Hydroxy metabolite concentrations: role of renal clearance
It is generally emphasized that basic lipophilic psychoactive drugs are cleared primarily through metabolism, not renal clearance (Potter et al., 1981). Kidney disease or other sources of alterations of renal clearance are not reported to affect plasma concentrations of drugs such as the tricyclic antidepressants, although the clearance of unmetabolized drugs such as lithium will clearly be affected (Amdisen, 1977). From any but an academic point of view this would be the limit of interest in renal clearance if extensively metabolized parent drugs were the only biologically active forms.
KeywordsLithium Noradrenaline Propranolol Diphenylhydantoin Tricyclic
Unable to display preview. Download preview PDF.
- Braithwaite, R.A. and Dawling, S. (1981). The pharmacokinetics and metabolism of tricyclic antidepressant drugs in patients with chronic renal failure. In Clinical Pharmacology in Psychiatry; Neuroleptic and Antidepressant Research (ed. E. Usdin, S.G. Dahl, L.F. Gram and O. Lingjaerde), Macmillan, London, pp. 285–95Google Scholar
- Garattini, S., Marcucci, F. and Mussini, E. (1975). Biotransformation of drugs to pharmacologically active metabolites. In Handbook of Experimental Pharmacology, XXVIII/3, Concepts in Biochemical Pharmacology (ed. J.R. Gillette and J.R. Mitchell), Springer-Verlag, Berlin, pp. 113–29CrossRefGoogle Scholar
- Kleinman, J.E., Nasrallah, H.A., Bigelow, L.B., Rogol, A.D., Zalcman, S., Wyatt, R.J. and Gillin, J.C. (1978). 7-Hydroxychlorpromazine, an active metabolite of chlorpromazine. Presented at American Psychiatric Association Annual Meeting, May 8–12, Atlanta, Georgia, Abstract No. NR29Google Scholar
- Lundborg, P., Regårdh, C.G. and Landahl, S. (1982). The pharmacokinetics of metoprolol in healthy elderly individuals (Abstract). Clin. Pharmacol. Ther., 31, 246Google Scholar
- Potter, W.Z., Bertilsson, L. and Sjöqvist, F. (1981). Clinical pharmacokinetics of psychotropic drugs: fundamental and practical aspects. In The Handbook of Biological Psychiatry, (ed. H.M. Van Praag, O. Rafaelsen, M. Lader and A. Sacher) Marcel Dekker, New York, pp. 71–134Google Scholar
- Potter, W.Z., and Calil, H.M. (1981). Metabolites of tricyclic antidepressants — biological activity and clinical implications. In Clinical Pharmacology in Psychiatry (ed. E. Usdin), Elsevier/North-Holland, New York, pp. 311–24Google Scholar