Data/hora: 08/06/2024 15:33:23

Provedor de dados: | Brazilian Journal of Medical and Biological Research
País: | Brazil
Título: | Cardiopulmonary bypass alters the pharmacokinetics of propranolol in patients undergoing cardiac surgery
Autores: | Carmona,M.J.C.; Malbouisson,L.M.S.; Pereira,V.A.; Bertoline,M.A.; Omosako,C.E.K.; Le Bihan,K.B.; Auler Jr.,J.O.C.; Santos,S.R.C.J.
Data: | 2005-05-01
Ano: | 2005
Palavras-chave: | Propranolol; Pharmacokinetics; Cardiopulmonary bypass.
Resumo: | The pharmacokinetics of propranolol may be altered by hypothermic cardiopulmonary bypass (CPB), resulting in unpredictable postoperative hemodynamic responses to usual doses. The objective of the present study was to investigate the pharmacokinetics of propranolol in patients undergoing coronary artery bypass grafting (CABG) by CPB under moderate hypothermia. We evaluated 11 patients, 4 women and 7 men (mean age 57 ± 8 years, mean weight 75.4 ± 11.9 kg and mean body surface area 1.83 ± 0.19 m²), receiving propranolol before surgery (80-240 mg a day) and postoperatively (10 mg a day). Plasma propranolol levels were measured before and after CPB by high-performance liquid chromatography. Pharmacokinetic Solutions 2.0 software was used to estimate the pharmacokinetic parameters after administration of the drug pre- and postoperatively. There was an increase of biological half-life from 4.5 (95% CI = 3.9-6.9) to 10.6 h (95% CI = 8.2-14.7; P &lt; 0.01) and an increase in volume of distribution from 4.9 (95% CI = 3.2-14.3) to 8.3 l/kg (95% CI = 6.5-32.1; P &lt; 0.05), while total clearance remained unchanged 9.2 (95% CI = 7.7-24.6) vs 10.7 ml min-1 kg-1 (95% CI = 7.7-26.6; NS) after surgery. In conclusion, increases in drug distribution could be explained in part by hemodilution during CPB. On the other hand, the increase of biological half-life can be attributed to changes in hepatic metabolism induced by CPB under moderate hypothermia. These alterations in the pharmacokinetics of propranolol after CABG with hypothermic CPB might induce a greater myocardial depression in response to propranolol than would be expected with an equivalent dose during the postoperative period.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2005000500008
Editor: | Associação Brasileira de Divulgação Científica
Relação: | 10.1590/S0100-879X2005000500008
Formato: | text/html
Fonte: | Brazilian Journal of Medical and Biological Research  v.38 n.5 2005
Fonte: | info:eu-repo/semantics/openAccess