Trimethoprim. Pharmacology, antimicrobial activity and clinical use in urinary tract infections.
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Biomedical subjects
Publications and source records attributed to M Anttila.
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A rapid, sensitive fluorometric method for the determination of ajmaline and N-propylajmaline (NPA) was used to follow serum concentrations after an i.v. administration of ajmaline, after an oral administration of ajmaline, and an oral dose of NPA bitartrate (NPAB) in beagle dogs. Ajmaline was eliminated from serum with an apparent half-life of approximately 1 h and NPA with one of approximately 4 h. 1 h after i.v. and oral administration of 50 mg of ajmaline the serum levels were of the same order of magnitude. The bioavailability of oral ajmaline, calculated from the area under the serum concentration/time curves, was about 90%. The peak serum concentrations of ajmaline and NPA after a single oral dose of 50 mg of ajmaline and NPAB were about 1.4 microgram/ml and 0.6 microgram/ml, respectively, the latter calculated as its bitartrate, with about the same peak time: 1 h.
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Acute inflammation was induced in rats by subcutaneous implantation of plastic sponges, and the penetration of salicylate and naproxen into the inflammatory exudate was studied after oral dosing with these compounds. The penetration of intravenously administered 22Na and 125I-albumin was also studied. It was found that salicylate and 22Na penetrated very rapidly, reaching maximum concentration in the exudate within 3 hours of administration. In contrast, naproxen and 125I-albumin penetrated much more slowly, maximum concentrations in the exudates not being reached until 5 hours after administration. The significance of these results and the role of protein binding is discussed.
Naproxen levels in serum, synovial fluid and synovium of eighteen patients with "classical" or "definite" rheumatoid arthritis and chronic knee effusion were studied. After oral administration of 250 mg naproxen twice daily, naproxen levels in synovial fluid were found to be more than half as high as in serum. Even in synovium itself naproxen levels were appreciable.
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The elimination of sotalol was studied in 25 patients with chronic renal failure. All patients were given a single 160 mg dose of sotalol orally and their sotalol serum levels were determined after 4, 6, 8, 10 and 12 hours. The elmination of sotalol was distinctly slower as the serum creatinine concentration rose. The half-lives, calculated graphically, were in lenear ratio to the serum creatinine values (r = 0,91; p less than 0.001). In accordance with the results, it is probable that sotalol accumulates in chronic renal insufficiency. Since beta-blockers may impair renal function, even in therapeutic concentrations, the dosage of sotalol, in particular, must be reduced in patient with kidney disease.
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The role of liver drug metabolism on blood pressure (BP) response to a lipophilic (propranolol) and hydrophilic (sotalol) beta blocker in thirty hypertensive patients was studied. Ten patient treated with diuretics were classified according to plasma antipyrine clearance rate as rapid and slow metabolizers. They were first treated for one month with propranolol and then for one month with sotalol at equivalent dosage. Four patients, classified as rapid drug metabolizers had a better response to sotalol, 139 (SD 13)/92 (SD 6) mmHg, than to propranolol, 164 (21)/104 (10) mmHg. For the other six patients, with slow drug metabolism, the response to propranolol, 142 (8)/95 (8) mmHg was equal to sotalol, 143 (19)/93 (8) mmHg. Twenty patients were randomly divided into two groups. The patients in these groups were similar as to sex, age, body mass index, BP and rate of drug metabolism. The subjects in the first group were treated with propranolol and diuretic and those in the second with sotalol and diuretic. The BP response was equal in both groups, propranolol 147 (14)/96 (7) mmHg and sotalol 143 (12)/95 (9) mmHg after two years' follow-up. The rate of drug metabolism must be considered when evaluating response to lipophilic but not to hydrophilic beta blocker.