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Body cells lack transport mechanisms for polyhydric alcohols such as mannitol (structure on p. 171) and sorbitol, which are thus prevented from penetrating cell membranes. Therefore, they need to be given by intravenous infusion. They also cannot be reabsorbed from the tubular fluid after glomerular filtration. These agents bind water osmotically and retain it in the tubular lumen.
This is so because the activity of elimination processes is concentration- dependent. The higher the drug concentration rises, the greater is the amount eliminated per unit of time. After several doses, the concentration will have climbed to a level at which the amounts eliminated and taken in per unit of time become equal, i. e. , a steady state is reached.


Desired effects. As anti-allergics, immunosuppressants, or anti-inflammatory drugs, glucocorticoids display excellent efficacy against “undesired” inflammatory reactions. Unwanted effects. With short-term use, glucocorticoids are practically free of adverse effects, even at the highest dosage.
Damage to the nervous system is a predicted adverse effect arising from injury to microtubule-operated axonal transport mechanisms. Paclitaxel, from the bark of the pacific yew (Taxus brevifolia), inhibits disassembly of microtubules and induces atypical ones. Docetaxel is a semisynthetic derivative. Inhibition of DNA and RNA synthesis (A).


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