Sulfadimidine kinetics in patients with various chronic liver diseases

Biotransformation and elimination of sulfonamides in healthy volunteers and patients with five various groups of chronic liver diseases was investigated with administration of sulfadimidine as testmaterial. Metabolic and kinetic parameters were estimated after intravenous and oral administration of the testmaterial in the same patients. The aim of study was to get an indirect information about the detoxication and elimination of drugs with elimination by acetylating reaction. Distribution of slow and fast acetylators showed an other ratio in patients than in the normal control; acetylating ability progressively decreased with the severity of liver diseases. Connection of kinetic and metabolic parameters seems to be the same in the patients as in the normal controls, however, kinetics of sulfonamides will be influenced in patients with liver diseases by the changed hemodynamic factors and by the elevated serum bilirubin level too. The mean conclusion is that dosage of drugs with elimination by acetylating reaction needs precaution in patients with liver diseases.