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Reduced quinidine clearance in elderly persons.

H R Ochs, D J Greenblatt, E Woo

    The American Journal of Cardiology
    |September 1, 1978
    PubMed
    Summary
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    Elderly individuals exhibit altered quinidine pharmacokinetics, with reduced total clearance and prolonged elimination half-life compared to younger adults. Dose adjustments are crucial to prevent potential toxicity in older patients.

    Area of Science:

    • Pharmacology
    • Geriatric Medicine
    • Clinical Pharmacokinetics

    Background:

    • Age-related physiological changes can significantly impact drug metabolism and elimination.
    • Quinidine is a commonly prescribed antiarrhythmic medication with a narrow therapeutic index.
    • Understanding age-related pharmacokinetic differences is vital for safe and effective drug use.

    Purpose of the Study:

    • To investigate the influence of age on the pharmacokinetic profile of quinidine.
    • To compare quinidine clearance, volume of distribution, and half-life in young versus elderly healthy volunteers.

    Main Methods:

    • A pharmacokinetic study involving 22 healthy volunteers (14 young, 8 elderly).
    • Intravenous administration of quinidine (180-300 mg) via constant rate infusion.

    Related Experiment Videos

  • Quantification of total and unbound quinidine in serum and urine using spectrophotofluorometric assay.

    • Main Results:

    • Elderly subjects showed a significantly longer elimination half-life (9.7 vs. 7.3 hours) and reduced total clearance (2.64 vs. 4.04 ml/min/kg) of quinidine.
    • Renal clearance of quinidine was also significantly lower in the elderly (0.99 vs. 1.43 ml/min/kg), correlating with reduced creatinine clearance.
    • Volume of distribution and percent unbound quinidine did not differ significantly between age groups.

    Conclusions:

    • Age significantly affects quinidine pharmacokinetics, leading to decreased clearance and prolonged half-life in the elderly.
    • These pharmacokinetic alterations may increase the risk of quinidine toxicity in older individuals.
    • Appropriate dose adjustments are recommended for elderly patients to ensure therapeutic efficacy and safety.