Initial Resuscitation for Upper GI Bleeding
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The blood-brain barrier (BBB) is formed by tightly joined endothelial cells lining the brain's capillaries. These cells prevent most substances from passively diffusing from the blood into the brain tissue. Additionally, many drugs, especially large or hydrophilic ones like methotrexate, are often substrates for efflux transporters (like P-glycoprotein) located at the BBB. These pumps actively transport drugs back into the bloodstream, further limiting their entry into the brain.
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