Atenolol pharmacokinetics in patients on continuous ambulatory peritoneal dialysis.

Salahudeen, A. K.; Wilkinson, Robert W.; McAinsh, J; Bateman, D. N.

doi:10.1111/j.1365-2125.1984.tb02490.x

Cited by 14 publications

(3 citation statements)

References 8 publications

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“…Although the poor transfer from the systemic circulation to the dialysate has previously been described for other compounds [gentamicin (Somani et al 1982), tobramycin (Bunke et al 1983a), vancomycin (Bunke et al 1983b), atenolol (Salahudeen et al 1984), omidazole (Merdjan et al 1985) and cefoxatime (Albin et al 1985)], the reasons for this characteristic are not yet known.…”

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confidence: 93%

Teicoplanin Pharmacokinetics in Patients with Chronic Renal Failure

Bonati

Traina

Villa

et al. 1987

Clinical Pharmacokinetics

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The pharmacokinetic profile of teicoplanin, a new glycopeptide antibiotic active against Gram-positive aerobic and anaerobic bacteria, was studied in 5 healthy male volunteers and 29 adult patients with various degrees of renal impairment, given a single 3 mg/kg intravenous dose. Teicoplanin was assayed in plasma and urine specimens by a microbiological method. Pharmacokinetic parameters for teicoplanin were estimated both by a 3-compartment open pharmacokinetic model and by non-compartmental analysis. Elimination half-life increased with the decrease in creatinine clearance and mean values ranged from 41 hours in volunteers to 163 hours in anuric patients. Renal failure did not affect either the volume of distribution of the central compartment (mean approximately 0.09 L/kg) or the steady-state volume of distribution (mean approximately 0.9 L/kg). Both total and renal clearance decreased with severity of disease, particularly the latter, while non-renal clearance was unaffected by renal failure. Average values were from 19 to 6 ml/min for total clearance and from 12 to 0.4 ml/min for renal clearance. There was a linear correlation between the total clearance of teicoplanin and creatinine clearance, as well as between renal clearance and creatinine clearance. The total urinary excretion of active teicoplanin averaged 65% of the administered dose in normal subjects, but was significantly reduced in the presence of renal insufficiency. Guidelines for administration of teicoplanin in patients with renal failure are given.

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confidence: 93%

Teicoplanin Pharmacokinetics in Patients with Chronic Renal Failure

Bonati

Traina

Villa

et al. 1987

Clinical Pharmacokinetics

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“…For BAAs with limited protein binding, hemoperfusion would not be expected to surpass diffusive or convective techniques as confirmed in one case of metoprolol overdose in which measured clearance [ 106 ] was comparable to that obtained during hemodialysis [ 101 ]. As expected, dialyzability of BAAs by peritoneal dialysis was consistently poor, with inconsequential impact on pharmacokinetics, i.e., approximately 6% of atenolol was removed in 24 h [ 90 ], 0.1% of labetalol in 72 h [ 92 ], and the peritoneal clearance of betaxolol only represented 7.5% of total clearance [ 86 ].…”

Section: Resultsmentioning

confidence: 93%

Extracorporeal treatment for poisoning to beta-adrenergic antagonists: systematic review and recommendations from the EXTRIP workgroup

et al. 2021

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Background β-adrenergic antagonists (BAAs) are used to treat cardiovascular disease such as ischemic heart disease, congestive heart failure, dysrhythmias, and hypertension. Poisoning from BAAs can lead to severe morbidity and mortality. We aimed to determine the utility of extracorporeal treatments (ECTRs) in BAAs poisoning. Methods We conducted systematic reviews of the literature, screened studies, extracted data, and summarized findings following published EXTRIP methods. Results A total of 76 studies (4 in vitro and 2 animal experiments, 1 pharmacokinetic simulation study, 37 pharmacokinetic studies on patients with end-stage kidney disease, and 32 case reports or case series) met inclusion criteria. Toxicokinetic or pharmacokinetic data were available on 334 patients (including 73 for atenolol, 54 for propranolol, and 17 for sotalol). For intermittent hemodialysis, atenolol, nadolol, practolol, and sotalol were assessed as dialyzable; acebutolol, bisoprolol, and metipranolol were assessed as moderately dialyzable; metoprolol and talinolol were considered slightly dialyzable; and betaxolol, carvedilol, labetalol, mepindolol, propranolol, and timolol were considered not dialyzable. Data were available for clinical analysis on 37 BAA poisoned patients (including 9 patients for atenolol, 9 for propranolol, and 9 for sotalol), and no reliable comparison between the ECTR cohort and historical controls treated with standard care alone could be performed. The EXTRIP workgroup recommends against using ECTR for patients severely poisoned with propranolol (strong recommendation, very low quality evidence). The workgroup offered no recommendation for ECTR in patients severely poisoned with atenolol or sotalol because of apparent balance of risks and benefits, except for impaired kidney function in which ECTR is suggested (weak recommendation, very low quality of evidence). Indications for ECTR in patients with impaired kidney function include refractory bradycardia and hypotension for atenolol or sotalol poisoning, and recurrent torsade de pointes for sotalol. Although other BAAs were considered dialyzable, clinical data were too limited to develop recommendations. Conclusions BAAs have different properties affecting their removal by ECTR. The EXTRIP workgroup assessed propranolol as non-dialyzable. Atenolol and sotalol were assessed as dialyzable in patients with kidney impairment, and the workgroup suggests ECTR in patients severely poisoned with these drugs when aforementioned indications are present.

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“…Atenolol appears to be a good tool drug not only in view of the widespread use of antihypertensive medication in CAPO patients (6), but also because of its pharmacokinetic profile, as it is excreted rapidly and mainly unchanged in the urine in humans (7) and animals (8). In addition, its disposition and effects may be altered during renal impairment (9,10).…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetic and pharmacodynamic modelling of atenolol in rabbits maintained on continuous peritoneal dialysis

Celardo

Traina

Arboix

et al. 1987

European Journal of Drug Metabolism and Pharmacokinetics

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The pharmacokinetic and pharmacodynamic profiles of atenolol were studied in adult male rabbits on continuous peritoneal dialysis given 3 mg/kg i.v. before and during renal failure. The average terminal elimination half-life for the drug was 2.5 h calculated from blood, dialysate or urinary data. This value increased about nine times in anuric conditions. Although atenolol was eliminated in the peritoneal fluid, the amount excreted was relatively low both in normal conditions and renal failure, respectively 0.6 and 7% of the administered dose. The pharmacokinetic model was extended by an "effect compartment", which has no influence on the predetermined mass of drug in the body, to analyse the relationship between heart rate fall and changes in atenolol blood concentrations. After drug administration, heart rate fell rapidly about 90 beats in both states. The mean equilibration half-time of atenolol effect and blood concentrations was 0.7 and 1.5 h in normal and pathological states, respectively. The mean blood concentration required to produce 50% of heart rate fall was similar in both conditions, 0.23 mg/l. The nine-fold decrease of atenolol elimination in anuria was in good agreement with the increase in duration of the drug's effect, and was suitably described by the "effect model".

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Atenolol pharmacokinetics in patients on continuous ambulatory peritoneal dialysis.

Cited by 14 publications

References 8 publications

Teicoplanin Pharmacokinetics in Patients with Chronic Renal Failure

Teicoplanin Pharmacokinetics in Patients with Chronic Renal Failure

Extracorporeal treatment for poisoning to beta-adrenergic antagonists: systematic review and recommendations from the EXTRIP workgroup

Pharmacokinetic and pharmacodynamic modelling of atenolol in rabbits maintained on continuous peritoneal dialysis

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