NOs functions complex -EHJ

http://eurheartj.oxfordjournals.org/content/early/2010/08/24/eurheartj.ehq279.full

P-glycoprotein blood barrier/PO/Drug availability/Anti-cancer

P-glycoprotein

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ATP-binding cassette, sub-family B (MDR/TAP), member 1
Crystallographic structure of the mouse MDR3 protein. The approximate positioning of the protein in the cell membrane is indicated by the blue (extracellular face) and red (cytoplasmic face) lines. The protein is depicted as a rainbow colored cartoon (N-terminus = blue, C-terminus = red). A cyclic peptide inhibitor QZ59 is represented by a space-filling model.[1]
[show]Available structures PDB 3G5U, 3G60, 3G61
Identifiers
Symbols	ABCB1; ABC20; CD243; CLCS; GP170; MDR1; MGC163296; P-gp; PGY1
External IDs	OMIM: 171050 MGI: 97570 HomoloGene: 55496 GeneCards: ABCB1 Gene
[show]Gene Ontology Molecular function • nucleotide binding • transporter activity • ATP binding • xenobiotic-transporting ATPase activity • hydrolase activity • ATPase activity Cellular component • membrane fraction • cell surface • membrane • integral to membrane Biological process • transport • response to drug Sources: Amigo / EGO
RNA expression pattern
More reference expression data
Orthologs
Species	Human	Mouse
Entrez	5243	18671
Ensembl	ENSG00000085563	ENSMUSG00000040584
UniProt	P08183	Q9QX25
RefSeq (mRNA)	NM_000927	NM_011076
RefSeq (protein)	NP_000918	NP_035206
Location (UCSC)	Chr 7: 86.97 - 87.18 Mb	Chr 5: 8.67 - 8.75 Mb
PubMed search	[1]	[2]

ABCB1 at EBI Gene Expression Atlas
ABCB1 is differentially expressed in 97 experiments [93 up/106 dn]: 26 organism parts: kidney [2 up/0 dn], bone marrow [0 up/2 dn], ...; 29 disease states: normal [10 up/3 dn], glioblastoma [0 up/2 dn], ...; 30 cell types, 22 cell lines, 11 compound treatments and 16 other conditions.
Factor Value	Factor	Up/Down
Legend: - number of studies the gene is up/down in
Normal	Disease state	10/3
None	Compound treatment	3/0
Stromal cell	Cell type	1/2
Kidney	Cell type	2/0
MDA-MB-231	Cell line	0/2
Glioblastoma	Disease state	0/2
Epithelial cell	Cell type	0/2
HeLa	Cell line	0/2
Primary	Disease staging	2/0
Bone marrow	Organism part	0/2
ABCB1 expression data in ATLAS

P-glycoprotein (permeability glycoprotein, abbreviated as P-gp or Pgp) is a well-characterized ABC-transporter of the MDR/TAP subfamily.^[2] P-gp is also called ABCB1, ATP-binding cassette sub-family B member 1, MDR1, and PGY1. P-glycoprotein has also recently been designated CD243 (cluster of differentiation 243). In humans, P-glycoprotein is encoded by the ABCB1 gene.^[3]

Pgp is extensively distributed and expressed in the intestinal epithelium, hepatocytes, renal proximal tubular cells, adrenal gland and capillary endothelial cells comprising the blood-brain and blood-testis barrier.

Contents [hide] 1 Function 2 Structure 3 Mechanism 4 Tissue distribution 5 Detecting the activity of the transporter 6 History 7 References 8 Further reading 9 See also 10 External links

[edit] Function

The membrane-associated protein encoded by this gene is a member of the superfamily of ATP-binding cassette (ABC) transporters. ABC proteins transport various molecules across extra- and intra-cellular membranes. ABC genes are divided into seven distinct subfamilies (ABC1, MDR/TAP, MRP, ALD, OABP, GCN20, White). This protein is a member of the MDR/TAP subfamily. Members of the MDR/TAP subfamily are involved in multidrug resistance. The protein encoded by this gene is an ATP-dependent drug efflux pump for xenobiotic compounds with broad substrate specificity. It is responsible for decreased drug accumulation in multidrug-resistant cells and often mediates the development of resistance to anticancer drugs. This protein also functions as a transporter in the blood-brain barrier.^[4]

ABCB1 is an ATP-dependent efflux pump with broad substrate specificity. It likely evolved as a defense mechanism against harmful substances.

ABCB1 transports various substrates across the cell membrane including:

• Drugs such as colchicine, tacrolimus and quinidine
• Chemotherapeutic agents such as etoposide, doxorubicin, and vinblastine
• Lipids
• Steroids
• Xenobiotics
• Peptides
• Bilirubin
• Cardiac glycosides like digoxin
• Immunosuppressive agents
• Glucocorticoids like dexamethasone
• HIV-type 1 antiretroviral therapy agents like protease inhibitors and nonnucleoside reverse transcriptase inhibitors.

Its ability to transport the above substrates accounts for the many roles of ABCB1 including:

• Regulating the distribution and bioavailability of drugs
  • Increased intestinal expression of P-glycoprotein can reduce the absorption of drugs that are substrates for P-glycoprotein. Thus, there is a reduced bioavailability, and therapeutic plasma concentrations are not attained. On the other hand, supratherapeutic plasma concentrations and drug toxicity may result because of decreased P-glycoprotein expression
  • Active cellular transport of antineoplastics resulting in multidrug resistance to these drugs
• The removal of toxic metabolites and xenobiotics from cells into urine, bile, and the intestinal lumen
• The transport of compounds out of the brain across the blood-brain barrier
• Digoxin uptake
• Prevention of ivermectin entry into the central nervous system
• The migration of dendritic cells
• Protection of hematopoietic stem cells from toxins.^[2]

[edit] Structure

Pgp is a 170 kDa transmembrane glycoprotein, which includes 10-15 kDa of N-terminal glycosylation. The N-term half of the molecule contains 6 transmembrane domains, followed by a large cytoplasmic domain with an ATP-binding site, and then a second section with 6 transmembrane domains and an ATP-binding site that shows over 65% of amino acid similarity with the first half of the polypeptide.^[5] In 2009, the first structure of a mammalian P-glycoprotein was solved (3G5U).^[6] The structure was derived from the mouse MDR3 gene product heterologously expressed in Pichia pastoris yeast. The structure of mouse P-gp is similar to structures of the bacterial ABC transporter MsbA (3B5W and 3B5X) ^[7] that adopt an inward facing conformation that is believed to be important for binding substrate along the inner leaflet of the membrane. Additional structures (3G60 and 3G61) of P-gp were also solved revealing the binding site(s) of two different cyclic peptide substrate/inhibitors. The promiscuous binding pocket of P-gp is lined with aromatic amino acid side chains.

[edit] Mechanism

Binding of a substrate and ATP molecule occur simulatenously. Following binding of each, ATP hydrolysis shifts the substrate into a position to be excreted from the cell. Release of the phosphate (from the original ATP molecule) occurs concurrently with substrate excretion. ADP is released, and a new molecule of ATP binds to the secondary ATP-binding site. Hydrolysis and release of ADP and a phosphate molecule resets the protein.

[edit] Tissue distribution

P-glycoprotein is expressed primarily in certain cell types in the liver, pancreas, kidney, colon, and jejunum.^[8]

[edit] Detecting the activity of the transporter

The activity of the transporter can be determined by both membrane ATPase and cellular calcein assays.

The ABCB1 Transporter is also used to differentiate Transitional B-cells from Naive B-cells. Dyes such as Rhodamine123 and MitoTracker Dyes from Invitrogen can be used to make this differentiation. ^[9]

[edit] History

ABCB1 was first cloned and characterized using its ability to confer a multidrug resistance phenotype to cancer cells that had developed resistance to chemotherapy drugs.^[2][10]

In 2001 a procedure for the synthesis of radioactive verapamil was described. This compound can be used for measuring P-glycoprotein function with positron emission tomography.^[11]

Ascending sensory pathway

Lateral medullary syndrome

Vestibulocochlear Nerve

Note: The passway of VII with VIII will are affected by otitis media in disfunction (Palsy). However, VII lesion will never cause vertigo.

Facial nerve

1. Functional distribution of VII nerve
http://www.google.com.hk/imgres?imgurl=http://www3.mdanderson.org/depts/rpi/mmlearn/pmimages/facial_nerve.gif&imgrefurl=http://www3.mdanderson.org/depts/rpi/mmlearn/pmpages/pmschem.html&usg=__Q3jmMYysUGQ2ApyG7EV8XpUcm2Y=&h=430&w=432&sz=56&hl=zh-TW&start=15&tbnid=rKnXGRrLsK3Q1M:&tbnh=131&tbnw=133&prev=/images%3Fq%3Dfacial%2Bnerve%26um%3D1%26hl%3Dzh-TW%26sa%3DN%26biw%3D1004%26bih%3D581%26tbs%3Disch:10%2C348&um=1&itbs=1&iact=hc&vpx=404&vpy=209&dur=10796&hovh=224&hovw=225&tx=134&ty=114&ei=aPlpTNP4HIPZcf-46Y4N&oei=EPlpTJC1IYmWcdqs_I8F&esq=2&page=2&ndsp=15&ved=1t:429,r:2,s:15&biw=1004&bih=581

2. Passway of VII nerve
http://www.google.com.hk/imgres?imgurl=http://www.ncbi.nlm.nih.gov/bookshelf/picrender.fcgi%3Fbook%3Dcm%26part%3DA1914%26blobname%3Dch62f1.jpg&imgrefurl=http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi%3Fbook%3Dcm%26part%3DA1914&usg=__JKMZZ9O0iA710rjnbWqKnSHWW6c=&h=377&w=707&sz=169&hl=zh-TW&start=0&tbnid=AZJUlZ8IjntFdM:&tbnh=105&tbnw=196&prev=/images%3Fq%3Dfacial%2Bnerve%26um%3D1%26hl%3Dzh-TW%26sa%3DN%26biw%3D1004%26bih%3D581%26tbs%3Disch:10%2C31&um=1&itbs=1&iact=rc&dur=360&ei=o_ppTOGAB8-5cYbI4Y8F&oei=T_ppTOSbH8e9cbO-hZAF&esq=3&page=1&ndsp=15&ved=1t:429,r:5,s:0&tx=102&ty=51&biw=1004&bih=581

Induction of P450 - useful for clinical evaluation

http://www.aafp.org/afp/980101ap/cupp.html

Focus: Acute pancreatitis

Important:
1. Ranson scores
http://www.mdcalc.com/ransons-criteria-for-pancreatitis-mortality
2. Apache II
http://www.mdcalc.com/apache-ii-score-for-icu-mortality

Arterial Supply of Mesentery

Great interpretation of mesenteric arterial supply
http://www.google.com.hk/imgres?imgurl=http://www.healthsystem.virginia.edu/internet/vascular/images/il_mad_mesenteric_arteries.gif&imgrefurl=http://www.healthsystem.virginia.edu/internet/vascular/docs/facts/mad.html&usg=__8FguBIppx6kFvBtRR7MDdOQ4DIA=&h=451&w=500&sz=81&hl=zh-TW&start=1&um=1&itbs=1&tbnid=bam8IskmshyrsM:&tbnh=117&tbnw=130&prev=/images%3Fq%3Dmesenteric%2Barteries%26um%3D1%26hl%3Dzh-TW%26tbs%3Disch:1

Warfarin LMWH Vitmine K

These are wonderful sites, Daytonite! Thank you so much for sharing.

PT/PTT are laboratory tests that measure the clotting time (how long it takes blood to clot.)

PT/PTT are blood tests and INR is a ratio calculated from the PT.

At least a dozen blood proteins, or blood clotting factors, are needed to clot blood and stop bleeding (coagulation).

Prothrombin, or factor II, is one of several clotting factors produced by the liver. Prothrombin time (PT) measures the presence and activity of five different blood clotting factors (factors I, II, V, VII, and X). This test measures the integrity of the extrinsic and common pathways of coagulation. The prothrombin time (PT) measures the clotting time from the activation of factor VII through the formation of the fibrin clot. Adequate amounts of vitamin K are needed to produce prothrombin. Warfarin (Coumadin) is sometimes prescribed as a "blood thinner" because it is an effective vitamin K antagonist (blocks the formation of vitamin K).

The activated partial thromboplastin time (PTT) measures the function of several other clotting factors, found in the intrinsic and common blood clotting pathways. It measures the clotting time from the activation of factor XII through the formation of the fibrin clot. PTT prolongations are caused by factor deficiencies (factors VIII, IX, XI, and/or XII), or inhibitors (most commonly, heparin). Heparin prevents clotting by blocking certain factors in the intrinsic pathway.

PTT and activated partial thromboplastin time (aPTT) are basically the same thing. The aPTT has largely replaced the older PTT, which was unable to incorporate variables in surface/contact time: http://www.rnceus.com/coag/coagptt.html

PT is used to monitor treatment with warfarin (Coumadin). Once warfarin is discontinued, it usually takes several days to clear it from the system. The PTT test allows the provider to check that there is enough heparin in the blood to prevent clotting, but not so much as to cause bleeding. Once heparin is discontinued, its blood-thinning effects usually only last a few hours.

The greater the PT/PTT values, the longer it takes the blood to clot. HIGH PT/PTT = risk for BLEEDING. LOW PT/PTT = risk for blood clots/ stroke.

The INR stands for International Normalized Ratio. The INR is calculated from the PT and is intended to allow valid comparisons of results regardless of the type of PT reagent used among different laboratories (INR = [patient PT / mean normal PT]). The INR is a method of standardizing the PT for coumadin anticoagulation. Before the INR, different labs using different reagents had different controls and widely differing PT value ranges.

An INR of 1 means the blood clots "normally" for that pt. The greater the INR, the longer it takes the blood to clot.

The warfarin (Coumadin) dosage for people being treated to prevent the formation of blood clots is usually adjusted so that the prothrombin time is about 1.5 to 2.5 times the normal value (or INR values 2 to 3). A patient may take warfarin to anticoagulate for atrial fibrillation (target INR around 2.5) or for a mechanical heart valve (target INR 3). An INR of 3 means the blood takes about three times as long to clot compared with the normal value for that pt.

Which value, PT or PTT, does heparin influence?

Which one does coumadin?

Stumped?
You can find the right answer by counting to 10:

- - - - - - - - - - = 10

H E P A R I N (7 letters) + 3 (PTT) = 10

C O U M A D I N (8 letters) + 2 (PT) = 10

Here's another one:

What is the antidote for heparin overdose?

Protamine sulfate (just remember P M S)

What is the antidote for too much Coumadin?

Vitamin K (just remember the hard "C" at the beginning of coumadin!)

LMWH Warfarin mechanism

Protain C & S in anticoagulation

http://intmedweb.wfubmc.edu/grand_rounds/2003/coumadindoc_files/image006.jpg
http://intmedweb.wfubmc.edu/grand_rounds/2003/coumadindoc_files/image006.jpg

Hairy cell in Hairy Cell leukemia

http://www.google.com.hk/imgres?imgurl=http://www.wadsworth.org/chemheme/heme/microscope/pix/hairycell_nw.jpg&imgrefurl=http://www.wadsworth.org/chemheme/heme/microscope/hairycell.htm&usg=__THduWBonuaZk2DcWgqiwNrlRRiU=&h=311&w=400&sz=14&hl=zh-TW&start=2&um=1&itbs=1&tbnid=oLfGJbUpRs2UdM:&tbnh=96&tbnw=124&prev=/images%3Fq%3Dhairy%2Bcell%26um%3D1%26hl%3Dzh-TW%26sa%3DN%26tbs%3Disch:1

hexose monophosphate shunt

http://www.google.com.hk/imgres?imgurl=http://www.pnas.org/content/103/7/2226/F1.large.jpg&imgrefurl=http://www.pnas.org/content/103/7/2226/F1.expansion.html&h=1280&w=1131&sz=143&tbnid=jumFG5TQ7Phy2M:&tbnh=150&tbnw=133&prev=/images%3Fq%3Dhexose%2Bmonophosphate%2Bshunt&hl=zh-TW&usg=__hk_Mi_08dJi_Ch5M5mp2hxsr4sk=&sa=X&ei=nkAcTICBKo7CccPgtIwN&ved=0CDUQ9QEwBQ

Fig. 1.
Schematic representations of the oxidative part of the hexose–monophosphate shunt and relevant sources of oxidative load (A) and the simplified reaction network that captures the essential features of these pathways (B) (see Supporting Text section 1 for details) and that is used in our analysis. Cat, catalase; G6P, glucose 6-phosphate; GL6P, gluconolactone 6-phosphate; Glc, glucose; GO6P, gluconate 6-phosphate; G6PD, glucose-6-phosphate dehydrogenase; GO6PD, gluconate-6-phosphate dehydrogenase; GRX, glutaredoxin; GSH, reduced glutathione; GSSG, oxidized glutathione; GPx, glutathione peroxidase; GSR, glutathione reductase; HbSH, hemoglobin; HbSSG, glutathionyl-hemoglobin; HK, hexokinase; SOD, superoxide dismutase.

CCK regulation of digestion

CCK mediates a number of physiological processes, including digestion and satiety. It is located in the small intestine, and detects the presence of fat in the chyme. CCK then tells the stomach to slow down the speed of digestion so the small intestine can effectively digest the fats

Hypercalcemia clinical sign mnemonics

Clinical sign: Easy to remember.

There is a general mnemonic for remembering the effects of hypercalcemia: "groans (constipation), moans (psychotic noise), bones (bone pain, especially if PTH is elevated), stones (kidney stones), and psychiatric overtones (including depression and confusion)."

ATP formation in mitochondia

http://highered.mcgraw-hill.com/sites/0072507470/student_view0/chapter25/animation__electron_transport_system_and_atp_synthesis__quiz_1_.html

J receptor

Significance in pulmonary regulation. See Wiki,
Juxtacapillary (J) receptors
From Wikipedia, the free encyclopedia
Jump to: navigation, search
This article is an orphan, as few or no other articles link to it. Please introduce links to this page from related articles; suggestions are available. (February 2009)

J-receptors (juxtacapillary) are nerves innervating into the body of the lung. They are present in the alveolar interstitium and are innervated by fibers of the vagus nerve.[1] J-receptors respond to events such as pulmonary edema, pulmonary emboli, pneumonia, and barotrauma, which cause a decrease in oxygenation and thus lead to an increase in ventilation/respiration. They may be also stimulated by hyperinflation of the lung as well as intravenous or intracardiac administration of chemicals.[citation needed]

The stimulation of the J-receptors causes a reflex increase in breathing rate, and is also thought to be involved in the sensation of dyspnea, the subjective sensation of difficulty breathing.[2][3] The reflex response that is produced is apnea followed by rapid breathing, bradycardia, and hypotension (pulmonary chemoreflex). The physiologic role of this reflex is uncertain, but it probably occurs in pathologic states such as pulmonary congestion or embolization.[4

Theophylline interaction with other drugs, really alot!

An Overview of Theophylline Drug Interactions
Theophylline can potentially interact with many other medicines. Some of these medicines that may lead to theophylline interactions include:

•Alcohol
•Allopurinol (Aloprim®, Zyloprim®)
•Certain antibiotics, including:


◦Ciprofloxacin (Cipro®)
◦Clarithromycin (Biaxin®, Biaxin XL®)
◦Erythromycin (Ery-Tab®)


•Certain benzodiazepines, including:


◦Diazepam (Valium®)
◦Flurazepam (Dalmane®)
◦Lorazepam (Ativan®)
◦Midazolam (Versed®)


•Certain seizure medications, including:


◦Carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®, Tegretol XR®)
◦Phenobarbital (Luminal®)
◦Phenytoin (Dilantin®, Phenytek®)


•Cimetidine (Tagamet®)
•Disulfiram (Antabuse®)
•Estrogen-containing medications, including hormone replacement therapy (HRT) or oral contraceptives (birth control pills)
•Fluvoxamine (Luvox®)
•Interferon alpha-2a (Roferon A®) or peginterferon alpha-2a (Pegasys®)
•Lithium (Eskalith®, Lithobid®)
•Methotrexate (Rheumatrex®)
•Mexiletine (Mexitil®)
•Moricizine (Ethmozine®)
•Pentoxifylline (Trental®)
•Propafenone (Rhythmol®)
•Propranolol (Inderal®, Inderal LA®, InnoPran XL®)
•Rifampin (Rifadin®)
•St. John's wort
•Tacrine (Cognex®)
•Ticlopidine (Ticlid®)
•Tobacco products
•Verapamil (Calan®, Verelan®).
Theophylline Interactions Explained
The following sections explain in detail the potentially negative interactions that can occur when theophylline is combined with any of the drugs listed above.

Alcohol
Drinking alcohol can increase the level of theophylline in your blood, which can cause dangerous side effects. It is best to avoid alcohol while taking theophylline.

Allopurinol (Aloprim, Zyloprim)
Taking theophylline with allopurinol can increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary.

Certain Antibiotics
Taking theophylline with certain antibiotics can increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary.

Certain Benzodiazepines
You may require higher doses of certain benzodiazepines while taking theophylline. If you stop taking theophylline, your previous dose of a benzodiazepine may be too high, causing excessive drowsiness or breathing problems.

Certain Seizure Medications
Taking theophylline with certain seizure medications can decrease the level of theophylline in your blood, perhaps making it less effective. In some cases, theophylline can affect the level of seizure medication in your blood. If you are taking these drugs together, your healthcare provider may need to adjust your dosages of theophylline or seizure medication.

Cimetidine (Tagamet)
Taking theophylline with cimetidine can greatly increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary. Do not take cimetidine (even over-the-counter cimetidine) with theophylline without first talking with your healthcare provider.

Disulfiram (Antabuse)
Taking theophylline with disulfiram can increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary.

Estrogen
Taking theophylline with estrogen-containing products can increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary.

Fluvoxamine (Luvox)
Taking theophylline with fluvoxamine can greatly increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary. Do not take fluvoxamine with theophylline without first talking with your healthcare provider.

Interferon Alpha-2a (Roferon A) or Peginterferon Alpha-2a (Pegasys)
Taking theophylline with certain interferon medications can greatly increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary. Do not take an interferon medication with theophylline without first talking with your healthcare provider.
Lithium (Eskalith, Lithobid)
Theophylline can decrease the level of lithium in your blood, perhaps decreasing its effectiveness. If you are taking these drugs together, your healthcare provider may need to monitor the level of lithium in your blood and adjust your lithium dosage as necessary.

Methotrexate (Rheumatrex)
Taking theophylline with methotrexate can increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary.

Mexiletine (Mexitil)
Taking theophylline with mexiletine can greatly increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary. Do not take mexiletine with theophylline without first talking with your healthcare provider.

Moricizine (Ethmozine)
Taking theophylline with moricizine can decrease the level of theophylline in your blood, perhaps making it less effective. If you are taking these drugs together, your healthcare provider may need to adjust your theophylline dosage.

Pentoxifylline (Trental)
Taking theophylline with pentoxifylline can increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary.

Propafenone (Rhythmol)
Taking theophylline with propafenone can increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary.
Propranolol (Inderal, Inderal LA, InnoPran XL)
Taking theophylline with propranolol can greatly increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary. Do not take propranolol with theophylline without first talking with your healthcare provider.

Rifampin (Rifadin)
Taking theophylline with rifampin can decrease the level of theophylline in your blood, perhaps making it less effective. If you are taking these drugs together, your healthcare provider may need to adjust your theophylline dosage.

St. John's Wort
Taking theophylline with St. John's wort can decrease the level of theophylline in your blood, perhaps making it less effective. If you are taking these drugs together, your healthcare provider may need to adjust your theophylline dosage. During treatment with theophylline, do not start or stop taking St. John's wort without first talking with your healthcare provider.

Tacrine (Cognex)
Taking theophylline with tacrine can greatly increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary. Do not take tacrine with theophylline without first talking with your healthcare provider.

Ticlopidine (Ticlid)
Taking theophylline with ticlopidine can increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary.
Tobacco
Tobacco can decrease the level of theophylline in your blood. If you stop using tobacco (even if you use nicotine replacement products), you may develop dangerously high levels of theophylline in your blood. Contact your healthcare provider if you plan to start or stop using tobacco products.

Verapamil (Calan, Verelan)
Taking theophylline with verapamil can increase the level of theophylline in your blood, which can cause dangerous side effects. If you are taking these drugs together, your healthcare provider should monitor the level of theophylline in your blood and adjust your theophylline dosage as necessary.

Final Thoughts on Theophylline Drug Interactions
Not every drug interaction with theophylline was discussed in this article. Therefore, you should talk with your pharmacist or healthcare provider about theophylline drug interactions that may apply to you. Because so many medications interact dangerously with theophylline, do not start or stop taking any medication (including over-the-counter medications or herbals) without first talking with your healthcare provider.

igoogle, a combo

Making igoogle a great combo. Why not? With more gadget included

COPD review

COPD review started yesterday.

Respiratory tract is compared with vascular system, with the functional containings, air and blood. Any change in the characters,
1. the ingredients of containings
2. the states of containings
3. the efficiencies of tract

will
1. definitely affect the function of the system.
2. be the target for clinical intervene
3. be reviewed for the adequate therapy and prognosis

As a start

Seems not a bad day to start here. 4 months, I have been considering to organizing these tools for the knowledge building, and now it is the time.

The tools will include
1. a blog platform, easy to upgrade knowledge in each form
2. Good connection with Google, in utilizing its doc functions.
3. Easy linkage to the web, wiki preferable
4. Easy to review established knowledge

That is all. Good luck, man.