The Association of Age and Frailty with the Pharmacokinetics and Pharmacodynamics of Metoclopramide
| Autor: | Alan V. Boddy, Hilary Wynne, K. W. Woodhouse, Catherine Yelland, L. H. Cope, D. N. Bateman |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Male Aging Metoclopramide Metabolic Clearance Rate Frail Elderly Sedation Administration Oral Akathisia law.invention Randomized controlled trial Pharmacokinetics Reference Values law Oral administration Humans Medicine Infusions Intravenous Aged Neurologic Examination business.industry Dopamine antagonist General Medicine Pharmacodynamics Anesthesia Female Geriatrics and Gerontology medicine.symptom business medicine.drug |
| Zdroj: | Age and Ageing. 22:354-359 |
| ISSN: | 1468-2834 0002-0729 |
| DOI: | 10.1093/ageing/22.5.354 |
| Popis: | We have investigated the association of age and frailty with the pharmacokinetics and pharmacodynamics of the conjugated drug, metoclopramide. Six healthy young, six healthy elderly (> 65 years), and six frail elderly (> 65 years) subjects were studied on two occasions, receiving 10 mg metoclopramide by intravenous bolus and orally, in random order. Blood and urine were collected for measurement of pharmacokinetic parameters. Liver volume was measured by ultrasound. Sedation and contentment were self-recorded on visual analogue scales. Liver volume was not significantly different in the three groups, nor was bio-availability of metoclopramide. Clearance was similar in the young and fit elderly but reduced in the frail elderly subjects when compared with the young (p < 0.05), both when expressed in absolute terms and per unit liver volume. There were no differences in percentages cleared as the free drug or as the sulphate or glucuronide metabolite within or between groups, suggesting that frailty can produce a general impairment of conjugation pathways. The frail elderly subjects reported more sedation after intravenous dosage than the other subjects, whilst only young subjects reported akathisia. This did not relate to pharmacokinetic differences and seemed therefore to reflect associated pharmacodynamic changes in specific receptor or target sites. |
| Databáze: | OpenAIRE |
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