Elliott H L, Thomson A H, Bryson S M
Eur J Clin Pharmacol. 1986;30(3):345-7. doi: 10.1007/BF00541541.
In the acute phase of myocardial infarction it is recognized that serum disopyramide concentrations may be lower than expected. This has generally been attributed to reduced oral bioavailability. This report describes data obtained routinely from 6 patients with acute myocardial infarction and cardiac dysrhythmias treated initially with intravenous disopyramide. Serum disopyramide concentrations were consistently lower than expected, on average by 2.6 micrograms/ml. This was interpreted as being due to relatively high drug clearance, calculated as 6.7 +/- 1.5 l/h, compared to expected values of 3-4 l/h. Dosage schedules determined on the basis of the acute phase pharmacokinetics subsequently produced higher than predicted concentrations at later times on average by 2.8 micrograms/ml. Clearance at this time was calculated to be 3.1 +/- 0.6 l/h. Thus even with intravenous disopyramide therapy there are problems with changing pharmacokinetic parameters after myocardial infarction.
在心肌梗死急性期，人们认识到血清丙吡胺浓度可能低于预期。这通常归因于口服生物利用度降低。本报告描述了从6例急性心肌梗死并伴有心律失常的患者中常规获得的数据，这些患者最初接受静脉注射丙吡胺治疗。血清丙吡胺浓度始终低于预期，平均低2.6微克/毫升。这被解释为是由于药物清除率相对较高，计算得出为6.7±1.5升/小时，而预期值为3 - 4升/小时。基于急性期药代动力学确定的给药方案随后在后期产生的浓度高于预测值，平均高2.8微克/毫升。此时计算得出的清除率为3.1±0.6升/小时。因此，即使采用静脉注射丙吡胺治疗，心肌梗死后药代动力学参数的变化仍存在问题。
