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1.
Br J Anaesth ; 85(6): 850-5, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11732518

RESUMO

We examined the pharmacokinetics and pharmacodynamics of atracurium besylate and its metabolites in children after orthotopic liver transplantation (OLT), as a suitable model for critically ill children. Ten children were studied after OLT on return to the intensive care unit (ICU). The mean (range) age was 36 (7-78) months, and weight 6-24.2 kg. Atracurium was started at induction of anaesthesia and adjusted in the ICU according to clinical need. Neuromuscular block was measured using accelerometry (TOFguard) and the train-of-four (TOF) ratio or count. Arterial plasma samples for atracurium and metabolites taken before, 12-hourly during, and at frequent intervals after the infusion were analysed by HPLC. The mean (range) maximum infusion rate during steady-state conditions was 1.44 (0.48-3.13) mg kg(-1) h(-1) and the duration of infusion 36.9 (22.5-98.4) h. Tachyphylaxis was not observed. The mean terminal half-life (t1/2) for atracurium was 18.8 (12-32.3) min. The steady-state plasma clearance (CLss) was 13.9 (7.9-20.3) ml min(-1) kg(-1) and the terminal volume of distribution (Vz) 390 (124-551) ml kg(-1); both were higher than in adults after successful OLT. The maximum concentration (Cmax) of laudanosine was 1190 (400-1890) ng ml(-1) and t1/2 was 3.9 (1.1-6.7) h. The renal clearance of laudanosine was 0.9 (0.1-2.5) ml min(-1) kg(-1) and increased with urine flow, but there was no significant relationship with serum creatinine. EEG spikes were confirmed in one child only; the corresponding laudanosine Cmax was 720 ng ml(-1). Monoquaternary alcohol Cmax was 986 (330-1770) ng ml(-1) and t1/2 42.9 (30-57.7) min. Mean recovery time on stopping the atracurium infusion to a TOF ratio >0.75 was 23.6 (12-27) min. Atracurium is an effective and safe neuromuscular blocking agent in this population. Laudanosine concentrations are not excessive if graft function is satisfactory.


Assuntos
Atracúrio/sangue , Cuidados Críticos/métodos , Transplante de Fígado , Fármacos Neuromusculares não Despolarizantes/sangue , Cuidados Pós-Operatórios/métodos , Atracúrio/administração & dosagem , Criança , Pré-Escolar , Esquema de Medicação , Feminino , Meia-Vida , Humanos , Lactente , Isoquinolinas/sangue , Masculino , Bloqueio Neuromuscular/métodos , Fármacos Neuromusculares não Despolarizantes/administração & dosagem
2.
Clin Pharmacol Ther ; 63(3): 342-53, 1998 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-9542478

RESUMO

OBJECTIVE: Zolmitriptan is a selective 5HT1B/1D-agonist for the treatment of migraine. In this study we investigated the cardiovascular and central nervous system effects and the pharmacokinetics of zolmitriptan in young and elderly adults. METHODS: Twelve young adult and 12 elderly volunteers received single doses of 5, 10, and 15 mg zolmitriptan during a randomized, double-blind, placebo-controlled study. Blood pressure, heart rate, ECG, and central nervous system effects were monitored, and pharmacokinetic parameters of zolmitriptan and its metabolites calculated. RESULTS: Zolmitriptan did not affect heart rate and had little effect on systolic blood pressure in the young adults. In the elderly, mean peak supine systolic blood pressure values were 9 to 16 mm Hg higher after zolmitriptan than after placebo. Mean peak diastolic pressure was 6 to 10 mm Hg higher in both age groups. These changes were transient. Postural changes in blood pressure were unaffected. There was a dose-related increase in sedation, but the magnitude of the effects was small. Mean observed peak plasma concentration (Cmax) and area under the plasma concentration-time profile [AUC(0-infinity)] for zolmitriptan and its active N-desmethyl metabolite were similar in both age groups but higher in young women than in young men. Metabolite/parent ratios probably the result of greater first-pass metabolism in young men. Zolmitriptan half-life was 2.8 to 3.6 hours in the elderly compared with 2.7 to 2.9 hours in young adults. Mean Cmax and AUC(0-infinity) for the inactive, N-oxide, and the indole acetic acid metabolites were higher in the elderly, associated with lower renal clearance. CONCLUSIONS: Zolmitriptan was well tolerated, with an effect of age on its effects on blood pressure and the pharmacokinetics of its metabolites. The data suggest no need for dose adjustment for age. In young subjects, concentrations were higher in women than in men, but the differences were insufficient to justify dosage adjustment.


Assuntos
Oxazóis/farmacologia , Oxazolidinonas , Agonistas do Receptor de Serotonina/farmacologia , Adulto , Fatores Etários , Idoso , Pressão Sanguínea/efeitos dos fármacos , Sistema Nervoso Central/efeitos dos fármacos , Método Duplo-Cego , Eletrocardiografia/efeitos dos fármacos , Feminino , Meia-Vida , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Oxazóis/farmacocinética , Valores de Referência , Agonistas do Receptor de Serotonina/farmacocinética , Fatores Sexuais , Triptaminas
3.
Br J Clin Pharmacol ; 45(1): 87-9, 1998 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9489600

RESUMO

AIMS: Changes in both digoxin and aciclovir renal clearance following coadministration with some other renally eliminated drugs have been reported. The potential interaction of valaciclovir, with its antiherpetic metabolite aciclovir, and digoxin was investigated. METHODS: Twelve healthy volunteers (seven males, five females) participated in an open, randomized, four-period crossover study. Valaciclovir, 1000 mg, was given alone on one occasion, and on another, after the second of two 0.75 mg digoxin doses administered 12 h apart. Blood samples and all urine were collected up to 12 h following the valaciclovir dose for aciclovir radioimmunoassay. On a third occasion, digoxin was given alone and on a fourth, with 1000 mg valaciclovir three times/day for 8 days starting 12 h before the first digoxin dose. Blood samples were taken up to 168 h and all urine collected up to 24 h following the second dose for digoxin radioimmunoassay. RESULTS: There were no clinically significant differences in digoxin or aciclovir pharmacokinetic parameters when digoxin or valaciclovir was given alone or in combination. CONCLUSIONS: No dosage adjustment is required when valaciclovir and digoxin are coadministered.


Assuntos
Aciclovir/análogos & derivados , Antivirais/farmacocinética , Cardiotônicos/farmacocinética , Digoxina/farmacocinética , Pró-Fármacos/farmacocinética , Valina/análogos & derivados , Aciclovir/efeitos adversos , Aciclovir/farmacocinética , Adulto , Antivirais/efeitos adversos , Cardiotônicos/efeitos adversos , Estudos Cross-Over , Digoxina/efeitos adversos , Esquema de Medicação , Interações Medicamentosas , Feminino , Humanos , Masculino , Pró-Fármacos/efeitos adversos , Valaciclovir , Valina/efeitos adversos , Valina/farmacocinética
4.
Br J Clin Pharmacol ; 44(6): 595-9, 1997 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9431839

RESUMO

AIMS: Zolmitriptan (Zomig, formerly known as 311C90), a selective 5HT1B/1D agonist is under development as an acute oral treatment for migraine. Despite the use of prophylactic medication, such as propranolol, breakthrough attacks often occur in patients. Consequently we investigated the effects of propranolol on the pharmacokinetics of, and cardiovascular responses to, zolmitriptan. METHODS: A double-blind, randomized, crossover study of the effects of pre-treatment with propranolol 160 mg daily for 7 days or placebo on the pharmacokinetics and effects on blood pressure of a single 10 mg dose of zolmitriptan in 12 healthy volunteers. RESULTS: Propranolol increased mean zolmitriptan Cmax and AUC by 56% and 37% respectively; mean t1/2 was prolonged from 3.1 to 4.0 h. Mean Cmax and AUC of the pharmacologically active N-desmethyl metabolite were reduced by 24% and 11% respectively and the metabolite:parent AUC ratio (AUCm/AUCp) fell from 0.46 to 0.26. Mean Cmax and AUC for the inactive indole acetic acid metabolite were both reduced by 13% and AUCm/AUCp from 1.04 to 0.59. A small pressor effect of short duration was observed following zolmitriptan with mean peak rises of 13 and 11 mmHg in systolic and diastolic pressures respectively; propranolol had no effect on the pressor response. CONCLUSIONS: The results suggest that propranolol inhibits biotransformation of zolmitriptan but with no change in the small pressor response to zolmitriptan. It is therefore unlikely that the pharmacokinetic changes will lead to clinically important changes in pharmacological effects and dosage adjustment of zolmitriptan is not required in patients taking propranolol for migraine prophylaxis.


Assuntos
Antagonistas Adrenérgicos beta/farmacologia , Oxazóis/farmacologia , Oxazóis/farmacocinética , Oxazolidinonas , Propranolol/farmacologia , Agonistas do Receptor de Serotonina/farmacologia , Agonistas do Receptor de Serotonina/farmacocinética , Adulto , Área Sob a Curva , Biotransformação , Pressão Sanguínea/efeitos dos fármacos , Estudos Cross-Over , Método Duplo-Cego , Interações Medicamentosas , Eletrocardiografia/efeitos dos fármacos , Feminino , Meia-Vida , Humanos , Masculino , Triptaminas
5.
Antimicrob Agents Chemother ; 39(1): 20-7, 1995 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-7695306

RESUMO

882C87 is a nucleoside analog with potent, specific activity against varicella-zoster virus. It is approximately seven times as potent as acyclovir with an in vitro 50% inhibitory concentration of 1 to 2 microM. The tolerability and pharmacokinetics of single doses of 882C87 have been investigated in a series of studies with healthy young and elderly adult volunteers. The young received 50 to 1,600 mg, and the elderly received 50 and 100 mg. Concentrations of 882C87 and its main metabolite, the pyrimidine base 5-(1-propynyl)uracil (5PU), in plasma and urine were assayed by an automated sequential trace enrichment of dialysate-high-performance liquid chromatography procedure, and noncompartmental pharmacokinetic parameters were derived from the data. Concentrations of 882C87 in plasma increased proportionally for doses of up to 400 mg, but after higher doses the increase was less than dose proportional. In young adults, after 200, 400, and 1,600 mg, the maximum concentrations of the drug in plasma were 9.0, 16.3, and 34.7 microM, respectively, and the areas under the concentration-time curve (AUC) from 0 h to infinity were 166.6, 333.7, and 822.9 microM.h, respectively. Elimination half-life was 11.3 to 13.0 h after 50 to 400 mg, increasing to 15.3 h after 1,600 mg, associated with a small decrease in renal clearance. In healthy elderly volunteers concentrations of 882C87 in plasma after 50 and 100 mg were similar to those in young adults after twice the dose; apparent clearance and renal clearance were significantly reduced, and half-life was significantly longer at 15 h. Administration of 882C87 with food produced a small, nonsignificant reduction in mean AUC from 0 h to infinity, but in subjects with a low fasting AUC there was an increase after food and in subjects with a high fasting AUC there was a decrease. Concentrations of 5PU in plasma were one-third to one-half those of 882C87 and, in most subjects, were not dose proportional. There was a lag of at least 5 h after dosing with 882C87 before 5PU was detectable in plasma.


Assuntos
Antivirais/farmacocinética , Arabinofuranosiluracila/análogos & derivados , Administração Oral , Adulto , Idoso , Envelhecimento/metabolismo , Antivirais/administração & dosagem , Antivirais/sangue , Arabinofuranosiluracila/administração & dosagem , Arabinofuranosiluracila/sangue , Arabinofuranosiluracila/farmacocinética , Cromatografia Líquida de Alta Pressão , Jejum/metabolismo , Herpesvirus Humano 3/efeitos dos fármacos , Humanos , Masculino , Método Simples-Cego
6.
Br J Clin Pharmacol ; 37(1): 13-20, 1994 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8148213

RESUMO

1. Atovaquone is a potent antiprotozoal slowly and irregularly absorbed after administration as tablets to fasting volunteers. A series of studies was performed to investigate the effects of food, bile and formulation on atovaquone absorption. 2. In 18 healthy male volunteers, a high-fat breakfast administered 45 min before 500 mg atovaquone as tablets increased AUC by 3.3-fold (95% CI 2.8-4.0) and Cmax 5.3-fold (4.3-6.6) compared with fasting. 3. The absorption of atovaquone from tablets was examined in 12 healthy male volunteers after an overnight fast, following toast alone, toast with 28 g butter (LOFAT), or toast with 56 g butter (HIFAT). Compared with absorption when fasted, toast had no significant effect but LOFAT increased AUC 3.0-fold (2.1-4.2) and Cmax 3.9-fold (2.6-5.8). HIFAT increased AUC 3.9-fold (2.7-5.5) and Cmax 5.6-fold (3.8-8.4). 4. The absorption of atovaquone was examined in nine healthy fasting male volunteers from tablets, an aqueous suspension, and an oily solution/suspension in miglyol (fractionated coconut oil). Compared with tablets, AUC following the aqueous suspension was increased 1.7-fold (1.0-2.7) and Cmax 2.4-fold (1.7-3.5). Following miglyol, AUC was increased to the same extent but Cmax was only increased 1.8-fold (1.2-2.6). 5. Atovaquone absorption was examined in eight healthy fasting male volunteers following an i.v. infusion of cholecystokinin octapeptide (CCK-OP) which decreased gallbladder volume by 82% (73%-90%) on occasion 1 or saline on occasion 2. AUC(0,12) was increased following CCK-OP by 1.6-fold (1.1-2.4) and Cmax by 1.5-fold (0.98-2.4).(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Gorduras na Dieta/administração & dosagem , Alimentos , Absorção Intestinal , Naftoquinonas/farmacocinética , Adulto , Atovaquona , Cromatografia Líquida de Alta Pressão , Jejum , Humanos , Infusões Intravenosas , Absorção Intestinal/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Naftoquinonas/administração & dosagem , Naftoquinonas/sangue , Sincalida/administração & dosagem , Sincalida/farmacologia , Suspensões , Comprimidos
7.
Br J Clin Pharmacol ; 35(4): 419-25, 1993 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8485022

RESUMO

1. Tucaresol (589C80; 4[2-formyl-3-hydroxyphenoxymethyl] benzoic acid) interacts stoichiometrically with haemoglobin to increase oxygen affinity. By decreasing the proportion of insoluble deoxy sickle haemoglobin at capillary oxygen concentrations, tucaresol may be of therapeutic benefit in sickle cell anaemia. 2. In this study, which involved the first administration to man, the pharmacokinetics and pharmacodynamics of tucaresol were studied in healthy male volunteers following oral doses of 200-3600 mg. 3. Peak drug concentrations in plasma and erythrocytes were linearly related to dose; mean (s.d.) values were 95.8 (26.1) and 1035 (67) micrograms ml-1, respectively, at the highest dose. Median tmax in plasma was 6.5 h and in erythrocytes 24.5 h, when approximately 60% of the administered dose was in the target tissue. Plasma drug concentrations fell biexponentially with commencement of the apparent terminal elimination phase at approximately 24 h. The terminal elimination half-life from plasma increased with dose (r = 0.77; P < 0.0001) from 133-190 h at 400 mg to a mean (s.d.) of 289 (30) h at 3600 mg. Erythrocyte drug concentrations declined mono-exponentially with a half-life that was always shorter than the apparent terminal half-life in plasma: overall mean (95% CI) of t1/2 erythrocyte/t1/2 plasma ratio was 0.57 (0.53, 0.61). The erythrocyte AUC/plasma AUC ratio increased with dose (r = 0.67; P < 0.001). 4. The proportion of haemoglobin modified to a form with high oxygen affinity (%MOD) increased in a dose-related manner above doses of 800 mg reaching 19-26% after the 3600 mg dose.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Antidrepanocíticos/farmacologia , Benzaldeídos/farmacologia , Benzoatos/farmacologia , Administração Oral , Adulto , Antidrepanocíticos/efeitos adversos , Antidrepanocíticos/farmacocinética , Benzaldeídos/efeitos adversos , Benzaldeídos/farmacocinética , Benzoatos/efeitos adversos , Benzoatos/farmacocinética , Contagem de Células Sanguíneas/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Hemoglobinas/efeitos dos fármacos , Hemoglobinas/metabolismo , Humanos , Masculino
8.
Epilepsia ; 34(1): 166-73, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8422853

RESUMO

This study was conducted to examine the effects of acute doses of lamotrigine (LTG) and carbamazepine (CBZ) in healthy subjects and determine whether the low tendency to impairment with LTG observed in animals applied to humans. Twelve healthy men participated in a placebo-controlled, balanced, double-blind comparison of the drugs on a series of psychomotor, autonomic, sensory, and subjective variables. Variables were analyzed by analysis of variance, and p < 0.05 was considered significant. Adaptive tracking and body sway were impaired by CBZ 600 mg. CBZ 400 and 600 mg impaired smooth pursuit eye movements and also reduced mean peak saccadic velocity. No differences from placebo occurred after LTG. CBZ 600 mg increased heart rate (HR), but no drug-related changes were noted in pupil size, salivary secretion, visual near point, or subjective effects. During the controlled study, mean plasma CBZ concentrations at 2 and 6.5 h after the 600-mg dose were 5.28 and 5.36 micrograms/ml; after LTG 300 mg, they were 3.16 and 3.00 micrograms/ml. Increased CBZ saliva concentrations were significantly associated (p < 0.01) with impaired adaptive tracking, smooth and saccadic eye movements and increased HR, and plasma concentrations were associated with impaired eye movements and body sway.


Assuntos
Carbamazepina/farmacologia , Movimentos Oculares/efeitos dos fármacos , Desempenho Psicomotor/efeitos dos fármacos , Triazinas/farmacologia , Adulto , Carbamazepina/administração & dosagem , Carbamazepina/farmacocinética , Relação Dose-Resposta a Droga , Método Duplo-Cego , Humanos , Lamotrigina , Masculino , Placebos , Equilíbrio Postural/efeitos dos fármacos , Postura , Saliva/química , Triazinas/administração & dosagem , Triazinas/farmacocinética
9.
Intensive Care Med ; 19 Suppl 2: S94-8, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8106686

RESUMO

OBJECTIVE: To determine the pharmacokinetics and pharmacodynamics of the neuromuscular blocking agent atracurium besylate in patients with fulminant hepatic failure (FHF). DESIGN: Open study of patients receiving atracurium infusions to facilitate mechanical ventilation. SETTING: Intensive care unit in a tertiary referral university teaching hospital. PATIENTS: Ten encephalopathic patients with FHF requiring mechanical ventilation while awaiting orthotopic liver transplantation. Three patients died before transplantation could be performed, three died after transplantation, and four survived following successful transplantation. METHODS: Plasma, urine and dialysate fluid were analysed for atracurium and its metabolites using HPLC. Neuromuscular blockade was measured using transcutaneous ulnar nerve stimulation and an accelerometer. Electroencephalography and liver function tests were performed daily. RESULTS: Patients received atracurium infusions for a period ranging from 38 to 217 h. Six patients required continuous arteriovenous haemodiafiltration (CAVHD) to replace renal function. Atracurium mean steady state clearance was 8.6 ml/min/kg, and train-of-four recovery ratio to 75% took 63 min (range 32-108). Laudanosine clearance was markedly reduced in the non-survivors; the half-life was 38.5 hrs compared with 5.3 h in the 4 patients who underwent successful transplantation. Laudanosine accumulation could be observed in all patients before transplantation, but kinetics returned to normal after successful transplantation. The highest laudanosine level recorded was 6,860 ng/ml. There was no evidence of adverse central neurological effects attributable to laudanosine. CAVHD did not contribute significantly to clearance of atracurium or its metabolites. CONCLUSIONS: Atracurium kinetics and dynamics are near-normal even in patients with fulminant hepatic failure and renal failure; laudanosine accumulation will occur, but this is not associated with measurable central neurological effects. Implantation of a functioning liver graft results in clearance of laudanosine, which seems to be independent of renal function. Atracurium is an appropriate choice for producing neuromuscular blockade for periods of several days in patients with fulminant hepatic failure and renal impairment.


Assuntos
Atracúrio/uso terapêutico , Encefalopatia Hepática/terapia , Transplante de Fígado , Adulto , Atracúrio/sangue , Atracúrio/metabolismo , Atracúrio/farmacologia , Atracúrio/urina , Monitoramento de Medicamentos , Quimioterapia Combinada , Feminino , Hemofiltração , Encefalopatia Hepática/sangue , Encefalopatia Hepática/metabolismo , Encefalopatia Hepática/mortalidade , Encefalopatia Hepática/urina , Humanos , Infusões Intravenosas , Isoquinolinas/farmacocinética , Isoquinolinas/uso terapêutico , Transplante de Fígado/mortalidade , Masculino , Taxa de Depuração Metabólica , Pessoa de Meia-Idade , Entorpecentes/farmacocinética , Entorpecentes/uso terapêutico , Respiração Artificial , Taxa de Sobrevida , Listas de Espera
10.
Br J Clin Pharmacol ; 33(5): 511-3, 1992 May.
Artigo em Inglês | MEDLINE | ID: mdl-1524964

RESUMO

Concomitant administration of sodium valproate (VPA) reduced lamotrigine (LTG) total clearance by approximately 21% and increased elimination half-life and AUC. Reduced elimination occurred acutely within the first hour. Renal elimination of LTG was not impaired. The most probable explanation for this effect is hepatic competition between VPA and LTG for glucuronidation. Volume of distribution and parameters related to absorption, Cmax and tmax were unchanged.


Assuntos
Anticonvulsivantes/farmacocinética , Triazinas/farmacocinética , Ácido Valproico/farmacologia , Adulto , Anticonvulsivantes/administração & dosagem , Anticonvulsivantes/sangue , Interações Medicamentosas , Glucuronatos/metabolismo , Humanos , Lamotrigina , Fígado/metabolismo , Masculino , Triazinas/administração & dosagem , Triazinas/sangue , Ácido Valproico/administração & dosagem
11.
Clin Pharmacol Ther ; 50(3): 267-77, 1991 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-1914361

RESUMO

The current mode of administration of recombinant tissue-type plasminogen activator (rt-PA) in acute myocardial infarction is rather complex, although the rationale for the different components of this scheme is not clearly established. We compared pharmacokinetics of a continuous infusion of 38.5 MU of Burroughs Wellcome t-PA (duteplase) over 90 minutes in nine patients (phase I) with a scheme including a 0.04 MU/kg bolus, a 60-minute 0.36 MU/kg lytic infusion and a 180-minute 0.21 MU/kg maintenance infusion in 15 patients with acute myocardial infarction (Phase II). t-PA activity and antigen were fitted in a one-compartment model from which model-dependent and model-independent parameters were derived. Clearance of t-PA activity was 1020 +/- 465 (mean +/- SD) ml/min in phase I and 1359 +/- 590 ml/min in phase II. Clearance of t-PA antigen was 666 +/- 230 ml/min in phase I and 704 +/- 199 ml/min in phase II. Clearance of activity was significantly (p less than 0.01) higher than of antigen. Clearance and steady-state plasma levels showed a large interindividual variability (coefficient of variation, 56.4%), but this was significantly reduced by dosing by weight (coefficient of variation, 28.9%; p = 0.031). A 10% bolus in phase II shortened the time to reach 75% and 90% of the steady-state plasma level by 4 and 5 minutes, respectively, not significantly different from phase I. A simulation study showed that a bolus should be approximately 15% of the lytic dose to achieve a maximal level in the shortest period.


Assuntos
Infarto do Miocárdio/metabolismo , Ativador de Plasminogênio Tecidual/farmacocinética , Idoso , Peso Corporal , Avaliação de Medicamentos , Meia-Vida , Humanos , Infusões Intravenosas , Injeções Intravenosas , Taxa de Depuração Metabólica , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Infarto do Miocárdio/tratamento farmacológico , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/sangue , Proteínas Recombinantes/farmacocinética , Terapia Trombolítica , Ativador de Plasminogênio Tecidual/administração & dosagem , Ativador de Plasminogênio Tecidual/sangue
12.
J Antimicrob Chemother ; 20(1): 69-76, 1987 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3624115

RESUMO

Once daily 60 min iv infusions of acyclovir at 2.5 mg/kg were administered to six uraemic patients (three male, three female of mean age 52 years and body weight 60 kg) treated by continuous ambulatory peritoneal dialysis (CAPD). Blood and dialysate samples were taken for analysis of acyclovir by radio-immunoassay. A three-compartment pharmacokinetic model was found necessary to explain the profiles obtained. Steady-state was reached by the third day, with little change in mean peak or trough plasma levels between day one (25 and 3 microM) and day five (29 and 4 microM). Mean total plasma clearance was 46 ml/h/kg, of which 12% was due to peritoneal dialysis. The model parameters predicted efficient transfer of acyclovir from the peritoneum to plasma, such that hypothetical peritoneal dosing might give 91% bioavailability. In patients treated by CAPD, iv acyclovir should be administered at 2.5 mg/kg/day.


Assuntos
Aciclovir/sangue , Falência Renal Crônica/sangue , Aciclovir/uso terapêutico , Adulto , Idoso , Assistência Ambulatorial , Feminino , Meia-Vida , Humanos , Cinética , Masculino , Taxa de Depuração Metabólica , Pessoa de Meia-Idade , Diálise Peritoneal Ambulatorial Contínua
13.
Br J Anaesth ; 59(6): 697-706, 1987 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-3606914

RESUMO

The plasma pharmacokinetic profiles of atracurium and its derivatives, laudanosine and monoquaternary alcohol, were studied in six patients with renal failure after a bolus dose of atracurium 0.3-0.4 mg kg-1. The pharmacokinetics of the derivatives only were studied in a group of four normal patients receiving atracurium 0.3 mg kg-1. Measurements of plasma and urine concentrations were performed by high pressure liquid chromatography. Pharmacokinetics of atracurium were not significantly different in the renal failure group when compared with those obtained in a previous study on six normal patients. Although 2-10% of the dose was recovered in the urine of normal patients as unchanged atracurium, and 3-4% as laudanosine, renal failure produced no significant differences in plasma pharmacokinetics, with mean plasma elimination half-lives of 20 min for atracurium, 234 min for laudanosine and 39 min for quaternary alcohol.


Assuntos
Atracúrio/metabolismo , Falência Renal Crônica/metabolismo , Adulto , Idoso , Álcoois/metabolismo , Feminino , Meia-Vida , Humanos , Isoquinolinas/metabolismo , Cinética , Masculino , Matemática , Pessoa de Meia-Idade , Modelos Biológicos
14.
Br J Clin Pharmacol ; 22(1): 61-71, 1986 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3741728

RESUMO

Four healthy male subjects received single oral doses of 15, 30 and 60 mg of codeine and pholcodine according to a balanced cross-over design with an interval of 7 days between the six treatments. Blood samples were collected for 8 h after each drug administration. In phase 2 of the study six different male volunteers received single oral doses of 60 mg of codeine and pholcodine with a 14 day interval between successive drug treatments. Blood was sampled for 12 h after codeine and 121 h after pholcodine administration. Plasma concentrations of free (unconjugated) and total (unconjugated plus conjugated) codeine, pholcodine and morphine were determined by radioimmunoassay and selected pharmacokinetic parameters were derived from these data. Pharmacokinetics of both drugs were independent of dose. Codeine was absorbed and eliminated relatively rapidly [elimination t1/2 = 2.3 +/- 0.4 h (mean +/- s.d.)]. While codeine kinetics were adequately described by a one-compartment open model with first-order absorption, a two-compartment model was required to describe pholcodine elimination from plasma (t1/2,z = 37.0 +/- 4.2 h). Plasma concentrations of conjugated codeine were much greater than those of the unconjugated alkaloid. By contrast, pholcodine appeared to undergo little conjugation. Biotransformation of codeine to morphine was evident in all subjects, although the extent of this metabolic conversion varied considerably between subjects. Morphine was not detectable in the plasma of any subject after pholcodine administration.


Assuntos
Antitussígenos/sangue , Codeína/análogos & derivados , Codeína/sangue , Morfolinas/sangue , Administração Oral , Adulto , Antitussígenos/administração & dosagem , Codeína/administração & dosagem , Relação Dose-Resposta a Droga , Esquema de Medicação , Humanos , Cinética , Masculino , Morfina/sangue , Morfolinas/administração & dosagem , Pupila/efeitos dos fármacos , Radioimunoensaio
15.
Br J Anaesth ; 58 Suppl 1: 6S-10S, 1986.
Artigo em Inglês | MEDLINE | ID: mdl-3754756

RESUMO

The pharmacokinetic profile of atracurium was studied in normal patients and in patients with renal failure, renal-hepatic failure, or hepatic disease. Its short elimination half-life was not significantly altered by renal failure, but in patients with severe liver disease elimination of its metabolites was prolonged, necessitating care during long-term i.v. infusions in patients with hepatic dysfunction.


Assuntos
Isoquinolinas/metabolismo , Hepatopatias/metabolismo , Bloqueadores Neuromusculares/metabolismo , Atracúrio , Doença Crônica , Meia-Vida , Humanos , Falência Renal Crônica/metabolismo , Cinética , Taxa de Depuração Metabólica
16.
Br J Clin Pharmacol ; 19(4): 471-81, 1985 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-3994894

RESUMO

BW12C, a potent left-shifting anti-sickling compound in vitro, was administered to normal healthy male Caucasian volunteers. Doses of 2-20 mg kg-1 given by intravenous infusion over 1 h caused a dose-dependent left-shift of the blood-oxygen saturation curve and at the highest dose some 16% of the haemoglobin existed in a high affinity form. Peak left-shift was observed at the end of infusion and decayed thereafter with a mean half-life of approximately 3 h. There were no adverse systemic effects, either clinical, biochemical or haematological, but there was some local irritation at the intravenous infusion site if the infusion was too concentrated. Pharmacokinetic measurements indicated uptake into erythrocytes, low levels in plasma and a volume of distribution not appreciably greater than the blood volume. A pilot radiolabel study indicated extensive metabolism with elimination into the urine.


Assuntos
Aldeídos/farmacologia , Antidrepanocíticos/farmacologia , Benzaldeídos , Oxigênio/sangue , Adulto , Aldeídos/sangue , Antidrepanocíticos/sangue , Sítios de Ligação , Eritrócitos/metabolismo , Hemoglobinas/metabolismo , Humanos , Cinética , Masculino , Mioglobina/metabolismo
17.
Br J Anaesth ; 55(2): 113-8, 1983 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-6687550

RESUMO

The plasma decay of atracurium besylate was examined in two groups of six patients. Group I received atracurium 0.6 mg kg-1 and group II 0.3 mg kg-1 as a single bolus dose i.v. The plasma concentrations were measured by high performance liquid chromatography. An individual two-compartment pharmacokinetic model was used for interpretation. The results from the two groups were not significantly different, giving overall mean values of 2 min (+/- 0.2 SEM) for the distribution half-life (T1/2 alpha), 19.9 min (+/- 0.6) for the elimination half-life (T1/2 beta), 5.5 ml min-1 kg-1 (+/- 0.2) for total clearance (Cl) and 157 ml kg-1 (+/- 7) for total distribution volume (Varea).


Assuntos
Isoquinolinas/sangue , Bloqueadores Neuromusculares/sangue , Adulto , Idoso , Atracúrio , Meia-Vida , Humanos , Injeções Intravenosas , Isoquinolinas/administração & dosagem , Cinética , Masculino , Taxa de Depuração Metabólica , Pessoa de Meia-Idade , Modelos Biológicos , Fatores de Tempo
18.
Br J Anaesth ; 55 Suppl 1: 39S-45S, 1983.
Artigo em Inglês | MEDLINE | ID: mdl-6688016

RESUMO

A complete pharmacokinetic and pharmacodynamic model for the novel non-depolarizing neuromuscular blocking agent atracurium is proposed, which accounts for tetanic and single twitch responses after any i.v. administration of this drug. The means and standard deviations of the kinetic parameters are given from studies in 19 patients, and the pharmacodynamic parameters from eight patients in whom plasma drug concentrations and dynamic responses were recorded concurrently. Similarities in dynamic parameters are noted for atracurium administered to cats, and for other non-depolarizing neuromuscular blocking agents in man. The use of this approach allows clinicians to understand and rationalize all the features associated with the time-course of blockade after varied i.v. regimens, but more importantly, allows them to design any required neuromuscular blocking profile which will also result in minimal drug loading of their patients.


Assuntos
Isoquinolinas/administração & dosagem , Bloqueadores Neuromusculares/administração & dosagem , Atracúrio , Relação Dose-Resposta a Droga , Humanos , Infusões Parenterais , Injeções Intravenosas , Isoquinolinas/sangue , Isoquinolinas/farmacologia , Cinética , Modelos Biológicos , Contração Muscular/efeitos dos fármacos , Bloqueadores Neuromusculares/sangue
19.
J Biol Chem ; 256(18): 9583-92, 1981 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-6793572

RESUMO

Arachidonic acid 15-lipoxygenase was purified from rabbit peritoneal polymorphonuclear leukocytes. The enzyme was recovered in the cytosol fraction after sonication and purified about 250-fold by acetone precipitation, column chromatography on CM52, Sephadex G-150, and hydroxyapatite. The enzyme catalyzed the conversion of arachidonic acid to 15-hydroperoxy-5,8,11,13-eicosatetraenoic acid (15-HPETE), which then decomposed to a mixture of 15-hydroxy-5,8,11,13-eicosatetraenoic acid (15-HETE), 15-keto-5,8,11,13-eicosatetraenoic acid, 13-hydroxy-14,15-epoxy-5,8,11-eicosatrienoic acid, and 11,14,15-trihydroxy-5,8,12-eicosatrienoic acid. The enzyme was specific for oxygenation at carbon 15 of arachidonic acid. The apparent molecular weight of the enzyme was about 61,000 as measured by Sephadex G-150 gel filtration chromatography. The enzyme was sensitive to sulfhydryl-blocking reagents such as p-chloromercuribenzoic acid. The enzyme activity was inhibited by eicosatetraynoic acid (ETYA) or 3-amino-1-(m-(trifluoromethyl)-phenyl)2-pyrazoline (BW755C), but not by indomethacin up to 200 micrograms/ml.


Assuntos
Lipoxigenase/sangue , Neutrófilos/enzimologia , Animais , Araquidonato Lipoxigenases , Ácido Araquidônico , Ácidos Araquidônicos/sangue , Cátions Bivalentes , Cromatografia Líquida de Alta Pressão , Cinética , Lipoxigenase/isolamento & purificação , Espectrometria de Massas , Peso Molecular , Coelhos
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