首页   按字顺浏览 期刊浏览 卷期浏览 Clinical Pharmacokinetics and Pharmacodynamics of ZolpidemTherapeutic Implications
Clinical Pharmacokinetics and Pharmacodynamics of ZolpidemTherapeutic Implications

 

作者: Pau Salvà,   Joan Costa,  

 

期刊: Clinical Pharmacokinetics  (ADIS Available online 1995)
卷期: Volume 29, issue 3  

页码: 142-153

 

ISSN:0312-5963

 

年代: 1995

 

出版商: ADIS

 

数据来源: ADIS

 

摘要:

Zolpidem is an imidazopyridine which differs in structure from the benzodiazepines and zopiclone. It is a strong sedative with only minor anxiolytic, myorelaxant and anticonvulsant properties, and has been shown to be effective in inducing and maintaining sleep in adults. The available evidence suggests that zolpidem produces no rebound or withdrawal effects, and patients have experienced good daytime alertness. Zolpidem 10mg in non-elderly and a reduced dose of 5mg in elderly individuals are clinically effective.In humans, the major metabolic routes include oxidation and hydroxylation; none of the metabolites appears to be pharmacologically active. The pharmacological activity of zolpidem results from selective binding to the central benzodiazepine receptors of the &ohgr;1subtype.Zolpidem is approximately 92% bound to plasma proteins; absolute bioavailability of zolpidem is about 70%. After single 20mg oral doses, typical values of pharmacokinetic variables for zolpidem in humans are: a peak plasma concentration of 192 to 324 μg/L occurring 0.75 to 2.6 hours postdose; a terminal elimination half-life of 1.5 to 3.2 hours; and total clearance of 0.24 to 0.27 ml/min/kg. Zolpidem pharmacokinetics are unchanged during multiple-dose treatment.Zolpidem pharmacokinetics are not significantly influenced by gender. Clearance of zolpidem in children is 3 times higher than in young adults, and is lower in very elderly people. There are no significant differences in the pharmacokinetic parameters between various racial groups. Dosage reduction appears to be prudent in patients with renal disease, and caution should be exercised when prescribing zolpidem to elderly patients with hepatic impairment.Coadministration of haloperidol, cimetidine, ranitidine, chlorpromazine, warfarin, digoxin or flumazenil do not alter the pharmacokinetics of zolpidem; flumazenil predictably antagonises the hypnotic effects of zolpidem. Alertness tends to be reduced when cimetidine is combined with zolpidem. Volunteers treated with imipramine plus zolpidem developed anterograde amnesia.

 

点击下载:  PDF (4645KB)



返 回