摘要:

The potential interaction between lithium and angiotensin-converting enzyme (ACE) inhibitors was investigated in a retrospective, longitudinal, case-control study of 20 hypertensive patients previously stabilized on lithium therapy. The objective of the study was to determine the impact of ACE inhibition on steady-state lithium concentrations and to evaluate the potential association of altered lithium clearance with age, renal function, and electrolyte balance. After initiation of the ACE inhibitor, steady-state lithium concentrations increased by 36.1%, lithium clearance was reduced by 25.5% (p < 0.0001), and four patients presented with symptoms suggestive of lithium toxicity. Significant bivariate correlations were observed for lithium clearance change and age (r = -0.45; p < 0.05) and for lithium clearance change and serum creatinine (r = -0.52; p < 0.02). Multiple regression analysis indicated that 25% of the change in lithium clearance was associated with a change in serum creatinine. This percentage was increased to 35% by the inclusion of age in the regression model. None of the other variables (age, height, weight, or change in serum sodium/potassium) made a significant contribution to this model. The authors concluded that a clinically important increase in lithium concentrations can occur in patients started on ACE inhibitor therapy. As elderly patients may be uniquely predisposed to this interaction, avoidance of this medication combination in older populations should be considered. (J Clin Psychopharmacol 1996;16:68-71).

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This is a descriptive report on the relationship between the pharmacokinetics and pharmacodynamics of d-amphetamine in healthy, normal volunteers. Six men, aged 22 to 31, attended two experimental sessions during which they received single oral doses of 20 mg of d-amphetamine. Plasma levels of drug and measures of drug effect were collected predrug and at regular intervals for 24 hours after drug administration. Plasma drug levels peaked at 4 hours and remained at detectable levels for 24 hours after drug administration. Subjective ratings, including "feel drug" and "feel high" peaked at 1 1/2 to 2 hours and returned to baseline levels by 3 to 4 hours. Evaluation of phase plots (i.e., drug effect vs. drug concentration) indicated that acute tolerance developed to the subjective but not to the cardiopressor effects of d-amphetamine. This finding implies that individuals who repeatedly administer the drug to maintain certain levels of subjective effects may increase plasma drug levels and physiologic effects to toxic levels. (J Clin Psychopharmacol 1996;16:72-76).

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0271-0749    

出版商:OVID    

年代:1996

数据来源: OVID