Skip to main content
Log in

Effects of cardiovascular disease on pharmacokinetics

  • Reviews
  • Published:
Cardiovascular Drugs and Therapy Aims and scope Submit manuscript

Summary

The pathophysiologic changes occurring in cardiovascular disease can affect the kinetics of drugs in several different ways. The present review examines these modifications and the underlying mechanisms. The kinetics of specific agents, such as antiarrhythmic, antihypertensive, cardiotonic, and other drugs are considered, and the clinical implications are outlined. The clinician should be aware of these modifications, because they require an adjustment of the dosage regimen. A rational basis for a correct therapeutic choice can be provided by adequate knowledge of these modifications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Barchowsky A, Shand DG, Stargel WW, et al. On the role of α-acid glycoprotein in lignocaine accumulation following myocardial infarction.Br J Clin Pharmacol 1982;13:411–415.

    PubMed  Google Scholar 

  2. Routledge PA, Stargel WW, Wagner GS, et al. Increased alpha-1-acid glycoprotein and lidocaine disposition in myocardial infarction.Ann Intern Med 1980;93:701–704.

    PubMed  Google Scholar 

  3. Le Lorier J, Grenon D, Latour Y, et al. Pharmacokinetics of lidocaine after prolonged intravenous infusions in uncomplicated myocardial infarction.Ann Intern Med 1977;87:700–702.

    PubMed  Google Scholar 

  4. Routledge PA, Shand DG, Barchowsky A, et al. Relationship between α glycoprotein and lidocaine disposition in myocardial infarction.Clin Pharmacol Ther 1981;30:154–157.

    PubMed  Google Scholar 

  5. Prescott LF, Adjepon-Yamoah KK, Talbot RG. Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure.Br Med J 1976;1:939–941.

    PubMed  Google Scholar 

  6. Davison R, Parker M, Atkinson A. Excessive serum lidocaine levels during maintenance infusions: Mechanisms and prevention.Am Heart J 1982;104:203–208.

    PubMed  Google Scholar 

  7. Bax NDS, Tucker GT, Woods HF. Lignocaine and indocyanine green kinetics in patients following myocardial infarction.Br J Clin Pharmacol 1980;10:353–361.

    PubMed  Google Scholar 

  8. Thomson PD, Melmon KL, Richardson JA, et al. Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans.Ann Intern Med 1973;78:499–508.

    PubMed  Google Scholar 

  9. Zito RA, Reid PR. Lidocaine kinetics predicted by indocyanine green clearance.N Engl J Med 1978;298:1160–1163.

    PubMed  Google Scholar 

  10. Cusson J, Nattel S, Matthews C, et al. Age-dependent lidocaine disposition in patients with acute myocardial infarction.Clin Pharmacol Ther 1985;37:381–386.

    PubMed  Google Scholar 

  11. Vozeh S, Berger M, Wenk M, et al. Rapid prediction of individual dosage requirements for lignocaine.Clin Pharmacokinet 1984;9:354–363.

    PubMed  Google Scholar 

  12. Stenson RE, Constantino RT, Harrison DC. Interrelationships of hepatic blood flow, cardiac output, and blood levels of lidocaine in man.Circulation 1971;43:205–211.

    PubMed  Google Scholar 

  13. Benowitz NL, Meister W. Clinical pharmacokinetics of lidocaine.Clin Pharmacokinet 1978;3:177–201.

    PubMed  Google Scholar 

  14. Halkin H, Meffin P, Melmon KL, et al. Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite.Clin Pharmacol Ther 1975;17:669–676.

    PubMed  Google Scholar 

  15. Nation RL, Triggs EJ, Selig M. Lignocaine kinetics in cardiac patients and aged subjects.Br J Clin Pharmacol 1977;4:439–448.

    PubMed  Google Scholar 

  16. Nattel S, Gagne G, Pineau M. The pharmacokinetics of lignocaine and β-adrenoceptor antagonists in patients with acute myocardial infarction.Clin Pharmacokinet 1987;13:293–316.

    PubMed  Google Scholar 

  17. Zito RA, Reid PR, Longstreth JA. Variability of early lidocaine levels in patients.Am Heart J 1977;94:292–296.

    PubMed  Google Scholar 

  18. Bauer LA, Brown T, Gibaldi M, et al. Influence of long-term infusions on lidocaine kinetics.Clin Pharmacol Ther 1982;31:433–437.

    PubMed  Google Scholar 

  19. Goldman L, Batsford WP. Risk-benefit stratification as a guide to lidocaine prophylaxis of primary ventricular fibrillation in acute myocardial infarction: An analytic review.Yale J Biol Med 1979;52:455–466.

    PubMed  Google Scholar 

  20. Koch-Weser J. Pharmacokinetics of procainamide in man.Ann NY Acad Sci 1971;179:370–382.

    PubMed  Google Scholar 

  21. Koch-Weser J, Kein SW. Procainamide dosage schedules, plasma concentrations, and clinical effects.JAMA 1971;215:1454–1460.

    PubMed  Google Scholar 

  22. Giardina E-GV, Dreyfuss J, Bigger JT, et al. Metabolism of procainamide in normal and cardiac subjects.Clin Pharmacol Ther 1976;19:339–351.

    PubMed  Google Scholar 

  23. Karlsson E, Molin L, Norlander B, et al. Acetylation of procaine amide in man studied with a new gas chromatographic method.Br J Clin Pharmacol 1974;1:467–475.

    Google Scholar 

  24. Lima JJ, Goldfarb AL, Conti DR, et al. Safety and efficacy of procainamide infusions.Am J Cardiol 1979;43:98–105.

    PubMed  Google Scholar 

  25. Lalka D, Wyman MG, Goldreyer BN, et al. Procainamide accumulation kinetics in the immediate postmyocardial infarction period.J Clin Pharmacol 1978;30:397–401.

    Google Scholar 

  26. Wyman MG, Goldreyer BN, Cannon DS, et al. Factors influencing procainamide total body clearance in the immediate postmyocardial infarction period.J Clin Pharmacol 1981;21:20–25.

    PubMed  Google Scholar 

  27. Grasela TH, Sheiner LB. Population pharmacokinetics of procainamide from routine clinical data.Clin Pharmacokinet 1984;9:545–554.

    PubMed  Google Scholar 

  28. du Souich P, Erill S. Metabolism of procainamide and p-aminobenzoic acid in patients with chronic liver disease.Clin Pharmacol Ther 1977;22:588–595.

    PubMed  Google Scholar 

  29. Drayer DE, Lowenthal DT, Woosley RL, et al. Cumulation of N-acetylprocainamide, an active metabolite of procainamide, in patients with impaired renal function.Clin Pharmacol Ther 1977;22:63–69.

    PubMed  Google Scholar 

  30. Koch-Weser J. Correlation of serum concentrations and pharmacological effects of antiarrhythmic drugs. In:Proceedings of the 5th International Congress of Pharmacology, San Francisco. 1972:69–85.

  31. Piergies AA, Ruo TI, Jansyn EM, et al. Effect kinetics of N-acetylprocainamide-induced QT interval prolongation.Clin Pharmacol Ther 1987;42:107–112.

    PubMed  Google Scholar 

  32. Roden DM, Reele SB, Higgins SB, et al. Antiarrhythmic efficacy, pharmacokinetics and safety of N-acetylprocainamide in human subjects: Comparison with procainamide.Am J Cardiol 1980;43:463–468.

    Google Scholar 

  33. Bellet S, Roman LR, Boza A. Relation between serum quinidine levels and renal function: Studies in normal subjects and patients with congestive heart failure and renal insufficiency.Am J Cardiol 1971;27:368–371.

    PubMed  Google Scholar 

  34. Ditlefsen EML. Quinidine concentration in blood and excretion in urine following parenteral administration as related to congestive heart failure.Acta Med Scand 1957;159:105–109.

    PubMed  Google Scholar 

  35. Ueda CT, Dzindzio BS. Quinidine kinetics in congestive heart failure.Clin Pharmacol Ther 1978;23:158–164.

    PubMed  Google Scholar 

  36. Crouthamel WG. The effect of congestive heart failure on quinidine pharmacokinetics.Am Heart J 1975;90:335–339.

    PubMed  Google Scholar 

  37. Kessler KM, Lowenthal DT, Warner H, et al. Quinidine elimination in patients with congestive heart failure or poor renal function.N Engl J Med 1974;290:706–709.

    PubMed  Google Scholar 

  38. Conrad KA, Molk BL, Chidsey CA. Pharmacokinetic studies of quinidine in patients with arrhythmias.Circulation 1977;55:1–7.

    Google Scholar 

  39. Thomson GW. Quinidine as a cause of sudden death.Circulation 1956;14:757–765.

    PubMed  Google Scholar 

  40. Wetherbee DG, Holzman D, Brown MG. Ventricular tachycardia following the administration of quinidine.Am Heart J 1952;43:89–96.

    PubMed  Google Scholar 

  41. McMahon B, Bakshi M, Branagan P, et al. Pharmacokinetics and haemodynamic effects of tocainide in patients with acute myocardial infarction complicated by left ventricular failure.Br J Clin Pharmacol 1985;19:429–434.

    PubMed  Google Scholar 

  42. Graffner C, Conradson TB, Hofvendahl S. et al. Tocainide kinetics after intravenous and oral administration in healthy subjects and in patients with acute myocardial infarction.Clin Pharmacol Ther 1980;27:64–71.

    PubMed  Google Scholar 

  43. Klein MD, Levine PA, Ryan TJ. Antiarrhythmic efficacy, pharmacokinetics and clinical safety of tocainide in convalescent myocardial infarction patients.Chest 1980;77:726–730.

    PubMed  Google Scholar 

  44. Wiegers U, Hanrath P, Kuck KH, et al. Pharmacokinetics of tocainide in patients with renal dysfunction and during haemodialysis.Eur J Clin Pharmacol 1983;24:503–507.

    PubMed  Google Scholar 

  45. Mohiuddin SM, Esterbrooks D, Hilleman DE, et al. Tocainide kinetics in congestive heart failure.Clin Pharmacol Ther 1983;34:596–603.

    PubMed  Google Scholar 

  46. Prescott LF, Pottage A, Clements JA. Absorption, distribution and elimination of mexiletine.Post Med J 1977;53 (Suppl 1):50–55.

    Google Scholar 

  47. Pottage A, Campbell RWF, Achuff SC, et al. The absorption of oral mexiletine in coronary care patients.Eur J Clin Pharmacol 1978;13:393–399.

    Google Scholar 

  48. Nimmo WS, Heading RC, Wilson J, et al. Inhibition of gastric emptying and drug absorption by narcotic analgesics.Br J Clin Pharmacol 1975;2:509–513.

    PubMed  Google Scholar 

  49. Pentikäinen PJ, Hietakorpi S, Halinen MO, et al. Cirrhosis of the liver markedly impairs the elimination of mexiletine.Eur J Clin Pharmacol 1986;30:83–88.

    PubMed  Google Scholar 

  50. Franciosa JA, Wilen M, Weeks CE, et al. Pharmacokinetics and hemodynamic effects of flecainide in patients with chronic low output heart failure.J Am Coll Cardiol 1983;1:699.

    Google Scholar 

  51. Conard GJ, Ober RE. Metabolism of flecainide.Am J Cardiol 1984;53:41B-51B.

    PubMed  Google Scholar 

  52. Pentikäinen PJ, Chang SF, Conard GJ, et al. Pharmacokinetics of flecainide in patients with impaired liver function.Acta Pharmacol Toxicol 1986;59 (Suppl 1):894.

    Google Scholar 

  53. Forland SC, Burgess E, Blair AD, et al. Oral flecainide pharmacokinetics in patients with impaired renal function.J Clin Pharmacol 1988;28:259–267.

    PubMed  Google Scholar 

  54. Williams AJ, McQuinn RL, Walls J. Pharmacokinetics of flecainide acetate in patients with severe renal impairment.Clin Pharmacol Ther 1988;43:449–455.

    PubMed  Google Scholar 

  55. Woosley RL, Echt DS, Roden DM. Effects of congestive heart failure on the pharmacokinetics and pharmacodynamics of antiarrhythmic agents.Am J Cardiol 1986;57:25B-33B.

    PubMed  Google Scholar 

  56. Woosley RL. Pharmacokinetics and pharmacodynamics of antiarrhythmic agents in patients with congestive heart failure.Am Heart J 1987;114:1280–1291.

    PubMed  Google Scholar 

  57. Woosley RL, Funck-Brentano C. Overview of clinical pharmacology of antiarrhythmic drugs.Am J Cardiol 1988;61:61A–69A.

    PubMed  Google Scholar 

  58. McQuinn RL, Weeks CE, Kvam DC, et al. Pharmacokinetics of flecainide in elderly subjects.Clin Pharmacol Ther 1986;39:210.

    Google Scholar 

  59. Jounela AJ, Pentikäinen PJ, Oksanen K. The pharmacokinetics of disopyramide in patients with acute myocardial infarction.Int J Clin Pharmacol Ther Toxicol 1982;20:276–282.

    PubMed  Google Scholar 

  60. Kumana CR, Rambihar VS, Willis K, et al. Absorption and antidysrhythmic activity of oral disopyramide phosphate after acute myocardial infarction.Br J Clin Pharmacol 1982;14:529–537.

    PubMed  Google Scholar 

  61. Pentikäinen PJ, Huikuri H, Jounela AJ, et al. Disopyramide pharmacokinetics in patients with acute myocardial infarction.Eur J Clin Pharmacol 1985;28:45–51.

    PubMed  Google Scholar 

  62. Ward JW, Kinghorn GR. The pharmacokinetics of disopyramide following myocardial infarction with special reference to oral and intravenous dose regimens.J Int Med Res 1976;4 (Suppl 1):49–53.

    PubMed  Google Scholar 

  63. David BM, Ilett KF, Whitford EG, et al. Prolonged variability in plasma protein binding of disopyramide after acute myocardial infarction.Br J Clin Pharmacol 1983;15:435–441.

    PubMed  Google Scholar 

  64. Ilett KF, Madsen BW, Woods JD. Disopyramide kinetics in patients with acute myocardial infarction.Clin Pharmacol Ther 1979;26:1–7.

    PubMed  Google Scholar 

  65. Bredesen JE, Kierulf P. Relationship between α-acid glycoprotein and distribution of disopyramide and mono-N-dealkyldisopyramide in whole blood.Br J Clin Pharmacol 1986;22:281–286.

    PubMed  Google Scholar 

  66. Landmark K, Bredesen JE, Thaulow E, et al. Pharmacokinetics of disopyramide in patients with imminent to moderate cardiac failure.Eur J Clin Pharmacol 1981;19:187–192.

    PubMed  Google Scholar 

  67. Bonde J, Angelo HR, Bodtker S, et al. Kinetics of disopyramide after intravenous infusion to patients with myocardial infarction and heart failure.Acta Pharmacol Toxicol 1985;56:278–282.

    Google Scholar 

  68. Siddoway LA, Woosley RL. Clinical pharmacokinetics of disopyramide.Clin Pharmacokinet 1986;11:214–222.

    PubMed  Google Scholar 

  69. Hagemeijer F. Absorption, half-life, and toxicity of oral aprindine in patients with acute myocardial infarction.Eur J Clin Pharmacol 1975;9:21–25.

    PubMed  Google Scholar 

  70. Doherty JE, Perkins WH, Mitchell GK. Tritiated digoxin studies in human subjects.Arch Intern Med 1961;108:531–539.

    PubMed  Google Scholar 

  71. Doherty JE, Perkins WH. Studies with tritiated digoxin in human subjects after intravenous administration.Am Heart J 1962;63:528–536.

    PubMed  Google Scholar 

  72. Marcus FI, Kapadia GJ, Kapadia GG. The metabolism of digoxin in normal subjects.J Pharmacol Exp Ther 1964;145:203–209.

    PubMed  Google Scholar 

  73. Ohnhaus EE, Vozeh S, Nuesch E. Absorption of digoxin in severe right heart failure.Eur J Clin Pharmacol 1979;15:115–120.

    PubMed  Google Scholar 

  74. Doherty E. The clinical pharmacology of digitalis glycosides: A review.Am J Med Sci 1968;255:382–414.

    PubMed  Google Scholar 

  75. Korhonen UR, Jounela AJ, Pakarinen AJ, et al. Pharmacokinetics of digoxin in patients with acute myocardial infarction.Am J Cardiol 1979;44:1190–1194.

    PubMed  Google Scholar 

  76. Benotti JR, Lesko LJ, McCue JE. Acute pharmacodynamics and pharmacokinetics of oral amrinone.J Clin Pharmacol 1982;22:425–432.

    PubMed  Google Scholar 

  77. Wilson H, Rocci ML, Weber KT. Pharmacokinetics of oral amrinone in patients with chronic cardiac failure.Clin Pharmacol Ther 1982;31:282.

    Google Scholar 

  78. Rocci ML, Wilson H, Likoff M, et al. Amrinone pharmacokinetics after single and steady state doses in patients with chronic cardiac failure.Clin Pharmacol Ther 1983;33:260.

    Google Scholar 

  79. Edelson J, LeJemtel JH, Alousi AA, et al. Relationship between amrinone plasma concentration and cardiac index.Clin Pharmacol Ther 1981;29:723–728.

    PubMed  Google Scholar 

  80. Edelson J, Stroshane R, Benziger DP, et al. Pharmacokinetics of the bipyridines amrinone and milrinone.Circulation 1896;73 (Suppl III):145–152.

    Google Scholar 

  81. Larsson R, Liedholm H, Andersson KE, et al. Pharmacokinetics and effects on blood pressure of a single oral dose of milrinone in healthy subjects and in patients with renal impairment.Eur J Clin Pharmacol 1986;29:549–553.

    PubMed  Google Scholar 

  82. Stroshane RM, Benziger DP, Edelson J. Pharmacokinetics of milrinone in congestive heart failure patients. In: Braunwald E, Sonnenblick EH, Chakrin LW, et al. (eds).Milrinone: Investigation of New Inotropic Therapy for Congestive Heart Failure. New York: Raven Press, 1984:119–131.

    Google Scholar 

  83. Benotti JR, Lesko LJ, McCue JE, et al. Pharmacokinetics and pharmacodynamics of milrinone in chronic congestive heart failure.Am J Cardiol 1985;56:685–689.

    PubMed  Google Scholar 

  84. Sainsbury EJ, Fitzpatrick D, Ikram H, et al. Pharmacokinetics and plasma-concentration-effect relationships of prenalterol in cardiac failure.Eur J Clin Pharmacol 1985;28:397–403.

    PubMed  Google Scholar 

  85. Dahlström U, Graffner C, Jonsson U, et al. Pharmacokinetics of prenalterol after single and multiple administration of controlled release tablets to patients with congestive heart failure.Eur J Clin Pharmacol 1983;24:495–502.

    PubMed  Google Scholar 

  86. Rönn O. Pharmacokinetics of prenalterol in healthy subjects and patients with congestive heart failure.Acta Med Scand 1982;659 (Suppl):89–98.

    Google Scholar 

  87. Scott AK, Webster J, Petrie JC, et al. The effect of age and cardiac failure on xamoterol pharmacokinetics.Br J Clin Pharmacol 1988;25:165–168.

    PubMed  Google Scholar 

  88. Vigholt Sorensen E, Faergeman O, Day M, et al. Pharmacokinetics of xamoterol after intravenous and oral administration to patients with chronic heart failure.Eur J Clin Pharmacol 1988;35:183–185.

    PubMed  Google Scholar 

  89. Vasko MR, Brown-Cartwright D, Knochel JP, et al. Furosemide absorption altered in decompensated congestive heart failure.Ann Intern Med 1985;102:314–318.

    PubMed  Google Scholar 

  90. Brater DG, Day B, Burdette A, et al. Bumetanide and furosemide in heart failure.Kidney Int 1984;26:183–189.

    PubMed  Google Scholar 

  91. Greither A, Goldman S, Edelen JS, et al. Pharmacokinetics of furosemide in patients with congestive heart failure.Pharmacology 1979;19:121–131.

    PubMed  Google Scholar 

  92. Brater DG, Seiwell R, Anderson S, et al. Absorption and disposition of furosemide in congestive heart failure.Kidney Int 1982;22:171–176.

    PubMed  Google Scholar 

  93. Brater DG, Chennavasin P, Seiwell R. Furosemide in patients with heart failure: Shift in dose-response curves.Clin Pharmacol Ther 1980;28:182–186.

    PubMed  Google Scholar 

  94. Perez J, Sitar DS, Ogilvie RI. Kinetic disposition and diuretic effect of furosemide in acute pulmonary oedema.Br J Clin Pharmacol 1980;9:471–478.

    PubMed  Google Scholar 

  95. Chau NP, Flouvat BL, Le Roux E, et al. Prazosin kinetics in essential hypertension.Clin Pharmacol Ther 1980; 28:6–11.

    PubMed  Google Scholar 

  96. Grahnen A, Seideman P, Lindström B, et al. Prazosin kinetics in hypertension.Clin Pharmacol Ther 1981; 30:439–446.

    PubMed  Google Scholar 

  97. Larochelle P, du Souich P, Hamet P, et al. Prazosin plasma concentration and blood pressure reduction.Hypertension 1982;4:93–101.

    PubMed  Google Scholar 

  98. Baughman RA, Arnold S, Benet LZ, et al. Altered prazosin pharmacokinetics in congestive heart failure.Eur J Clin Pharmacol 1980;17:425–428.

    PubMed  Google Scholar 

  99. Jaillon P, Rubin P, Yee YG, et al. Influence of congestive heart failure on prazosin kinetics.Clin Pharmacol Ther 1979;25:790–794.

    PubMed  Google Scholar 

  100. Baughman R, Lin ET, Williams RL, et al. Prazosin disposition in patients with congestive heart failure and in healthy controls.Clin Pharmacol Ther 1979;25:213A.

    Google Scholar 

  101. Silke B, Lakhani ZM, Taylor SH. Pharmacokinetic and pharmacodynamic studies with prazosin in chronic heart failure.J Cardiovasc Pharmacol 1981;3:329–335.

    PubMed  Google Scholar 

  102. Godehardt E, Wambach G, Heitz W, et al. Pharmacokinetics of urapidil in patients with normal and impaired renal function. In: Amery A (ed).Treatment of Hypertension with Urapidil: Preclinical and Clinical Update. London: ICSS 101, Royal Society of Medicine Services Limited, 1986:71–86.

    Google Scholar 

  103. Kirsten R, Nelson K, Steinijans VW, et al. Clinical pharmacokinetics of urapidil.Clin Pharmacokinet 1988;14:129–140.

    PubMed  Google Scholar 

  104. Hanson A, Johansson BW, Wernersson B, et al. Pharmacokinetics of oral hydralazine in chronic heart failure.Eur J Clin Pharmacol 1983;25:467–473.

    PubMed  Google Scholar 

  105. Packer M, Meller J, Medina N, et al. Dose requirements of hydralazine in patients with severe chronic congestive heart failure.Am J Cardiol 1980;45:655–660.

    PubMed  Google Scholar 

  106. Persson B, Pettersson A, Hedner T. Pharmacokinetics of ketanserin in patients with essential hypertension.Eur J Clin Pharmacol 1987;32:259–265.

    PubMed  Google Scholar 

  107. Waller PC, Tucker GT, Ramsay LE. The pharmacokinetics of ketanserin after a single dose and at steadystate in hypertensive subjects.Eur J Clin Pharmacol 1987;33:423–426.

    PubMed  Google Scholar 

  108. Hedner T, Persson B. Experience with ketanserin and ritanserin in hypertensive patients.J Cardiovasc Pharmacol 1988;11 (Suppl 1):S44-S48.

    PubMed  Google Scholar 

  109. Kurowski M. Bioavailability and pharmacokinetics of ketanserin in elderly subjects.Eur J Clin Pharmacol 1985;28:411–417.

    PubMed  Google Scholar 

  110. McKinstry DN, Kripalani KJ, Migdalof BH, et al. The effect of repeated administration of captopril (CP) on its disposition in hypertensive patients.Clin Pharmacol Ther 1980;27:270–271.

    Google Scholar 

  111. Richer C, Giroux B, Plouin PF, et al. Captopril: Pharmacokinetics, antihypertensive and biological effects in hypertensive patients.Br J Clin Pharmacol 1984;17:243–250.

    PubMed  Google Scholar 

  112. Giudicelli JF, Chaignon M, Richer C, et al. Influence of chronic renal failure on captopril pharmacokinetics and clinical and biological effects in hypertensive patients.Br J Clin Pharmacol 1984;18:749–758.

    PubMed  Google Scholar 

  113. Cody RJ, Covit A, Schaer G, et al. Captopril pharmacokinetics and the acute hemodynamic and hormonal response in patients with severe chronic congestive heart failure.Am Heart J 1982;104:1180–1183.

    PubMed  Google Scholar 

  114. Cody RJ, Schaer GL, Covit AB, et al. Captopril kinetics in chronic congestive heart failure.Clin Pharmacol Ther 1982;32:721–726.

    PubMed  Google Scholar 

  115. Shaw TRD, Duncan FM, Williams BC, et al. Plasma free captopril concentrations during short and long term treatment with oral captopril for heart failure.Br Heart J 1985;54:160–165.

    PubMed  Google Scholar 

  116. Ferguson RK, Vlasses PH, Swanson BN, et al. Effects of enalapril, a new converting enzyme inhibitor, in hypertension.Clin Pharmacol Ther 1982;32:48–53.

    PubMed  Google Scholar 

  117. Johnston CI, Jackson B, McGrath B, et al. Relationship of antihypertensive effect of enalapril to serum MK-422 levels and angiotensin convering enzyme inhibition.J Hypertens 1983;1(Suppl 1):71–75.

    Google Scholar 

  118. Schwartz JB, Taylor A, Abernethy D, et al. Pharmacokinetics and pharmacodynamics of enalapril in patients with congestive heart failure and patients with hypertension.J Cardiovasc Pharmacol 1985;7:767–776.

    PubMed  Google Scholar 

  119. Halstenson CE, Matzke GR, Abraham PA, et al. Single and multiple dose pharmacokinetics of enalapril in hypertensive (HTN) patients with renal insufficiency.Clin Pharmacol Ther 1987;41:223.

    Google Scholar 

  120. Kelly JG, Doyle G, Donohue J, et al. Pharmacokinetics of enalapril in normal subjects and patients with renal impairment.Br J Clin Pharmacol 1986;21:63–69.

    PubMed  Google Scholar 

  121. Levine TB, Olivari MT, Garberg V, et al. Hemodynamic and clinical reponse to enalapril, a long-acting converting-enzyme inhibitor, in patients with congestive heart failure.Circulation 1984;69:548–553.

    PubMed  Google Scholar 

  122. Johnston CI, Jackson BJ, Larmour I, et al. Plasma enalapril levels and hormonal effects after short- and long-term administration in essential hypertension.Br J Clin Pharmacol 1984;18:233S-239S.

    PubMed  Google Scholar 

  123. Rocci ML, Shaw EW, Vlasses PH, et al. Bioactivation of the angiotensin converting enzyme inhibition enalapril in cirrhosis.Clin Res 1986;34:406A.

    Google Scholar 

  124. Hockings N, Ajayi AA, Reid JL. Age and the pharmacokinetics of angiotensin converting enzyme inhibitors enalapril and enalaprilat.Br J Clin Pharmacol 1986;21:341–348.

    PubMed  Google Scholar 

  125. Lees KR, Reid JL. Age and the pharmacokinetics and pharmacodynamics of chronic enalapril treatment.Clin Pharmacol Ther 1987;41:597–602.

    PubMed  Google Scholar 

  126. Gautam PC, Vargas E, Lye M. Pharmacokinetics of lisinopril (MK 521) in healthy young and elderly subjects and in elderly patients with cardiac failure.J Pharm Pharmacol 1987;39:929–931.

    PubMed  Google Scholar 

  127. Gibson TP, Shaw WC, Koch KM, et al. Pharmacokinetics of lisinopril in renal insufficiency.J Clin Pharmacol 1986;26:544.

    Google Scholar 

  128. van Schaik BAM, Geyskes GG, van der Wouw PA, et al. Pharmacokinetics of lisinopril in hypertensive patients with normal and impaired renal function.Eur J Clin Pharmacol 1988;34:61–65.

    PubMed  Google Scholar 

  129. Cirillo VJ, Till AE, Gomez HJ, et al. Effect of age on lisinopril pharmacokinetics.Clin Pharmacol Ther 1986;39:187.

    Google Scholar 

  130. Singh BN, Ellrodt G, Peter T. Verapamil: A review of its pharmacological properties and therapeutic use.Drugs 1978;15:169–197.

    PubMed  Google Scholar 

  131. Aronow WS, Landa D, Plasencia G, et al. Verapamil in atrial fibrillation and atrial flutter.Clin Pharmacol Ther 1979;26:578–583.

    PubMed  Google Scholar 

  132. Dominic J, McAllister RG, Kuo CS, et al. Verapamil plasma levels and ventricular rate response in patients with atrial fibrillation and flutter.Clin Pharmacol Ther 1979;26:710–714.

    PubMed  Google Scholar 

  133. Anderson P, Bondesson U, Sylven C. Clinical pharmacokinetics of verapamil in patients with atrial fibrillation.Eur J Clin Pharmacol 1982;23:49–57.

    PubMed  Google Scholar 

  134. Eichelbaum M, Somogyi A. Inter- and intra-subject variation in the first-pass elimination of highly cleared drugs during chronic dosing.Eur J Clin Pharmacol 1984;26:47–53.

    PubMed  Google Scholar 

  135. Freedman SB, Richmond DR, Ashley JJ, et al. Verapamil kinetics in normal subjects and patients with coronary artery spasm.Clin Pharmacol Ther 1981;30:644–652.

    PubMed  Google Scholar 

  136. Schwartz JB, Keefe DL, Kirsten E, et al. Prolongation of verapamil elimination kinetics during chronic oral administration.Am Heart J 1982;104:198–203.

    PubMed  Google Scholar 

  137. Gutierrez LM, Lesko LI, Whipps R, et al. Pharmacokinetics and pharmacodynamics of nifedipine in patients at steady state.J Clin Pharmacol 1986;26:587–592.

    PubMed  Google Scholar 

  138. Taburet AM, Singlas E, Colin J, et al. Pharmacokinetics studies of nifedipine tablet correlation with antihypertensive effects.Hypertension 1983;5 (Suppl 2):29–33.

    Google Scholar 

  139. Kleinbloesem CH, van Brummelen P, Faber H, et al. Pharmacokinetics and hemodynamic effects of long-term nifedipine treatment in hypertensive patients.J Cardiovasc Pharmacol 1987;9:202–208.

    PubMed  Google Scholar 

  140. Kleinbloesem CH, van Harten J, Wilson JPH, et al. Nifedipine: Kinetics and hemodynamic effects in patients with liver cirrhosis after intravenous and oral administration.Clin Pharmacol Ther 1986;40:21–28.

    PubMed  Google Scholar 

  141. Ene MD, Roberts CJC. Pharmacokinetics of nifedipine after oral administration in chronic liver disease.J Clin Pharmacol 1987;27:1001–1004.

    PubMed  Google Scholar 

  142. Kleinbloesem CH, van Brummelen P, van Harten J, et al. Nifedipine: Influence of renal function on pharmacokinetic/haemodynamic relationship.Clin Pharmacol Ther 1985;37:563–574.

    PubMed  Google Scholar 

  143. Robertson DRC, Waller DG, Renwick AG et al. Agerelated changes in the pharmacokinetics and pharmacodynamics of nifedipine.Br J Clin Pharmacol 1988;25:297–305.

    PubMed  Google Scholar 

  144. Scott M, Castleden CM, Adam HK, et al. The effect of ageing on the disposition of nifedipine and atenolol.Br J Clin Pharmacol 1988;25:289–296.

    PubMed  Google Scholar 

  145. Montamat SC, Abernethy DR. N-monodesmethyldiltiazem is the predominant metabolite of diltiazem in the plasma of young and elderly hypertensives.Br J Clin Pharmacol 1987;24:185–189.

    PubMed  Google Scholar 

  146. Hung J, Hackett PL, Gordon SPF, et al. Pharmacokinetics of diltiazem in patients with unstable angina pectoris.Clin Pharmacol Ther 1988;43:466–470.

    PubMed  Google Scholar 

  147. Smith MS, Verghese CP, Shand DG, et al. Pharmacokinetic and pharmacodynamic effects of diltiazem.Am J Cardiol 1983;51:1369–1374.

    PubMed  Google Scholar 

  148. Grech-Bélanger O, Langlois S, LeBoeuf E. Pharmacokinetics of diltiazem in patients undergoing continuous ambulatory peritoneal dialysis.J Clin Pharmacol 1988;28:477–480.

    PubMed  Google Scholar 

  149. Saltiel E, Ellrodt AG, Monk JP, et al. Felodipine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension.Drugs 1988;36:387–428.

    PubMed  Google Scholar 

  150. Edgar B, Collste P, Haglund K, et al. Pharmacokinetics and haemodynamics of felodipine as monotherapy in hypertensive patients.Drugs 1987;34(Suppl 3):28–29.

    PubMed  Google Scholar 

  151. Hedner T, Elmfeldt D, Dahlöf C, et al. Comparison of antihypertensive effect and pharmacokinetics of conventional and extended release felodipine tablets in patients with arterial hypertension.Drugs 1987;34 (Suppl 3):125–131.

    PubMed  Google Scholar 

  152. Edgar B, Aurell M, Johnsson G, et al. Effects of impaired renal function on the pharmacokinetics of felodipine.Drugs 1987;34 (Suppl 3):31–32.

    PubMed  Google Scholar 

  153. Regardh CG, Collste P. Edgar B, et al. The effect of reduced hepatic function on the pharmacokinetics and haemodynamics of felodipine. Abstract 900 presented at Third World Conference on Clinical Pharmacology and Therapeutics, Stockholm, 1986.

  154. Rehnqvist N, Billing E, Moberg L, et al. Pharmacokinetics of felodipine and effect on digoxin plasma levels in patients with heart failure.Drugs 1987;34 (Suppl 3):33–42.

    Google Scholar 

  155. Landahl S, Edgar B, Gabrielsson M, et al. Pharmacokinetics and blood pressure effects of felodipine in elderly hypertensive patients: A comparison with healthy subjects.Clin Pharmacokinet 1988;14:374–383.

    PubMed  Google Scholar 

  156. Swift C, Bayer A, Allen E, et al. The steady state pharmacokinetic and haemodynamic effects of oral felodipine in young and elderly volunteers. Abstract 1148 presented at Third World Conference on Clinical Pharmacology and Therapeutics, Stockholm, 1986.

  157. Crome P, Baksi A, MacMahon D, et al. Plasma nitrendipine concentrations in elderly hypertensive patients after single and multiple dosing.Br J Clin Pharmacol 1988;26:323–326.

    PubMed  Google Scholar 

  158. Kendall MJ, Lobo J, Jack DB, et al. The influence of age on the pharmacokinetics of nitrendipine.J Cardiovasc Pharmacol 1987;9 (Suppl 4):S96–S100.

    Google Scholar 

  159. Baumelou A, Bentchikou A, Vray M, et al. Nitrendipine in patients with renal disease.J Cardiovasc Pharmacol 1987;9 (Suppl 4):S174-S177.

    Google Scholar 

  160. Kirch W, Dylewicz D, Hutt HJ, et al. Pharmacokinetics of nitrendipine in liver disease.J Clin Pharmacol 1985;25:467.

    Google Scholar 

  161. Saris SD, Porter RS, Lowenthal DT, et al. Effect of chronic vs. acute dosing of nitrendipine in chronic liver disease.Clin Pharmacol Ther 1986;39:226.

    Google Scholar 

  162. Kuntz HD, Straub H, May B. Theophylline elimination in congestive heart failure.Klin Wochenschr 1983;61:1105–1106.

    PubMed  Google Scholar 

  163. Bauer LA, Bauer SP, Blouin RA. The effect of acute and chronic renal failure on theophylline clearance.J Clin Pharmacol 1982;22:65–68.

    PubMed  Google Scholar 

  164. Piafsky KM, Sitar DS, Rangno RE, et al. Theophylline kinetics in acute pulmonary edema.Clin Pharmacol Ther 1977;21:310–316.

    PubMed  Google Scholar 

  165. Zwillich CW, Sutton FD, Neff TA, et al. Theophyllineinduced seizures in adults. Correlation with serum concentrations.Ann Intern Med 1975;82:784–787.

    PubMed  Google Scholar 

  166. Ochs HR, Schuppan U, Greenblatt DJ, et al. Reduced distribution and clearance of acetaminophen in patients with congestive heart failure.J Cardiovasc Pharmacol 1983;5:697–699.

    PubMed  Google Scholar 

  167. Maurer G, Lemaire M. Biotransformation and distribution in blood of cyclosporine and its metabolites.Transplant Proc 1986;18 (Suppl 5):25–34.

    PubMed  Google Scholar 

  168. Burckart GJ, Fricker FJ, Venkataramanan R, et al. Cyclosporine kinetics in pediatric patients with congestive heart failure.Transplant Proc 1987;19:1528–1529.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rodighiero, V. Effects of cardiovascular disease on pharmacokinetics. Cardiovasc Drug Ther 3, 711–730 (1989). https://doi.org/10.1007/BF01857622

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01857622

Key Words

Navigation