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Bronchial asthma: Increased sympathetic activity prevents bronchospasm in patients disposed to paroxysmal constriction of the bronchial tree (bronchial asthma, bronchitis in smokers). In this condition, ?2-receptor blockade will precipitate acute respiratory distress (B).
In these cases, an amide bond is formed between the carboxyl groups of the acceptor and the amino group of the donor molecule (e. g. , formation of salicyluric acid from salicylic acid and glycine). The acidic group of glycine or glutamine remains free. Most drugs are eliminated in urine either chemically unchanged or as metabolites.

 

This fact assumes practical significance with any drug that may be rapidly transformed or possibly inactivated in the liver (first-pass hepatic elimination). Even with rectal administration, at least a fraction of the drug enters the general circulation via the portal vein, because only veins draining the short terminal segment of the rectum communicate directly with the inferior vena cava.
Researchers have formulated ODT for various categories of drugs used for therapy in which rapid peak plasma concentration is required to achieve the desired pharmacological response.

 

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