首页   按字顺浏览 期刊浏览 卷期浏览 Pharmacokinetics of the Digoxin-Quinidine Interaction via Mixed-Effect Modelling
Pharmacokinetics of the Digoxin-Quinidine Interaction via Mixed-Effect Modelling

 

作者: Paul J. Williams,   James Lane,   William Murray,   Michael A. Mergener,   Masanobu Kamigaki,  

 

期刊: Clinical Pharmacokinetics  (ADIS Available online 1992)
卷期: Volume 22, issue 1  

页码: 66-74

 

ISSN:0312-5963

 

年代: 1992

 

出版商: ADIS

 

数据来源: ADIS

 

摘要:

It was the purpose of this study to evaluate the effect of quinidine administration on the population estimates of the volume of distribution (Vdpop) and clearance (CLpop) of digoxin. The data collected on 94 patients included 230 measured serum digoxin concentrations, height, age, sex, weight (wt), serum creatinine, history of digoxin and quinidine administration and the presence or absence of congestive heart failure (CHF). Using the NONMEM software program, estimates were obtained for CLpopand Vdpop. Variables tested for inclusion in the CLpopmodel were creatinine clearance (CLCR), CHF, wt, ideal bodyweight, quinidine (QUIN) [both as a discrete variable and in a dose-dependent manner], and body surface area. Variables tested for inclusion in the Vdpopmodel were CLCR, wt, ideal bodyweight, body surface area and quinidine. During model building a p-value of 0.05 was chosen for variable inclusion. The final model was as follows:CLpop(L/h) = (3.1 + 0.0516 × CLCR) × QUINVdpop(L) = (4.03 + 0.0832 × CLCR) × wtF = 0.82where F is bioavailability. In the above, QUIN is 0.567 if quinidine is being concurrently administered and 1.0 if it is not. The coefficient of variation (CV) of CLpopwas 44% while that of Vdpopwas 48%. The residual intrasubject CV was 26%. These results compare favourably with previously derived methods of estimating digoxin CLpopand Vdpopbut may improve on those methods due to the inclusion of quinidine in the model. These better estimates should result in improved initial dosage of digoxin.

 

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