-compartmental method based on statistical moments. Neuromuscular block was assessed by measuring the electromyographic evoked response of the adductor pollicis muscle to train-of-four stimulation of the ulnar nerve. The mean time to recovery of 25% neuromuscular transmission, T25, was greater in the patients with liver failure (57.2 min) than in control patients (18.7 min). The volume of distribution at steady rate (Vdss) was comparable in the three groups. Patients with impaired liver function had significantly longer mean residence time and smaller plasma clearance than did patients with renal failure or control patients. There were significant negative correlations between plasma cholinesterase activity and both T25 (r = 0.79) and mean residence time (r = 0.62).
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PMID:Pharmacokinetics of mivacurium in normal patients and in those with hepatic or renal failure. 812 24

We treated a patient with idiopathic fatty liver of pregnancy and a subsequent uncomplicated pregnancy. She experienced general fatigue, nausea, vomiting and jaundice, and renal failure occurred in the third trimester of her first pregnancy. Liver biopsy revealed swollen hepatocytes with microvesicular changes in the cytoplasm. A diagnosis of idiopathic fatty liver of pregnancy was made. Following delivery of a dead fetus, she recovered completely and was discharged on the 30th hospital day. Eighteen months later, she became pregnant again and was delivered of a healthy male baby in the 39th week of gestation. Total bilirubin and transaminase levels were normal, and renal function tests revealed no significant changes during the course of the pregnancy. However, cholinesterase activity increased progressively from the 7th month, thereby suggesting a predisposition to idiopathic fatty liver of pregnancy.
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PMID:Idiopathic fatty liver of pregnancy with a subsequent uncomplicated pregnancy and a progressive increase in serum cholinesterase activity during the third trimester. A case report. 395 27

We report a case of suicide due to organophosphate poisoning in an 80-year-old woman who ingested malathion mixed with a fruit drink. She presented with signs and symptoms of cholinergic crisis and initially improved with therapy. Her plasma cholinesterase (ChE) level remained low, her course progressively deteriorated with respiratory and renal failure, and she died 12 days after hospital admission. The antemortem blood malathion level of 23.9 mg/L is the highest reported in the literature, as determined by modern methods. Postmortem toxicologic analysis revealed still greatly reduced ChE activity.
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PMID:A case of fatal ingestion of malathion. 849 70

The present study was designed as a hospital-based, group-matched, case-control investigation into the risk factors associated with age-related cataract in central India. The study included 262 cases of age-related cataract and an equal number of controls. A total of 21 risk factors were evaluated: namely, low socioeconomic status (SES), illiteracy, marital status, history of diarrhoea, history of diabetes, glaucoma, use of cholinesterase inhibitors, steroids, spironolactone, nifedipine, analgesics, myopia early in life, renal failure, heavy smoking, heavy alcohol consumption, hypertension, low body mass index (BMI), use of cheaper cooking fuel, working in direct sunlight, family history of cataract, and occupational exposure. In univariate analysis, except marital status, low BMI, renal failure, use of steroids, spironolactone, analgesics, and occupational exposure, all 14 other risk factors were found significantly associated with age-related cataract. Unconditional multiple logistic regression analysis confirmed the significance of low SES, illiteracy, history of diarrhoea, diabetes, glaucoma, myopia, smoking, hypertension and cheap cooking fuel. The etiological role of these risk factors in the outcome of cataract is confirmed by the estimates of attributable risk proportion. The estimates of population attributable risk proportion for these factors highlight the impact of elimination of these risk factors on the reduction of cataract in this population.
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PMID:Risk factors for cataract: a case control study. 1021 5

Many drugs interact with neuromuscular blocking drugs and often enhance the induced block; this is of clinical importance for volatile anaesthetics, antimicrobials, magnesium and some more specific drugs. Difficulty in reversing the block occurs with calcium-channel blockers and polymyxin. Phenytoin, carbamazepine and other anticonvulsants may cause resistance to neuromuscular blocking drugs. Moreover, clinically important interactions are found between individual neuromuscular blockers. Giving succinylcholine after a non-depolarizing neuromuscular blocking drug prolongs the onset of succinylcholine; when non-depolarizing drugs are administered after succinylcholine their effects are prolonged. The succinylcholine block is prolonged when the drug is administered during recovery from pancuronium or following neostigmine reversal. Drugs or diseases that decrease the activity of plasma cholinesterase may prolong a succinylcholine-induced block. Finally, liver dysfunction, renal failure, disturbances of acid-base balance, change in temperature and neurological diseases all have an effect on the profile of the neuromuscular blocking drugs; the response to an induced block may be altered in patients under intensive care and those with cancer. Although knowledge of the most important theoretical interactions of neuromuscular blocking drugs is favourable, the anaesthetist should be aware that pharmacological interactions can lead to an unpredictable induced neuromuscular block in many cases in daily clinical practice. Therefore anaesthetists should become familiar with the use of neuromuscular transmission monitoring in order to manage the block correctly.
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PMID:Interactions of neuromuscular blocking drugs. 1179 68

Patients receiving the following drugs should be closely monitored during heatwaves: psychotropics, atropinics, amphetamine-like drugs, parasympathomimetic agents such as cholinesterase inhibitors, thyroid hormones, drugs that increase the risk of renal failure in case of dehydration, and betablockers.
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PMID:Adverse drug reactions during heatwaves. 1732 79

The Molecular Adsorbent Recirculating System (MARS) clears the blood from catabolites that either occur free in the plasma water (through dialysis), such as uremic toxins and ammonia, or are bound by albumin, such as hepatic toxins. The latter are transferred from the albumin in the blood to the albumin circulating in a closed loop where toxins are removed by adsorption on resins (charcoal and ion-exchange resin). The efficacy of this extracorporeal blood purification method in the treatment of acute or acute-on-chronic liver failure (also associated with renal failure) has been demonstrated in numerous studies. Fifty-one patients, 5 affected by acute liver failure and 46 by acute-onchronic liver failure (8 of them with additional renal failure) were treated with MARS. The results demonstrated that the method, which effectively removes ammonia, bilirubin, bile acids and uremic toxins, reduces the blood concentration of these molecules. It thereby improves the patient's clinical condition and biochemical parameters including cholinesterase, alkaline phosphatase and prothrombin activity, eliminating, in addition, the drug-refractory pruritus that is a very frequent symptom in cholestatic liver disease. These results agree with those reported in the literature concerning the efficacy of MARS in the replacement of the detoxifying function of kidneys and liver.
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PMID:[Development of extracorporeal blood purification methods: Molecular Adsorbent Recirculating System (MARS) for hepatic and renal function replacement]. 1792 57

The present study investigated the effect of the administration of N-acetylcysteine (NAC), on memory, on acetylcholinesterase (AChE) activity and on lipid peroxidation in different brain structures in cadmium (Cd)-exposed rats. The rats received Cd (2 mg/kg) and NAC (150 mg/kg) by gavage every other day for 30 days. The animals were divided into four groups (n=12-13): control/saline, NAC, Cd, and Cd/NAC. The results showed a decrease in step-down latency in the Cd-group, but NAC reversed the impairment of memory induced by Cd intoxication. Rats exposed to Cd and/or treated with NAC did not demonstrate altered shock sensitivity. Decreased AChE activity was found in hippocampus, cerebellum and hypothalamus in the Cd-group but NAC reversed this effect totally or partially while in cortex synaptosomes and striatum there was no alteration in AChE activity. An increase in TBARS levels was found in hippocampus, cerebellum and hypothalamus in the Cd-group and NAC abolished this effect while in striatum there was no alteration in TBARS levels. Urea and creatinine levels were increased in serum of Cd-intoxicated rats, but NAC was able to abolish these undesirable effects. The present findings show that treatment with NAC prevented the Cd-mediated decrease in AChE activity, as well as oxidative stress and consequent memory impairment in Cd-exposed rats, demonstrating that this compound may modulate cholinergic neurotransmission and consequently improve cognition. However, it is necessary to note that the mild renal failure may be a contributor to the behavioral impairment found in this investigation.
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PMID:N-acetylcysteine prevents memory deficits, the decrease in acetylcholinesterase activity and oxidative stress in rats exposed to cadmium. 2039 62


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