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[老年患者舌下含服硝苯地平后血药浓度及其即时降压效果]

[Nifedipine level in the blood and its immediate hypotensive effect after its sublingual administration to aged patients].

作者信息

Kawecka-Jaszcz K, Grodzicki T, Skoczeń M, Czarnecka D, Gryglewska B, Dubiel J P, Kocemba J, Witek J

出版信息

Przegl Lek. 1989;46(2):311-5.

PMID:2772233
Abstract

In 28 aged patients (means = 73.1 years) with arterial hypertension nifedipine has been administered sublingually in a single dose of 20 mg and the hypotensive effect of that drug under the control of its concentration in the blood serum was evaluated. The nifedipine concentration was determined by the use of gas chromatography with electron capture detector. The mean drug concentration increased from 38.1 ng/ml to 82.3 ng/l during the 2nd hour of observation. After 3 hours the lowering of the nifedipine concentration and the decrease of its hypotensive effect was observed. After 15 min from the drug application the systolic pressure lowered by the average 22.1 mmHg whereas the diastolic pressure was 7.0 mmHg lower. The most significant pressure decrease (mean of systolic pressure 52.7 mmHg) 7.03 kPa and that of diastolic pressure 23.2 mmHg (3.1 kPa) occurred after 2 and 1.5 hours. The decrease of pressures after nifedipine correlated with the start-point value of systolic pressure. The frequency of the heart action in the whole group did not altered significantly, however, in individual cases both the acceleration of that action (34 per min) or acceleration (42 systoles per min) was noted. Slight typical side-effects were noted in 5 treated patients. A single-dose sublingual 20 mg nifedipine (Cordafen--Polfa) administration enabled in all the subjects the obtaining of therapeutic drug level in the blood and in the aged patients with hypertension may be regarded as efficacious antihypertensive treatment.

摘要

在28例老年患者(平均年龄73.1岁)的动脉高血压治疗中,舌下含服硝苯地平单剂量20mg,并在血清浓度监测下评估该药物的降压效果。硝苯地平浓度通过带有电子捕获检测器的气相色谱法测定。在观察的第2小时,平均药物浓度从38.1ng/ml升至82.3ng/l。3小时后,观察到硝苯地平浓度降低及其降压效果减弱。用药后15分钟,收缩压平均降低22.1mmHg,舒张压降低7.0mmHg。用药2小时和1.5小时后,压力下降最为显著(收缩压平均下降52.7mmHg,即7.03kPa;舒张压下降23.2mmHg,即3.1kPa)。硝苯地平用药后的压力下降与收缩压起始值相关。全组患者的心率无显著改变,但个别病例出现了心率加快(每分钟加快34次)或心动过速(每分钟加快42次)。5例接受治疗的患者出现了轻微的典型副作用。单剂量舌下含服20mg硝苯地平(Cordafen - Polfa)使所有受试者血液中达到治疗药物水平,对于老年高血压患者可视为有效的降压治疗。

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