摘要:

Clinical Pharmacology and Therapeutics(1986)40,369–372; doi:10.1038/clpt.1986.1

ISSN:0009-9236    

DOI:10.1038/clpt.1986.192

年代:1986

数据来源: WILEY

摘要:

The incidence of potentially serious drug‐related elevations of BUN or serum creatinine was examined among 1468 patients with rheumatoid arthritis or osteoarthritis who took daily therapeutic doses of aspirin, ibuprofen, or Oxaprozin, an investigational nonsteroidal antiinflammatory drug (NSAID), in multicenter clinical trials. Algorithms were developed to identify patients with potentially important elevations of these renal laboratory parameters and to assess the possible relation between these elevations and the study drugs. All three drugs were associated with a low (4% to 6%) incidence of potentially significant elevations in renal function parameters. Changes considered serious occurred in only three (<1%) patients (one treated with Oxaprozin and two with ibuprofen), all of whom were receiving concomitant diuretic therapy. None of the changes led to adverse clinical consequences. Thus despite recent controversy regarding the renal safety of NSAIDs, all three drugs proved safe in these studies, despite the fact that aspirin and ibuprofen were given in doses equal to or higher than those used for over‐the‐counter indications.Clinical Pharmacology and Therapeutics(1986)40,373–377; doi:10.1038/clpt.

ISSN:0009-9236    

DOI:10.1038/clpt.1986.193

年代:1986

数据来源: WILEY

摘要:

Two benzodiazepine hypnotics, triazolam, 0.25 mg, with a short elimination t1/2, and quazepam, 15 mg, with a long t1/2, were evaluated in 22‐night sleep laboratory studies. Quazepam improved sleep significantly during both short‐ and intermediate‐term use. Daytime sleepiness, which decreased with continued use, was the side effect most often associated with quazepam dosing. In contrast, triazolam dosing did not significantly improve any of the major sleep efficiency parameters, and there was a rapid development of tolerance for the drug's slight initial effectiveness. In addition, there were a number of behavioral side effects including amnesia, confusion, and disinhibition. Withdrawal of triazolam was associated with sleep and mood disturbances (rebound insomnia and rebound anxiety), whereas quazepam exerted carryover effectiveness. Thus the data in this study show that the 0.25 mg dose of triazolam, which is being prescribed increasingly, has a profile of side effects that is similar to that of the 0.5 mg dose.Clinical Pharmacology and Therapeutics(1986)40,378–386; doi:10.1038/clpt.

ISSN:0009-9236    

DOI:10.1038/clpt.1986.194

年代:1986

数据来源: WILEY

摘要:

The role of genetic polymorphism in the oxidative metabolism of metoprolol and debrisoquin was investigated in a population of 138 unrelated Nigerians. The debrisoquin/4‐hydroxydebrisoquin 0‐8 hour urinary ratio (D/HD) correlated significantly with the metoprolol/α‐hydroxymetoprolol 0–8 hour urinary ratio (M/HM) (rs= 0.54; P<0.001), the metoprolol/H 117‐04 [4‐(2‐hydroxy‐3‐isopropylaminopropoxy)‐phenylacetic acid] 0‐8 hour urinary ratio (M/Hl 17‐04) (rs= 0.42; P<0.001), and the plasma metoprolol concentration at 3 hours (rs= 0.48; P<0.01). Both the median D/HD and M/HM ratios were significantly higher in this population than in a previously studied population of white British subjects. According to criteria established in studies of white populations, only one subject, later identified as an Indian, would be classified unequivocally as a poor metabolizer of both metoprolol and debrisoquin. All the other subjects were black Africans. Bimodality in the frequency distribution of both the log10M/ HM and D/HD ratios was not apparent. The poor hydroxylation trait may, therefore, be present at a lower frequency than in whites, absent altogether, or obscured by other factors. In ethnic studies of drug metabolism each racial group should be examined separately for evidence of polymorphic metabolism and antimodes should not be extrapolated from one population to another.Clinical Pharmacology and Therapeutics(1986)40,387–394

ISSN:0009-9236    

DOI:10.1038/clpt.1986.195

年代:1986

数据来源: WILEY

摘要:

The use of ß‐adrenoceptor blocking drugs has been thought to impair physical performance. To test this statement, 12 patients with mild to moderate hypertension performed a submaximal exercise test during treatment with placebo and after 3 and 24 months of monotherapy with betaxolol, 20 to 40 mg daily. The resting heart rate and systolic and diastolic blood pressures were reduced after 3 months of treatment and the reduction was maintained 24 hours after the last dose at the 2‐year visit. A 12% to 14% reduction of exercise‐induced tachycardia was found, but blood pressure during exercise was reduced only in the patients with mild hypertension. However, in no patient did the working capacity decrease.Clinical Pharmacology and Therapeutics(1986)40,395–399; doi:10.1038/clpt

ISSN:0009-9236    

DOI:10.1038/clpt.1986.196

年代:1986

数据来源: WILEY

摘要:

A chronic‐dosing pharmacokinetic study was carried out in six healthy subjects to examine the potential for Cimetidine to reduce the CLRand CLHof triamterene. Blood and urine samples were collected frequently for 24 hours after dosing with triamterene alone (100 mg/day) for 4 days and concomitant Cimetidine (400 mg twice daily) for an additional 4 days. Cimetidine significantly reduced the clearance of triamterene by hydroxylation by 32% (P<0.016) and the CLRof triamterene by 28% (P<0.063), with no change in its protein binding. The CLRof the active sulfate conjugate of triamterene was not altered by Cimetidine. There was a reduced recovery of triamterene and its metabolites in urine after Cimetidine, suggesting a decreased absorption. These results are consistent with Cimetidine inhibiting cytochrome P‐450 enzymes in the liver and also competing with triamterene for renal tubular secretion. Despite the pharmacokinetic interaction, Cimetidine caused minimal alteration to the natriuretic and antikaliuretic effects of triamterene.Clinical Pharmacology and Therapeutics(1986)40,400–407; doi:10.1038/clpt.19

ISSN:0009-9236    

DOI:10.1038/clpt.1986.197

年代:1986

数据来源: WILEY

摘要:

The influence of a high‐protein meal as compared to fasting on the disposition of simultaneous intravenous and oral doses of propranolol, as well as on indocyanine green clearance, was examined in six normal subjects. The intravenous dose (0.1 mg/kg) was unlabeled propranolol and the oral dose (80 mg) was a stereospecifically deuterium‐labeled pseudoracemate of propranolol. Systemic clearance of propranolol increased 38%, from 1005 ± 57 to 1384 ±115 ml/min (mean ± SE; P<0.05) as a result of the meal, with no change in t1/2or apparent volume of distribution. A 12% decrease in oral clearance occurred with the meal but was not statistically significant (3717 ± 185 ml/min, fasting; 3245 ± 498 after meal), whereas bioavailability increased 67% (27.2% ± 1.7% fasting; 45.5% ± 4.3% after meal; P<0.01). Estimated hepatic blood flow, as measured by indocyanine green clearance, rose 34% 60 minutes after the meal (1719 ± 155 ml/min fasting; 2304 ± 218 ml/min after meal; P<0.02). A difference was observed in the oral clearance of the propranolol enantiomers in the fasting state, but this difference was unaffected by the meal. These alterations in propranolol disposition, as the result of a high‐protein meal, are consistent with a transient increase in hepatic blood flow.Clinical Pharmacology and Therapeutics(1986)40,408–414; doi:10.1

ISSN:0009-9236    

DOI:10.1038/clpt.1986.198

年代:1986

数据来源: WILEY

摘要:

We investigated hepatic microsomal enzyme activity by the one‐sample saliva test for antipyrine clearance determination in 35 homozygous, α1‐antitrypsin‐deficient outpatients with chronic pulmonary disease. Twenty‐five outpatients with chronic obstructive lung disease and comparable lung function impairment and 31 healthy volunteers served as controls. Antipyrine clearance did not differ significantly between the two groups of patients with pulmonary disease. However, the clearance was 18% lower in these two groups than in the healthy volunteers (P<0.01). Antipyrine clearance was lowest in patients with severe lung function impairment (P<0.01).Clinical Pharmacology and Therapeutics(1986)40,415–419; doi:10.1038/cl

ISSN:0009-9236    

DOI:10.1038/clpt.1986.199

年代:1986

数据来源: WILEY

摘要:

Ethanol and tobacco consumption are commonly associated. Both are risk factors for adverse cardiovascular events. To better understand the interactions, the influence of oral ethanol pretreatment (0.5 or 1.0 gm/kg over 60 minutes) on cardiovascular responses to and disposition kinetics of intravenous nicotine was studied in healthy volunteers. Ethanol increased heart rate, systolic blood pressure, and pressure‐rate product in a dose‐related manner. Nicotine had additive effects on heart rate and pressure‐rate product. It also decreased skin temperature, reflecting cutaneous vasoconstriction, but this effect was antagonized by ethanol. Ethanol did not affect metabolic clearance but increased CLRof nicotine by 25%. Additive cardiovascular effects of ethanol and nicotine could contribute to arrhythmias and sudden death in patients with coronary heart disease. It is unlikely that an effect of ethanol on nicotine metabolism is responsible for increased cigarette smoking while drinking ethanol.Clinical Pharmacology and Therapeutics(1986)40,420–424; doi:10.1038/clpt.

ISSN:0009-9236    

DOI:10.1038/clpt.1986.200

年代:1986

数据来源: WILEY

摘要:

The disposition of vancomycin was assessed in five patients receiving hemofiltration after intravenous dosing with an 18 mg/kg dose after a hemofiltration procedure. The serum concentration‐time profile was characterized before, during, and after the next hemofiltration procedure. The t1/2of vancomycin was 136.0 ± 27.2 hours (mean ± SD) before hemofiltration and 4.1 ± 1.2 during hemofiltration. Approximately 400 mg of vancomycin was recovered in the filtrate and the hemofiltration clearance was 152.6 ±21.5 ml/min. A significant relationship was observed between vancomycin clearance and ultrafiltration flow rate (r = 0.9914). A marked rebound in vancomycin serum concentration (52.4% ± 15.6%) was observed in all patients. Hemofiltration has a significant effect on the disposition of vancomycin. Because of the marked interpatient variability in elimination t1/2and the degree and time course of the rebound, an individualized approach to vancomycin therapy in this patient population is recommended.Clinical Pharmacology and Therapeutics(1986)40,425–429; doi:10.1038/clpt

ISSN:0009-9236    

DOI:10.1038/clpt.1986.201

年代:1986

数据来源: WILEY