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This reaction does not proceed spontaneously, but requires the activated form of glucuronic acid, namely glucuronic acid uridine diphosphate. Microsomal glucuronyl transferases link the activated glucuronic acid with an acceptor molecule. When the latter is a phenol or alcohol, an ether glucuronide will be formed.
The sartans (candesartan, eprosartan, irbesartan, losartan, and valsartan) are AT1 antagonists that reliably lower high blood pressure. They do not inhibit degradation of kinins and cough is not a frequent side-effect. Bronchodilators. Narrowing of bronchioles raises airway resistance, e.g., in bronchial or bronchitic asthma.

 

The effect becomes evident approx. 10 d after the start of therapy. The small therapeutic index necessitates frequent monitoring of Li+ serum levels. Therapeutic levels should be kept between 0. 81. 0 mM in fasting morning blood samples. At higher values there is a risk of adverse effects. CNS symptoms include fine tremor, ataxia or seizures.
The TCAs have affinity for both receptors and transporters of monoamine transmitters and behave as antagonists in both respects. Thus, the neuronal reuptake of norepinephrine and serotonin is inhibited, with a resultant increase in activity. Muscarinic acetylcholine receptors, ?-adrenoceptors, and certain 5-HT and histamine( H1) receptors are blocked.

 

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