Pharmacokinetics of Omeprazole Given by Continuous Intravenous Infusion to Patients with Varying Degrees of Hepatic Dysfunction
| Autor: | Josep M. Piqué, Faust Feu, Gloria de Prada, Kerstin Röhss, Göran Hasselgren |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis medicine.drug_class Metabolite Population Proton-pump inhibitor Pharmacology Gastroenterology Drug Administration Schedule chemistry.chemical_compound Bolus (medicine) Pharmacokinetics Internal medicine Confidence Intervals medicine Humans Pharmacology (medical) Infusions Intravenous education Omeprazole Aged education.field_of_study Liver Diseases Middle Aged medicine.disease chemistry Area Under Curve Toxicity Female Follow-Up Studies medicine.drug |
| Zdroj: | Clinical Pharmacokinetics. 41:999-1004 |
| ISSN: | 0312-5963 |
| DOI: | 10.2165/00003088-200241120-00004 |
| Popis: | To examine the pharmacokinetics of omeprazole during intravenous infusion in patients with varying degrees of liver dysfunction (Child-Pugh categories A to C).Nonblinded single-period study.Thirteen patients, five males and eight females with a mean age of 59 years and proven hepatic cirrhosis, classified according to Child-Pugh criteria as A (n = 5), B (n = 4) or C (n = 4).Each patient received an 80mg bolus of omeprazole over 30 minutes followed by a continuous infusion of 8 mg/h for 47.5 hours. Blood samples were taken frequently throughout the infusion and during the subsequent 24-hour washout period for determination of omeprazole and its metabolites. Laboratory screening was also performed at the start of the study, after 72 hours and at the 14 day follow-up visit.Data were evaluable for 12 patients. For omeprazole, the mean total area under the plasma concentration-time curve (AUC) was 286.5 micromol x h/L, peak plasma concentration was 14.9 micromol/L and terminal elimination half-life was 4.1 hours; these values were higher than those observed historically in control patient populations. Concentrations of the metabolite omeprazole sulphone were also increased, but there was a decrease in concentrations of hydroxy-omeprazole. Deviations from normal values increased with increasing disease severity for all parameters. For example, in patients with liver dysfunction of Child-Pugh categories A, B and C, AUC(48 )was 240.8, 280.4 and 323.3 micromol x h/L compared with 151.3 micromol x h/L in the historical control population. Despite its altered pharmacokinetics, omeprazole was not associated with any serious or untoward effects.Exposure to omeprazole following intravenous administration was higher in patients with liver dysfunction than in the normal population. However, even in patients with severely impaired liver function, the omeprazole plasma concentration did not change by more than 100% and the drug was well tolerated. |
| Databáze: | OpenAIRE |
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