Clinical Pharmacokinetics of Drugs in Patients with Heart Failure

摘要: Heart failure is one of the leading causes death in developed countries, and its prevalence expected to increase further coming years. While pharmacokinetic changes observed patients with heart have been reviewed twice Clinical Pharmacokinetics, approximately a quarter century has passed since latest article was published 1988. Since then, many important classes agents (e.g. ACE inhibitors, angiotensin receptor antagonists inotropes) introduced for treatment failure. The aim present update information regarding pharmacokinetics these drugs. For this purpose we made systematic survey literature using MEDLINE, EMBASE Japan Centra Revuo Medicina (in Japanese) found total 111 relevant publications 58 pathophysiological state where damaged heart, from whatever causes, no longer pumps enough blood needs body tissues at rest or during normal daily activities. spectrum ranges acute decompensated (including circulatory shock) chronic compensated Because hypoperfusion organs may influence drug absorption gastrointestinal tract, distribution into elimination either by liver kidneys, it conceivable that drugs be altered light physiologically based model are discussed, can interpret terms binding plasma tissue, flow drug-eliminating intrinsic activity elimination. Pharmacokinetic after intravenous administration described here Part 1 those oral will discussed 2 later issue Pharmacokinetics. Reviewing retrieved data, considered asymptomatic seem minimal alterations parenterally administered as long there concurrent and/or kidney dysfunction. In contrast, systemic clearance least six (i.e. milrinone, carperitide, molsidomine, theophylline, ciclosporin hydralazine) reduced 50 % more severe (New York Association class III IV) compared healthy subjects. paucity failure, close attention should paid monitoring efficacy their associated adverse effects.