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替索沙坦与阿替洛尔在1级和2级原发性高血压患者中潜在药物相互作用的药代动力学和药效学研究。

A pharmacokinetic and pharmacodynamic study of the potential drug interaction between tasosartan and atenolol in patients with stage 1 and 2 essential hypertension.

作者信息

Andrawis N S, Battle M M, Klamerus K J, Burghart P H, Neefe L, Weinryb I, Mayer P, Abernethy D R

机构信息

Department of Medicine and Pharmacology, Georgetown University Medical Center, Washington, D.C., USA.

出版信息

J Clin Pharmacol. 2000 Mar;40(3):231-41. doi: 10.1177/00912700022008892.

Abstract

The primary objective of this study was to evaluate the pharmacokinetics (PK) and pharmacodynamics (PD) of tasosartan and atenolol administered alone and concomitantly under steady-state conditions in 17 patients ages 18 to 65 years diagnosed with stage 1 to 2 essential hypertension. After a 3- to 14-day qualification period, all patients received placebo tasosartan on days--1 through 5 and 25 through 34, atenolol alone (50 mg) on days 1 through 5, atenolol (50 mg) + tasosartan (50 mg) on days 6 through 19, and tasosartan (50 mg) alone on days 20 through 24. A PK and PD evaluation of atenolol alone was performed on study day 5. On study day 19, PK and PD of both tasosartan and atenolol were assessed. PK and PD evaluation for tasosartan alone was assessed on study day 24. The coadministration of atenolol + tasosartan did not affect the pharmacokinetics of tasosartan, its major metabolite (enoltasosartan), or atenolol when compared with tasosartan or atenolol administered separately. For area under the change in diastolic blood pressure curve, the reduction was significantly greater after tasosartan + atenolol compared with that after atenolol alone (336 +/- 85 and 190 +/- 71 mmHg.24 h; p < 0.05 for combination and atenolol alone, respectively; mean +/- SEM). Combination therapy also caused a maximal reduction in diastolic blood pressure that is significantly more than with monotherapy with atenolol (-27 +/- 2 mmHg and -20 +/- 2 mmHg, respectively, p < 0.05). The additive effects of tasosartan and atenolol in decreasing diastolic blood pressure may provide a rationale for combination antihypertensive therapy.

摘要

本研究的主要目的是评估在17例年龄为18至65岁、诊断为1至2期原发性高血压的患者中,在稳态条件下单独及联合给予他索沙坦和阿替洛尔后的药代动力学(PK)和药效动力学(PD)。经过3至14天的资格期后,所有患者在第 -1天至第5天和第25天至第34天接受安慰剂他索沙坦,在第1天至第5天单独接受阿替洛尔(50mg),在第6天至第19天接受阿替洛尔(50mg)+他索沙坦(50mg),在第20天至第24天单独接受他索沙坦(50mg)。在研究第5天对单独使用阿替洛尔进行PK和PD评估。在研究第19天,评估他索沙坦和阿替洛尔的PK和PD。在研究第24天评估单独使用他索沙坦的PK和PD。与单独给予他索沙坦或阿替洛尔相比,阿替洛尔+他索沙坦的联合给药不影响他索沙坦、其主要代谢物(烯醇他索沙坦)或阿替洛尔的药代动力学。对于舒张压曲线变化下的面积,与单独使用阿替洛尔后相比,他索沙坦+阿替洛尔后降低幅度明显更大(分别为336±85和190±71mmHg·24h;联合用药和单独使用阿替洛尔分别为p<0.05;均值±标准误)。联合治疗还导致舒张压的最大降低幅度明显大于阿替洛尔单药治疗(分别为-27±2mmHg和-20±2mmHg,p<0.05)。他索沙坦和阿替洛尔在降低舒张压方面的相加作用可能为联合抗高血压治疗提供理论依据。

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