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Liver Injury Caused by Endothelin Receptor Antagonists, Article Review Example

Pages: 8

Words: 2115

Article Review

Multiple Compound-Related Adverse Properties Contribute To Liver Injury Caused by Endothelin Receptor Antagonists By Gerry Kenna (et al)

Background

The problem with the emergent utilization of medical proceedings in treating specifically critical health situations is that of the fact that most of these medications invoke the development of particularly critical medical situation that specifically come from the side effects of the medicines and other treatments applied for the patient to undergo. In this case, the study of Gerry Kenna (2015) and his colleagues give attention to the drug-induced liver injuries that patients undergoing endothelin receptor antagonist medication often develop. How this matter develops and how it could be controlled or at least managed in order to reduce the occurrence of such medical issues later on is give specific attention in the study undergone. Through an experimental approach, mixing up the different components of endothelin receptor antagonist medications and observing which of these components fully affect the overall development of medical deconstruction of the liver and how the medical approaches applied for these operations cause more problems later on as it resolved another at present.

The primary objective of this study [based on the background of the research] is basically understood to have a strong relevance on the current healthcare issues that the society needs to deal with. Relatively, it is dedicated towards providing a huge number of individuals in the population to be eased out from their health concerns especially through the use of proper medical operations and medical substances that could set the balance in the body’s functional value. These medical applications are expected to support the supposed imbalance in the body allowing the patients to function in a more balanced manner. Nevertheless, since cases like this one need to induce a definite insistence on how maintenance medication needs to be managed, the danger of having the liver [and probably other parts of the body such as the kidney] to suffer the effect of such medications. Relatively, through major observational studies, it has been found that the more defined the medication approaches are [or at least the stronger the medicines are] the more damage they make on the different parts of the body.

Noticeably, it could be understood that when it comes to studying matters such as this one [which affects a huge number of individuals in the society], the impact of the research is also huge in nature especially that it entails to protect the value for life that the healthcare institutions are specifically aiming to provide. Basing on the background of the research then, it is rather important to note that the study aims to affect a large scope of members of the society hence giving them the assistance and protection they need from the institutions having such authority and expertise to provide them the proper guidance that they need especially when it comes to improving their personal [as well as that of the social] health cases.

Hypothesis and Predictions

There were two primary medicines that were compared in this study; bosentan and ambrisentan. These two endothelin receptor antagonists are noted to be the most common medications used for hypertension medication and management. In the beginning of the study, the researchers aimed to impose that one of these two medications would be more suitable for use for a particular group of patients, while the other might have other specific impact on other groups of patients. To make the comparison more indicative on how hypertension is treated at present [among patients], the insertion of sitaxentan was also imposed in order to set balance on the comparison of the drug selections available for observation. It is then further assumed as part of the hypothesis for this study that the compounded structures of substances in the medicines [being observed] would fully affect the overall structure as to how the said substance would affect the internal structure of the body’s response to the treatment [which involves the emergence of possible treatment issues regarding the capacity of the liver and kidney to support the body’s needs for cleansing] (282). This process is expected to be affected by the change in compounded structure that would best determine the condition of the medicine as it is supposed to make a definite turn on how the ailment is to be targeted with a much lessened impact on the functionality of either the liver or the kidney.

Common substances making up these medicines were separated and set aside while particular differential points among these medications were set for observation and experimentation. The approach to providing the hypothesis of the study is more quantitative in nature. This approach was considered effective and proper enough to give definite directive on how the study is to be handled accordingly. This also provided a better foundation in determining the application of the study’s point of methodology towards the more actual process of providing medical assistance to the target population as desired.

Methodology

As noted in the previous section, the methodology embraced by the researchers for this study is that of the adaptation on experimentation. Utilizing the different substances serving as the point of separation among the medications in focus, the researchers tried to test how the mitochondrial reaction to the process of systems management would actually create a more definite impact on how the patient recovers and how much the said medications would directly impact that liver and kidney function of the systems among the patients being treated off from experiencing the effects and symptoms of hypertension.

To note, there were five primary elements of procedural evaluation taken into account by the researchers to complete this study which include (a) Synthesis of Radiolabeled ERAs; (b) Evaluation of Toxicity to THLE cell lines; (c) Covalent binding studies in human hepatocytes; (d) BSEP and multidrug resistance associated protein 2 transporter activity; (d) evaluation of mitochondrial respiratory function (282-284). These procedures would be able to make a definite impact on how the condition of development of evaluation is fully dependent on the conditional differentiation of the structural construction of the medicine so as to support the need to mandate the medical needs of the patients being treated by the said operation.

Since the target goal is to make medical maintenance more supportive of the health needs of the patients, the need to provide a more concrete pattern of evidence is a necessary foundation for this study to be considered valid and applicable in the actual world where patients with hypertension are in dire need of being supported with their health management needs. Basing from the experimentations undergone by the researchers, it could be understood that good management was evident and proper recording of results contributed to the development of the overall value of the study especially when it comes to reflecting the point of reality that the medical industry is in need of using in order to provide a more constructive process of assisting patients with hypertension more fully.

Results

Recorded results have shown that among the three medical applications, bosentan was observed to have the highest propensity of causing liver injury; while ambrisentan is the one to have provided the least result for such point of causation. The problem that was found to have put the other medicine more applicable compared to that of the other is the way its substances have been compounded making the dissolving of such elements much easier to contend with by individuals who have hypertensive events (284-285). The difference between the two medicines was shown to have been dependent on the way they manage the situation through affecting specific parts or functions of the body.

Brosentan was observed to develop construction of the pulmonary blood vessels which at some point have a strong impact fon the overall function of the heart [which in the same manner requires much tighter compounding of substances in the medicine thus making it harder to break]; this results to the trashing of the liver and even that of the kidney causing complications in the patient’s situation. On the other hand, ambrisentan follows a different pattern where as it basically improves exercise capacity of the patient, thus making it easier for the patient to recover without necessarily putting all the pressure in the liver; enlivening the activities of the patient[s] makes the dissolving process that the medicine needs to undergo basically creates a more effective sense of helping the medicine do its work in the functional system of the patient.

Discussion

Patients undergoing endothelin receptor antagonist medications are often identified to be suffering from pulmonary artery hypertension. This particular ailment is usually managed by driving the condition of blood circulation into a much better balance [aiming to resolve the imbalance with the use managing agents that are found in antagonists]. Since there are several medications that are used to support the maintenance needs of patients suffering from hypertension issues, the study aimed towards creating a more defined understanding about hypertension medication through research and references that were provided for support on the claims and medical presentations that were determined to have direct impact on the value of the study.

The discussion of the research was thorough especially that it features the different aspects of modern hypertension medication released in the market today. Citing the different substances used to identify the medical value of the said medications, the research was able to mandate a better sense of control, especially on how the readers would understand how each aspect of medical considerations noted in such operations would be able to impact the overall treatment of individuals needing such attention from the medical practitioners and institutions that are dedicated towards providing ease to individuals suffering from hypertension.

Since hypertension is becoming a definitely common type of health problem among members of the community, it is important that a better understanding of its basics along with the way of medication that it needs to be treated with be given attention to, especially that the effect of such understanding would be dedicated to a lot of members of the population. It has also been realized that the patients experiencing such points of problems are getting younger every year; this means that the maintenance point dedicated to such individuals need to be longer in time and duration. This would entail the need for the medical practitioners to find a way to improve the ways by which the point of medication is managed for the sake of creating a more feasible manner of managing hypertension in a much appreciated manner; one that would create lesser problems in relation to the development of medical issues that are connected to medical side effects brought about by such substances as they are induced in the body.

Clear and detailed; this is what could be observed on the discussion part of the research. Relatively, the researchers were able to make use of effective and simple layman’s terms that would be easier to understand for the general reader. Nevertheless, there are some technical matters that cannot be changed into other terms in any way, thus making some parts of the research less feasible to the local readers who have not so much of the medical background that is required to take note of the meaning of such terms.

References

Kenna, G.J. (et al). (2015). Multiple Compound-Related Adverse Properties Contribute to Liver Injury Caused by Endothelin Receptor Antagonists. The Journal of Pharmacology and Experimental Therapeutics.

Vatter H, Seifert V (2006). “Ambrisentan, a non-peptide endothelin receptor antagonist”. Cardiovasc Drug Rev 24 (1): 63–76.

Frampton JE. Ambrisentan. American Journal of Cardiovascular Drugs August 1, 2011; 11 (4): 215-226.

Waknine, Yael (2005-05-09). “International Approvals: Ambrisentan, Oral-lyn, Risperdal“. Medscape.

Funke C, Farr M, Werner B, Dittmann S, Uberla K, Piper C, Niehaus K, Horstkotte D (Apr 2010). “Antiviral effect of Bosentan and Valsartan during coxsackievirus B3 infection of human endothelial cells.”. Journal of General Virology 91 (8): 1959–1570.

James, PA.; Oparil, S.; Carter, BL.; Cushman, WC.; Dennison-Himmelfarb, C.; Handler, J.; Lackland, DT.; Lefevre, ML. et al. (Dec 2013). “2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)”. JAMA 311 (5): 507–20.

Arguedas, JA; Leiva, V; Wright, JM (Oct 30, 2013). “Blood pressure targets for hypertension in people with diabetes mellitus.“. The Cochrane database of systematic reviews 10: CD008277.

Sundström, Johan; Arima, Hisatomi; Jackson, Rod; Turnbull, Fiona; Rahimi, Kazem; Chalmers, John; Woodward, Mark; Neal, Bruce (February 2015). “Effects of Blood Pressure Reduction in Mild Hypertension”. Annals of Internal Medicine 162: 184–91.

Fisher ND, Williams GH (2005). “Hypertensive vascular disease“. In Kasper DL, Braunwald E, Fauci AS et al. Harrison’s Principles of Internal Medicine (16th ed.). New York, NY: McGraw-Hill. pp. 1463–81.

Whelton PK et al. (2002). “Primary prevention of hypertension. Clinical and public health advisory from the National High Blood Pressure Education Program“. JAMA 288 (15): 1882–1888.

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