从临床药理学的角度来看,弗莱卡尼德的毒性
Naoyuki Otani1,2,3, Hirokazu Wakuda2, Ichiro Oikawa2
1Cardiology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN.
Cureus
|September 2, 2024
概括
这个案例研究发现了一个病人.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
- 心脏病学 心脏病学
背景情况:
- 一位84岁的老妇人曾经进行过门置换,患有厌食症和呼吸障碍.
- 她接受了弗莱卡因因德治疗,以治疗心房动.
- 电心电图显示了加快的内心节律,促使人们怀疑弗莱卡因尼德的毒性.
研究的目的:
- 为了比较在患者中测量到的弗莱卡尼尼德半衰期与制造商声明的半衰期.
- 在临床环境中研究弗莱卡尼尼德的药物动力学概况.
- 突出治疗药物监测对抗心律失常药物的重要性.
主要方法:
- 由于怀疑有毒性,停止弗莱卡尼德治疗.
- 测量血清中flekainide度的连续测量.
- 根据测量药物水平计算患者实际的弗莱卡尼尼德半衰期.
主要成果:
- 血清中flekainide度为1348ng/mL,超过了治疗范围.
- 患者计算的弗莱卡尼尼德半衰期为56.8小时.
- 这种测量半衰期大约是药物标签上标明的11.0小时半衰期的五倍.
结论:
- 弗莱卡尼德的实际消除半衰期可能会显著偏离标记的值.
- 治疗药物监测和药理动力学评估对于安全有效的弗莱卡尼尼德使用至关重要.
- 在消除阶段进行密切监测对于预防药物不良事件至关重要.
相关概念视频
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
935
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
935
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.3K
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.3K
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
719
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
719
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
104
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
104
Heart Failure Drugs: Inotropic Agents
545
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
545
Nonlinear Pharmacokinetics: Overview
313
Nonlinear or dose-dependent pharmacokinetics is a phenomenon that occurs when the pharmacokinetic parameters of certain drugs deviate from linear pharmacokinetics at higher doses. These drugs do not follow the expected first-order kinetics, where the rate of drug elimination is directly proportional to the drug concentration. Instead, they exhibit a nonlinear relationship, which can be attributed to several factors.
Nonlinearity can arise due to the saturation of plasma protein-binding or...
Nonlinearity can arise due to the saturation of plasma protein-binding or...
313


