Download Cardiac Glycosides: Part II: Pharmacokinetics and Clinical by Liv Storstein (auth.), Professor Dr. med. Kurt Greeff (eds.) PDF

By Liv Storstein (auth.), Professor Dr. med. Kurt Greeff (eds.)

The pharmacokinetics of digitalis glycosides were the topic of intensive re­ view (IISALO, 1977; ARONSON, 1980; PERRIER et ai., 1977). examine on glycoside kinetics has improved at a speedy velocity, requiring carrying on with reevaluation of the country of our knowing of this challenge. the current article specializes in the impact of ailment states (renal, gastrointestinal, thyroid, and cardiac) at the absorption, distribution, and clearance of a couple of digitalis glycosides. facts is significantly reviewed, and interpreted with appreciate to attainable scientific implications. A. Renal Insufficiency I. Strophanthin Strophanthin disposition in renal failure has been evaluated in just experiences. KRAMER et ai. (1970) decided an removing half-life of 14 h in normals as com­ pared to 60 h in anuric sufferers. comparable effects have been said through BRASS and Pm­ LIPPS (1970) utilizing tritiated strophanthin. they discovered a half-life price of 18 h in fit contributors in comparison to sixty eight h in anuric sufferers. The findings sincerely in­ dicate that the removal half-life of strophanthin is lengthy in renal failure.

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Concentrations are expressed as logarithms. The broken lines indicate that plasma concentrations are measured in 10 x ng/ml (RIETBROCK et ai. 5 " Time (h) Fig. 3. , 1972). , 1977). p-Methyldigoxin has a six times higher penetration into the cerebrospinal fluid, where the ratio is 36 N. G. , 1977). , 1979). Drug concentrations in the cerebrospinal fluid do not necessarily reflect concentrations in various parts of the cerebrum. B. , 1973). A three-compartment model has been proposed by KRAMER et al.

1969) followed serum digitoxin concentration and renal and fecal excretion of digitoxin 72 h after injection of radioactively labeled drug. They studied a group of patients with mixed hepatic disease and found that these patients had lower serum digitoxin levels than control subjects. , 1976), four with cirrhosis, four with acute hepatitis, and two with extrahepatic cholestasis, a normal or increased clearance of digitoxin was found in most patients. One patient with concomitant renal disease had a marked prolongation of serum digitoxin half-life.

XI. Digitoxin metabolism in patients with impaired renal function. Clin. Pharmacol. Ther. : Studies on digitalis. IX. Some kinetic aspects of digitoxin metabolism. Clin. Pharmacol. Ther. : Studies on digitalis. XII. Kinetic pattern of digitoxin metabolism in patients with biliary fistulas. Clin. Pharmacol. Ther. : Digitoksin i klinisk bruk. T. norske Legeforen. : Pharmacokinetics and metabolism in patients with chronic active hepatitis. In: Digitoxin als Alternative in der Therapie der Herzinsuffizienz.

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