Zhou H H, Whelan E, Wood A J
Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-6602.
Br J Clin Pharmacol. 1992 Jan;33(1):121-3. doi: 10.1111/j.1365-2125.1992.tb04012.x.
The elderly are more resistant to the effects of propranolol than the young. To determine whether the decreased sensitivity in the elderly could be due to stereoselective alteration in propranolol metabolism, we investigated the effect of age on the oral clearance of (-)- and (+)-propranolol. Six young (aged 24-32, mean 27.3 +/- 1.3 years) and six elderly (65-80, mean 71.3 +/- 2.7 years) white male volunteers were given a single 80 mg oral dose of racemic propranolol. The mean peak plasma concentrations of both (+)- and (-)-propranolol were significantly higher (P less than 0.05) in the elderly (105.7 +/- 19.7 and 165.0 +/- 29.7 nmol l-1) compared with the young subjects (68.6 +/- 10.1 and 115.7 +/- 18.1 nmol l-1). The oral clearances of both (+)- and (-)-propranolol were significantly higher (P less than 0.05) in the young (6933 +/- 598 and 4554 +/- 372 ml min-1) than in the elderly (4548 +/- 712 and 2941 +/- 473 ml min-1). Age had no effect on the relative concentration of the two isomers. Thus, the ratio of (+)-propranolol to (-)-propranolol was 0.67 +/- 0.05 in the young compared with 0.65 +/- 0.02 in the elderly.
老年人比年轻人对普萘洛尔的作用更具耐受性。为了确定老年人敏感性降低是否可能是由于普萘洛尔代谢的立体选择性改变所致,我们研究了年龄对(-)-和(+)-普萘洛尔口服清除率的影响。六名年轻(年龄24 - 32岁,平均27.3±1.3岁)和六名老年(65 - 80岁,平均71.3±2.7岁)的白人男性志愿者口服了单次80mg的消旋普萘洛尔。与年轻受试者(68.6±10.1和115.7±18.1nmol l-1)相比,老年人中(+)-和(-)-普萘洛尔的平均血浆峰浓度显著更高(P<0.05)(105.7±19.7和165.0±29.7nmol l-1)。年轻受试者中(+)-和(-)-普萘洛尔的口服清除率(6933±598和4554±372ml min-1)显著高于老年人(4548±712和2941±473ml min-1)(P<0.05)。年龄对两种异构体的相对浓度没有影响。因此,年轻受试者中(+)-普萘洛尔与(-)-普萘洛尔的比值为0.67±0.05,而老年人中为0.65±0.02。