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健康志愿者口服秋水仙碱的零级吸收和线性处置

Zero-order absorption and linear disposition of oral colchicine in healthy volunteers.

作者信息

Thomas G, Girre C, Scherrmann J M, Francheteau P, Steimer J L

机构信息

Department of Clinical Pharmacology, Hôpital Fernand Widal, Paris, France.

出版信息

Eur J Clin Pharmacol. 1989;37(1):79-84. doi: 10.1007/BF00609430.

DOI:10.1007/BF00609430
PMID:2591469
Abstract

The pharmacokinetics of colchicine has been studied in nine healthy male volunteers after oral doses of 0.5, 1, and 1.5 mg as tablets. Plasma and urine samples were collected over 48 h and analysed for colchicine by radioimmunoassay. Individual colchicine concentration profiles in plasma and urine were well described by a two-compartment open model with zero-order input. Considering the absorption variables as specific to each experiment, the lag time (0-0.35 h) and duration (0.39-2.38 h) of absorption were found to be independent of dose, while the zero-order rate constant of absorption (k0) increased linearly with dose. Disposition variables were taken as common to the three experiments, except in six subjects in whom renal excretion varied significantly across experiments in a dose-independent manner. For seven subjects the terminal half-life was 19.4 h, the oral apparent volume of distribution at steady-state (Vss/f) was 691 l, and the oral systemic clearance (CL/f) was 33.1 l.h-1. In the two other subjects, the values were unreliable, but the estimated terminal half-life was greater than 48 h, Vss/f ranged from 1690 to 3480 l, and CL/f was in the range of the other subjects in 1 subject, and it was about 15 l.h-1 in the other. In the latter subject, these estimates, together with the observation that plasma concentration reached a plateau at 2 to 5 h after ingestion, suggest enterohepatic cycling of colchicine. Overall, the disposition of colchicine was linear in the dose range 0.5-1.5 mg, with a long terminal half-life, and absorption obeyed zero-order kinetics, with k0 proportional to dose.

摘要

已对9名健康男性志愿者口服0.5毫克、1毫克和1.5毫克片剂形式的秋水仙碱后的药代动力学进行了研究。在48小时内采集血浆和尿液样本,并通过放射免疫分析法分析秋水仙碱。血浆和尿液中个体秋水仙碱浓度曲线可用具有零级输入的二室开放模型很好地描述。将吸收变量视为每个实验所特有的,发现吸收的滞后时间(0 - 0.35小时)和持续时间(0.39 - 2.38小时)与剂量无关,而吸收的零级速率常数(k0)随剂量呈线性增加。处置变量被视为三个实验所共有的,除了6名受试者,其肾脏排泄在不同实验中以剂量无关的方式有显著变化。对于7名受试者,终末半衰期为19.4小时,稳态时口服表观分布容积(Vss/f)为691升,口服全身清除率(CL/f)为33.1升/小时。在另外两名受试者中,这些值不可靠,但估计的终末半衰期大于48小时,Vss/f在1690至3480升之间,一名受试者的CL/f在其他受试者范围内,另一名受试者约为15升/小时。在后者受试者中,这些估计值以及摄入后2至5小时血浆浓度达到平台期的观察结果表明秋水仙碱存在肠肝循环。总体而言,在0.5 - 1.5毫克的剂量范围内,秋水仙碱的处置呈线性,终末半衰期长,吸收遵循零级动力学,k0与剂量成正比。

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本文引用的文献

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Colchicine kinetics in patients with familial Mediterranean fever.家族性地中海热患者的秋水仙碱动力学
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CYP3A4/P-糖蛋白抑制剂相关秋水仙碱中毒模拟感染性休克。
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Case Report: Colchicine Toxicokinetic Analysis in a Poisoned Child Requiring Extracorporeal Life Support.病例报告:一名需要体外生命支持的中毒儿童的秋水仙碱毒代动力学分析
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Colchicine for the treatment of COVID-19 patients: efficacy, safety, and model informed dosage regimens.秋水仙碱治疗 COVID-19 患者:疗效、安全性和基于模型的剂量方案。
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Comparison of the efficacy of once- and twice-daily colchicine dosage in pediatric patients with familial Mediterranean fever--a randomized controlled noninferiority trial.儿童家族性地中海热患者每日一次与每日两次秋水仙碱剂量的疗效比较——一项随机对照非劣效性试验。
Arthritis Res Ther. 2016 Apr 7;18:85. doi: 10.1186/s13075-016-0980-7.
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Colchicine suppresses neutrophil superoxide production in a murine model of gouty arthritis: a rationale for use of low-dose colchicine.秋水仙碱在痛风性关节炎小鼠模型中抑制中性粒细胞超氧化物生成:低剂量秋水仙碱应用的理论依据。
Br J Pharmacol. 2008 Mar;153(6):1288-95. doi: 10.1038/bjp.2008.20. Epub 2008 Feb 11.
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Pharmacokinetics and absolute bioavailability of colchicine after i.v. and oral administration in healthy human volunteers and elderly subjects.秋水仙碱在健康志愿者和老年受试者中静脉注射及口服给药后的药代动力学和绝对生物利用度。
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Colchicine plasma levels. Implications as to pharmacology and mechanism of action.秋水仙碱血浆水平。对药理学及作用机制的启示。
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Plasma levels of colchicine after oral administration of a single dose.单次口服秋水仙碱后的血浆水平。
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Colchicine therapy for familial mediterranean fever. A double-blind trial.秋水仙碱治疗家族性地中海热。一项双盲试验。
N Engl J Med. 1974 Oct 31;291(18):934-7. doi: 10.1056/NEJM197410312911804.
9
A prospective trial of colchicine for primary biliary cirrhosis.秋水仙碱治疗原发性胆汁性肝硬化的前瞻性试验。
N Engl J Med. 1986 Dec 4;315(23):1448-54. doi: 10.1056/NEJM198612043152304.
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Colchicine in the treatment of cirrhosis of the liver.秋水仙碱治疗肝硬化
N Engl J Med. 1988 Jun 30;318(26):1709-13. doi: 10.1056/NEJM198806303182602.