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Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Drug Elimination: Non-Renal Routes01:23

Drug Elimination: Non-Renal Routes

The liver plays a pivotal role in eliminating drugs and their metabolites, primarily through a process known as biliary excretion. This process involves the hepatocytes, the primary cells in the liver that generate bile. A range of transporters actively expels polar drugs or hydrophilic drug metabolites into the bile, which transports the drugs and metabolites into the small intestine. From here, they are eventually expelled from the body through feces. In some instances, the original drug or a...
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Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
Drug Elimination: Overview01:18

Drug Elimination: Overview

Drug elimination involves many complex processes and does not necessarily differentiate between distribution and elimination. It is divided into two primary components: excretion and biotransformation.
Excretion refers to removing a drug from the body, either in its unchanged form or as its metabolites. Nonvolatile and polar drugs are primarily excreted through the kidneys, with other pathways including bile, sweat, saliva, and milk. Volatile drugs such as anesthetic gases are excreted via the...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
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Drug Elimination: The Concept of Clearance

Drug elimination refers to removing drugs from the body, either through urine by the kidneys or through bile by the liver. Drug clearance is a pharmacokinetic parameter that measures the efficiency of drug removal from the bloodstream within a specific time frame. It is calculated as the rate at which a drug is eliminated from plasma divided by the plasma concentration of the drug.
Drug clearance is not limited to renal excretion but encompasses all organs involved in drug elimination,...

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Related Experiment Videos

Corticosteroid elimination: the Cincinnati experience.

E Steve Woodle1, Rita Alloway, Adele Rike

  • 1University of Cincinnati, the Christ Hospital, Cincinnati, Ohio, USA.

Clinical Transplants
|July 22, 2008
PubMed
Summary
This summary is machine-generated.

Researchers have successfully reduced corticosteroid-related morbidity in kidney transplant patients by developing corticosteroid-free immunosuppression strategies. This approach allows for tailored treatment plans based on individual patient risk assessments.

Related Experiment Videos

Area of Science:

  • Nephrology
  • Immunology
  • Transplantation Medicine

Background:

  • Corticosteroid-related morbidity is a significant concern in long-term renal transplant recipients.
  • Reducing or eliminating corticosteroid use has been a long-standing clinical objective.

Purpose of the Study:

  • To describe a 15-year effort to eliminate corticosteroid therapy from maintenance immunosuppression in kidney transplant patients.
  • To assess the impact of corticosteroid-free immunosuppression on patient outcomes and morbidity.

Main Methods:

  • Conducted five multicenter trials and over ten single-center trials.
  • Involved more than 650 kidney transplant patients at the University of Cincinnati.
  • Focused on developing and evaluating corticosteroid-free immunosuppression regimens.

Main Results:

  • Achieved near-complete elimination of corticosteroid-related morbidity.
  • Provided a precise risk/benefit assessment for corticosteroid withdrawal in various patient populations.
  • Enabled individualized and tailored corticosteroid-free immunosuppression strategies.

Conclusions:

  • Eliminating corticosteroids from maintenance immunosuppression is feasible and significantly reduces patient morbidity.
  • Individualized assessment of risk and benefit is crucial for tailoring successful corticosteroid-free immunosuppression.
  • This approach represents a significant advancement in optimizing long-term outcomes for kidney transplant recipients.