Nortriptyline metabolism in chronic renal failure: metabolite elimination
| Autor: | Kelvin Lynn, Rachel Rosser, Robin Braithwalte, S. Dawling |
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| Rok vydání: | 1982 |
| Předmět: |
Adult
Male medicine.medical_specialty Chromatography Gas Adolescent medicine.medical_treatment Metabolite Urology Renal function Nortriptyline Pharmacology Excretion chemistry.chemical_compound Renal Dialysis medicine Humans Pharmacology (medical) Dialysis Aged Depressive Disorder business.industry Metabolism Middle Aged Kinetics chemistry Chronic renal failure Kidney Failure Chronic Female Hemodialysis business medicine.drug |
| Zdroj: | Clinical pharmacology and therapeutics. 32(3) |
| ISSN: | 0009-9236 |
| Popis: | Single oral dose kinetics of nortriptyline and of tis two major metabolites, conjugated and unconjugated 20-hydroxynortriptyline, were studied in eight healthy subjects and 15 patients with chronic renal failure, five of whom were being treated with hemodialysis. Nortriptyline kinetics were unaltered, but the elimination of the metabolites was reduced in both groups of patients. In chronic renal failure the excretion of nortriptyline metabolites appeared to be the rate-limiting step in nortriptyline elimination. Three depressed hemodialysis patients were treated with nortriptyline (75 mg at night) for 6 wk. The ratios of the steady-state plasma concentrations of unconjugated 10-hydroxynortriptyline to nortriptyline (0.74 to 2.30) were in the same range as those in a control group of depressed patients with adequate renal function (0.53 to 4.08) who were also receiving nortriptyline. Conjugated 10-hydroxynortriptyline in renal failure patients was slow to reach steady-state concentrations and these were 10 to 20 times as high as those of the control depressed patients. Conjugated 10-hydroxynortriptyline in dialysis fluid during treatment showed that a mean 43 +/- 7% (SD) of the dose was removed by a 10-hr dialysis. Dialysis clearance of conjugated 10-hydroxynortriptyline was 58 +/- 8 (SD) ml min-1, but nortriptyline and unconjugated 10-hydroxynortriptyline were not appreciably removed by dialysis. Hemodialysis is not likely to be of value in the management of acute nortriptyline poisoning. |
| Databáze: | OpenAIRE |
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