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肾功能不全患者中异波帕胺的药代动力学

Pharmacokinetics of ibopamine in patients with renal impairment.

作者信息

Salvadeo A, Villa G, Bovio G, Pocchiari F, Pataccini R, Longo A, Ventresca G P

机构信息

Clinica del Lavoro Foundation, Department of Nephrology and Hemodialysis, Pavia, Italy.

出版信息

Int J Clin Pharmacol Ther Toxicol. 1988 Feb;26(2):98-104.

PMID:3410592
Abstract

The pharmacokinetics of a single oral dose of ibopamine 100 mg were studied in 15 patients with various degrees of chronic renal impairment (CRI) and in 8 subjects with normal renal function and of comparable age, taken as a control group. Plasma total (mainly conjugated) and free epinine and urinary metabolites (total epinine, HVA and DOPAC) were measured. Both total and free epinine were detectable at the earliest sampling time (15 min) in CRI patients and in normal subjects, thus confirming the promptness of ibopamine absorption. Free epinine pharmacokinetic parameters did not show any appreciable differences among the groups with different degrees of renal impairment, and no statistically significant differences were observed between normal subjects and CRI patients. Progressive renal impairment was associated with higher Cmax, longer t1/2 and larger AUC infinity of total epinine, and with reduced urinary elimination of total epinine and metabolites. Statistically significant differences (p less than 0.01) in Cmax/70 kg, t1/2, and AUC infinity/70 kg of total epinine were found between normal subjects and patients with mild renal impairment. No statistically significant differences were observed in 24-h urinary recoveries of both total epinine and metabolites between normal subjects and patients with mild renal impairment. No adverse effects were experienced during the course of the study. As the kinetics of ibopamine's active moiety, free epinine, were not apparently altered by chronic renal failure, adjustment of its dosage should not be necessary in renal diseases.

摘要

对15例不同程度慢性肾功能损害(CRI)患者及8例肾功能正常、年龄相仿的受试者(作为对照组),研究了单次口服100毫克异波帕明的药代动力学。测定了血浆总(主要是结合型)和游离表阿宁以及尿代谢产物(总表阿宁、高香草酸和3,4-二羟基苯乙酸)。在CRI患者和正常受试者最早的采样时间(15分钟)就可检测到总表阿宁和游离表阿宁,从而证实了异波帕明吸收迅速。游离表阿宁的药代动力学参数在不同程度肾功能损害的组间未显示出任何明显差异,正常受试者与CRI患者之间也未观察到统计学上的显著差异。进行性肾功能损害与总表阿宁的Cmax更高、t1/2更长和AUC无穷大更大相关,且与总表阿宁和代谢产物的尿排泄减少有关。正常受试者与轻度肾功能损害患者之间,总表阿宁的Cmax/70kg、t1/2和AUC无穷大/70kg存在统计学显著差异(p小于0.01)。正常受试者与轻度肾功能损害患者之间,总表阿宁和代谢产物的24小时尿回收率未观察到统计学显著差异。研究过程中未出现不良反应。由于慢性肾衰竭未明显改变异波帕明活性部分游离表阿宁的动力学,因此在肾脏疾病中可能无需调整其剂量。

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