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Related Experiment Videos

Propranolol disposition in renal failure

A J Wood, R E Vestal, C L Spannuth

    British Journal of Clinical Pharmacology
    |December 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

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    Propranolol dosage does not need adjustment in renal failure patients. Studies show no significant pharmacokinetic changes affecting steady-state drug concentrations, despite altered binding during hemodialysis.

    Area of Science:

    • Pharmacology
    • Nephrology
    • Clinical Pharmacy

    Background:

    • Conflicting previous studies on propranolol disposition in renal failure.
    • Need to clarify drug pharmacokinetics in patients with varying degrees of renal impairment.

    Purpose of the Study:

    • To determine propranolol disposition in normal subjects, patients with severe renal impairment, and those on hemodialysis.
    • To investigate the impact of hemodialysis on propranolol binding and free fraction.

    Main Methods:

    • Simultaneous intravenous [3H]-propranolol and oral unlabelled propranolol administration.
    • Calculation of drug distribution determinants in different patient groups.
    • Examination of propranolol binding and free fraction changes during hemodialysis.

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    Main Results:

    • Propranolol's unbound fraction increased during hemodialysis due to elevated free fatty acids.
    • Blood to plasma concentration ratios were higher in renal failure and hemodialysis patients, correlating negatively with hematocrit.
    • Propranolol half-life was shortened in renal failure, but liver blood flow and clearance remained unchanged.

    Conclusions:

    • No pharmacokinetic basis exists to adjust propranolol dosage in patients with renal failure.
    • Despite altered binding during hemodialysis, key determinants of steady-state drug concentrations are not significantly affected.