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  • 1
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Experimental Cell Research 73 (1972), S. 41-48 
    ISSN: 0014-4827
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Journal of Chromatography B: Biomedical Sciences and Applications 228 (1982), S. 409-412 
    ISSN: 0378-4347
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 52 (1997), S. 387-390 
    ISSN: 1432-1041
    Keywords: Key words CYP2D6 ; Fluoxetine ; Maprotiline; CYP2C19 ; CYP3A4 ; CYP1A2 ; antide-pressant therapy ; ultra-rapid metaboliser
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Case: We are reporting about a patient with major depression who failed to respond to pharmacotherapy due to ultra-rapid metabolism of maprotiline. Under daily oral doses of 175 mg maprotiline, the patient's metabolic ratio (MR) for maprotiline in plasma was 9.2 (expected MRp: 2.4) and the clearance of maprotiline (CLM) was 4190 ml · min−1 (expected CLM = 1220 in extensive metabolisers of CYP2D6). Results: The patient's MRurine for sparteine was 0.5, which is within the range for extensive metabolisers of CYP2D6. Genotyping did not show a duplication of the CYP2D6L allele. The patient's caffeine half-life was 10 h, thus, precluding ultra-rapid metabolism for CYP1A2. The therapeutic regimen was changed to coadministration of 200 mg maprotiline and 20 mg fluoxetine once per day in order to inhibit metabolism via CYP2D6. Subsequently, MRp of maprotiline (4.9) and CLM were reduced (1900 ml · min−1; expected CLM in poor metabolisers: of CYP2D6 364). This regimen improved the clinical outcome of the underlying disease. Conclusion: We conclude that for the non-response seen with maprotiline, P450 isozymes other than CYP2D6 or CYP1A2 are responsible. As CYP2C19 is involved in the metabolism of a number of tricyclic antidepressants it may be a candidate for ultra-rapid metabolism in this patient.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1041
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: The pharmacokinetics and pharma-codynamics of the angiotensin (AT) II receptor, AT1-subtype, antagonist candesartan were investigated in a dose-finding study in 232 patients of either gender, aged 28–69 years and weighing 54–110 kg. The study was a double-blind, placebo-controlled trial in which oral doses of 2, 4, 8, 12 and 16 mg once daily were given as the pro-drug candesartan cilexetil from day 0 to day 28. Results: The population pharmacokinetics of candesartan could be best described by a two-compartment body model, parameterized in terms of clearance (14.1 l · h−1), central volume of distribution (118 l), peripheral volume (272 l) and intercompartmental clearance (15.4 l · h−1). From these model parameters, a cumulation half-life (t1/2,β) of 29 h was derived. Age and weight were influencing factors for the distribution and elimination of the drug. Systolic and diastolic blood pressure were lowered by the treatment in a dose-dependent fashion. The maximum effect of each dose was reached after repeated administration. The link between plasma concentrations and effect could be described by a linear model when trough concentrations and blood pressure, measured at the same time, were modelled. In this model, the time dependence is implicitly handled as the trough concentrations increased during repeated administration. After treatment with the highest dose used in the trial (16 mg), the population estimate for the diastolic blood pressure was reduced from 103.2 mmHg (pre-dose day 0) to 93.3 mmHg (on day 29) and the systolic blood pressure from 154.6 mmHg (pre-dose day 0) to 137.9 mmHg (on day 29). None of the covariates (age, weight, gender) had an influence on the concentration–effect relationship.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 6 (1973), S. 268-270 
    ISSN: 1432-1041
    Keywords: Diphenhydramine ; orphenadrine ; gas-liquid chromatography ; N-selective detector ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary A method is described for the assay of nanogram quantities of diphenhydramine and orphenadrine in human plasma. The procedure employs gas-liquid chromatography and a high sensitivity nitrogen detector. It has been used to assay diphenhydramine in plasma after oral administration of therapeutic doses.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 6 (1973), S. 133-136 
    ISSN: 1432-1041
    Keywords: Ethambutol ; CSF ; protein binding ; tuberculous meningitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Using a chemical assay method, which had been confirmed by chromatography, the concentration of ethambutol in CSF and serum was determined in 13 patients. Ethambutol entered the CSF, even at low serum concentrations. For serum levels greater than 1 µg/ml, a linear correlation was found between the serum and CSF concentrations. In order to reach therapeutic levels in CSF (more than 1 µg/ml) the serum concentration should be at least 2 µg/ml, corresponding to a daily dose of about 20–30 mg/kg. The serum protein binding of ethambutol varied from 39.3% at a serum level of 0.61 µg/ml, to 8.3% at a serum level of 4.82 µg/ml.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 45 (1993), S. 275-277 
    ISSN: 1432-1041
    Keywords: Fenoterol ; Pregnancy ; pharmacokinetics ; premature labour
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The pharmacokinetics of the β2-adrenergic drug fenoterol, which is used as a tocolytic agent in pregnancy, has been investigated in pregnant (n=9) and nonpregnant (n=5) women during a constant rate intravenous infusion. Clearance and mean residence time were found to be 1990 (1879/2220; Median, Q25/Q75) ml/min and 9.2 (8.0/14.0) min in the pregnant and 2126 (1915/2130) ml/min and 16.6 (16.5/32.1) min in the nonpregnant women, respectively. In addition, fenoterol clearance was estimated in 88 women from a single blood sample collected at steady state during IV therapy and the effect of gestational age on clearance was studied. Clearance displayed large inter-individual variation. There was no apparent correlation between clearance and gestational age. We conclude that there is no need to adjust the dose on pharmacokinetic grounds in the course of pregnancy.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 45 (1993), S. 1-7 
    ISSN: 1432-1041
    Keywords: Good clinical practice ; therapeutic equivalence ; bioequivalence ; statistical analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Absolute proof of efficacy can only be given by placebo controlled trials. It is, however, important to classify a drug within the spectrum of existing therapeutic alternatives and, where effective treatment is available, it may be imperative due to ethical considerations to demonstrate that one drug is as effective as another. The issue of therapeutic equivalence trials is discussed along the lines of the important items which should be defined in the protocol: a) the target parameter, which is the primary endpoint of the trial, b) the reference drug, which should be selected with respect to efficacy (superior to others), and safety (largest amount of data), c) the acceptance range, which depends on the primary endpoint, and its implication for the clinical endpoints of morbidity and mortality (the conventional acceptance range for bioequivalence trials does not apply), and d) the statistical procedures, which must take into consideration the unsuitability of the conventional power approach for confirming equivalence. In an equivalence trial, compared to those that are placebo-controlled, the proof that one drug is as effective as another relies much more upon the quality of conduct of the study according to Good Clinical Practice.
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  • 9
    ISSN: 1432-1041
    Keywords: Key words Fenoterol ; Tachycardia ; Hypokalaemia; β2-adrenoceptor agonist ; NONMEM ; pharmacokinetic/pharmacodynamic modeling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: To analyse fenoterol-induced tachycardia and hypokalaemia, the most important and most frequent adverse effects of tocolytic therapy with β2-adrenoceptor agonists in females of childbearing age. Methods: The study was performed as a double blind, randomised, placebo controlled, cross over trial. Seven healthy women aged 22–38 y, received intravenous infusions of fenoterol at 3 different rates within the therapeutic range for tocolysis (0.5,1.0, and 2.0 μg⋅min−1) and placebo. The time courses of the plasma concentrations of fenoterol and potassium, and the heart rate were analysed with mixed effects pharmacokinetic-pharmacodynamic (PKPD) modeling using NONMEM. Results: The plasma concentration-time course followed a linear two compartment model. Fenoterol-induced tachycardia was described by a linear concentration-effect model with baseline. The estimated baseline and slope parameters were 78 beats⋅min−1 and 0.032 beats⋅min−1⋅μg−1⋅l, respectively. Fenoterol-induced hypokalaemia could be described by a physiological indirect response model including feedback; the Estimated basal plasma potassium concentration was 3.93 mmol⋅l−1 and the slope factor for the fenoterol-induced relative increase in the efflux of potassium from the extracellular space was 6.22*10−4 ng⋅l−1. Conclusion: The estimated population parameters permitted calculation of the expected time course of tachycardia and hypokalaemia in women after the initiation of tocolysis with fenoterol over the clinically relevant concentration range, and prediction of its variability. Based on simulation, our model predicted that a continous infusion of 2.0 μg⋅min−1 (highest rate examined) would increase heart rate to 113 beats⋅min−1 at steady state and lower the plasma potassium concentration to 2.77 mmol⋅l−1 1.5 h after beginning the infusion. Thereafter, the plasma potassium concentration would slowly return to normal.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 7 (1974), S. 393-395 
    ISSN: 1432-1041
    Keywords: Diphenhydramine ; antihistamine ; plasma level ; gas chromatographic assay ; psychometric tests
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Plasma levels of diphenhydramine were determined by gas chromatography up to 34 h after oral administration of 50 mg to 6 healthy men. The antihistaminic activity of diphenhydramine was assessed by reduction in the area of wheals induced by intradermal injection of 5 µg histamine hydrochloride. The plasma level of drug and reduction in size of wheal were related in 4 of the 6 subjects, but not in the other two although all six had similar concentrations of the drug in plasma. In two experiments designed to measure psychometric parameters (number facility and a time evaluation test), no relationship was found between plasma levels of diphenhydramine and the performances of the subjects.
    Type of Medium: Electronic Resource
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