La depuracin de este frmaco disminuye significativamente en pacientes con enfermedad renal crnica en hemodilisis ya que su eliminacin es principalmente por filtracin glomerular, por lo que no est recomendada en pacientes con depuracin de creatinina 30 ml/min), pero debe monitorearse una posibilidad de mayor incidencia de efectos adversos gastrointestinales y renales, mientras que debido a la falta de datos en pacientes con enfermedad renal terminal, no se recomienda su uso 69,70
CBS and CSE, both of which are pyridoxal 5-phosphate (PLP)-dependent enzymes, function sequentially in the transsulfuration pathway, converting homocysteine and serine into cystathionine and subsequently cysteine (Figures 2 a,b) ( 2 S by utilizing alternative substrates, namely, a combination of cystine and homocysteine for CBS and either cysteine or homocysteine for CSE ( in vitro (Figure 2c) ( in vivo
Dosing & Reconstitution Guide Pramlintide is titrated slowly because gastrointestinal tolerability nausea is the dose-limiting factor, not peak effect
Any provider should include metabolic labs, structured follow-up, and meal planning that works with West Texas food culture
