Schock pp 339-346 | Cite as

Der Einfluß von Herzinsuffizienz und kardiogenem Schock auf die Pharmakokinetik

  • G. Paumgartner
Part of the Handbuch der inneren Medizin book series (INNEREN, volume 9 / 2)

Zusammenfassung

Wenn man die Transportfunktion des Blutes für Pharmaka vor Augen hat, so verwundert es nicht, daß Schockzustände über eine verminderte Organ- bzw. Gewebsperfusion — nämlich eine Minderdurchblutung von Darm, Muskulatur, Fettgewebe, Leber und Niere — die Absorption, Verteilung und Elimination von Arzneimitteln beeinflussen können. Darüber hinaus können Schockzustände durch eine ungenügende Sauerstoffversorgung von Leber und Niere zu einer reversiblen Fuuktionseinschränkung oder einer irreversiblen Schädigung dieser Eliminationsorgane führen. Auf diese Weise können sie die Elimination von Pharmaka noch stärker und zeitlich über den eigentlichen Schockzustand hinaus beeinträchtigen (Abb. 1).

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Literatur

  1. Barr WH, Riegelmann S (1970) Intestinal drug absorption and metabolism. I. Comparison of methods and models to study physiological factors of in vitro and in vivo intestinal absorption. J Pharm Sci 59:154PubMedCrossRefGoogle Scholar
  2. Bax NDS, Tucker GT, Wood HF (1978) Does indocyanine green predict lidocaine requirements? N Engl J Med 299:662Google Scholar
  3. Benet LZ, Greither A, Meister W (1976) Gastrointestinal absorption of drugs in patients with cardiac failure. In: Benet LZ (ed) The effect of disease states on drug pharmacokinetics. American Pharmaceutical Association, Washington, p 33Google Scholar
  4. Benett WM (1979) Drug prescribing in renal failure. Drugs 17:111CrossRefGoogle Scholar
  5. Bynum TE, Jacobson ED (1975) Shock, intestinal ischemia, and digitalis. Circ Shock 2:235Google Scholar
  6. Crouthamel WG (1975) The effect of congestive heart failure on quinidine pharmacokinetics. Am Heart J 90:335–339PubMedCrossRefGoogle Scholar
  7. Crouthamel WG, Diamond L, Dittert LW, Doluisio JT (1975) Drug absorption VII: Influence of mesenteric blood flow on intestinal drug absorption in dogs. J Pharm Sci 64:664PubMedCrossRefGoogle Scholar
  8. Dettli L (1976) Drug dosage in renal disease. Clin Pharmacokinet 1:126PubMedCrossRefGoogle Scholar
  9. Ditlefsen EL (1957) Quinidine concentration in blood and excretion in urine following parenteral administration as related to congestive heart failure. Acta Med Scand 159:105PubMedCrossRefGoogle Scholar
  10. Evans EF, Proctor JD, Fratkin MJ, Velandia J, Wasserman AJ (1975) Blood flow in muscle groups and drug absorption. Clin Pharmacol Ther 17:44PubMedGoogle Scholar
  11. Fuchshofen-Röckel M, Heusler H, Hansen H, May E, Epping J, Richter E (1981) Lidokainkinetik und Plasmakonzentrationen bei Intensivpatienten. Kurzreferate der 13. Tagung der Deutschen und der Österr Gesellschaft für internist Intensivmedizin, Ludwigshafen 1981Google Scholar
  12. Hagemeijer F (1975) Absorption, half-life, and toxicity of oral aprindine in patients with acute myocardial infarction. Eur J Clin Pharmacol 9:21PubMedCrossRefGoogle Scholar
  13. Halpern SD, Hunt LM, Yagiela JA (1978) A comparison of intralingual and intravenous epinephrine before and during cardiovascular depression. Oral Surg 46:333PubMedCrossRefGoogle Scholar
  14. Koch-Weser J, Klein SW (1971) Procainamide dosage schedules, plasma concentrations, and clinical effects. JAMA 215:1454PubMedCrossRefGoogle Scholar
  15. Korhonen UR, Jounela AJ, Pakarinen AJ, Pentikainen PJ, Takkunen JT (1979) Pharmacokinetics of digoxin in patients with acute myocardial infarction. Am J Cardiol 44:1190PubMedCrossRefGoogle Scholar
  16. LeLorier J, Grenon D, Latour Y, Caillé G, Dumont G, Brosseau A, Solignac A (1977) Pharmacokinetics of lidocaine after intravenous infusion in uncomplicated myocardial infarction. Ann Intern Med 87:700PubMedGoogle Scholar
  17. Meier PJ (1982) Arzneimitteltherapie bei Leberkrankheiten. Schweiz Med Wochenschr 112:258PubMedGoogle Scholar
  18. Nies AS (1977) The effects of haemodynamic alterations on drug disposition. Haemodynamic drug interactions. Neth J Med 20:46PubMedGoogle Scholar
  19. Nitsch J, Steinbeck G, Lüderitz B (1981) Mexiletinspiegel bei Patienten mit ventrikulären Arrhythmien und Nieren-Leber- oder Herzinsuffizienz. Verh Dtsch Ges Inn Med 87:429Google Scholar
  20. Paumgartner G (1980) Der Einfluß von Lebererkrankungen auf Bioverfügbarkeit und Clearance von Medikamenten. Internist 21:718PubMedGoogle Scholar
  21. Pessayre D, Lebrec D, Descatoire V, Peignoux M, Benhamou JP (1978) Mechanism for reduced drug clearance in patients with cirrhosis. Gastroenterology 74:566PubMedGoogle Scholar
  22. Prescott LF (1978) Pharmacokinetic abnormalities in myocardial infarction. In: Sandoe E, Julian DG, Bell JW (eds) Management of ventricular tachycardia: Role of mexiletine. Excerpta Medica, Amsterdam, p 465Google Scholar
  23. Prescott LF, Adjepon-Yamoah KK, Talbot RG (1976) Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure. Br Med J 1:939PubMedCrossRefGoogle Scholar
  24. Richter E, Epping J, Fuchshofen-Röckel M, Heusler H, Zilly W (1980) Arzneimittelmetabolismus bei Patienten mit Lebererkrankungen. Leber Magen Darm 10:234PubMedGoogle Scholar
  25. Ritz R, Cavanilles J, Michaels S, Shubin H, Weil MH (1973) Disappearance of indocyanine green during circulatory shock. Surg Gynecol Obstet 136:57PubMedGoogle Scholar
  26. Roberts RK, Brauch RA, Desmond PV, Schenker S (1979) The influence of liver disease on drug disposition. Clin Gastroenterol 8:105PubMedGoogle Scholar
  27. Ronfeld RA (1982) Pharmacokinetics of new antiarrhythmic drugs. In: Harrison DC (ed) Cardiac arrhythmias. A decade of progress. Hall, Boston, p 135Google Scholar
  28. Schwartz ML, Meyer MB, Covino BG, Narang RM, Sethi V, Schwartz AJ, Kamp P (1974) Antiarrhythmic effectiveness of intramuscular lidocaine: influence of different injection sites. J Clin Pharmacol 14:77PubMedGoogle Scholar
  29. Stenson RE, Constantino RT, Harrison DC (1971) Interrelationships of hepatic blood flow, cardiac output, and blood levels of lidocain in man. Circulation 43:205PubMedGoogle Scholar
  30. Ther L, Winne D (1971) Drug absorption. Annu Rev Pharmacol 2:57CrossRefGoogle Scholar
  31. Thomson PD, Rowland M, Melmon KL (1971) The influence of heart failure, liver disease, and renal failure on the disposition of lidocaine in man. Am Heart J 82:417PubMedCrossRefGoogle Scholar
  32. Thomson PD, Melmon KL, Richardson JA, Cohn K, Steinbrunn W, Cudihee R, Rowland M (1973) Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans. Ann Intern Med 78:499PubMedGoogle Scholar
  33. Welling GP, Craig WA (1976) Pharmacokinetics in disease states modifying renal function. In : Benet LZ (ed) The effect of disease states on drug pharmacokinetics. American Pharmaceutical Association, Washington, p 155Google Scholar
  34. Wilkinson GR, Shand DG (1975) A physiological approach to hepatic drug clearance. Clin Pharmacol Ther 18:377PubMedGoogle Scholar
  35. Zito R, Reid PR (1978) Lidocaine kinetics predicted by indocyanine green clearance. N Engl J Med 298:1160PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1984

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  • G. Paumgartner

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