ABSTRACT
This study examined the hemodynamic effects of arbutamine, a synthetic catecholamine, in 12 patients with and 7 patients without coronary artery disease. Arbutamine produced a balanced positive inotropic (increase in left ventricular dp/dt) and chronotropic effect (increase in heart rate).
Subject(s)
Angina Pectoris/diagnosis , Cardiotonic Agents , Catecholamines , Coronary Disease/diagnosis , Hemodynamics/drug effects , Adult , Cardiac Catheterization , Cardiotonic Agents/administration & dosage , Catecholamines/administration & dosage , Dose-Response Relationship, Drug , Electrocardiography/drug effects , Female , Heart Rate/drug effects , Humans , Infusion Pumps , Male , Middle Aged , Myocardial Contraction/drug effects , Sensitivity and Specificity , Tomography, Emission-Computed, Single-PhotonABSTRACT
The purpose of this randomized, double-blind multicenter trial was to investigate the potential therapeutic effect of epoprostenol (prostacyclin, PGI2) in patients with unstable angina, as compared with placebo, and to investigate the safety of this agent. Of the 184 patients enrolled, 28 did not fit the study criteria; of the remaining 156 patients, 30 received prostacyclin in an open-label fashion. In the double-blind portion of the study, 63 patients each received prostacyclin or placebo. The drug or its vehicle was infused intravenously up to 5 ng/kg/min dose for 72 hours with a tapering off period for the last 12 hours. Both treatment groups from the double-blind portion were comparable in regard to the demographic data, length of infusion, and total dose received. There were no significant differences between the placebo and prostacyclin group in the following clinical endpoints: levels of cardiac enzymes throughout hospitalization period (with the exception of lower SGOT level in the prostacyclin group at day 2), and severity of angina (throughout the study), and at the end of the study (day 30). The number of patients who had congestive heart failure, new myocardial infarction, balloon pump insertion, coronary artery bypass grafting, or percutaneous coronary angioplasty was similar in both groups. Similar results in regard to the efficacy endpoints were also apparent in the prostacyclin group that was treated under open-label fashion. There was also no difference in the New York Heart Association (NYHA) functional status at the end of the double-blind study.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Angina Pectoris/drug therapy , Angina, Unstable/drug therapy , Epoprostenol/therapeutic use , Adolescent , Adult , Aged , Clinical Trials as Topic , Double-Blind Method , Epoprostenol/adverse effects , Female , Humans , Male , Middle AgedABSTRACT
The absorption and disposition of quinidine were measured in nine patients following single oral and intravenous dosing. A new specific chromatographic method was used to measure the drug in plasma and urine. After intravenous administration, the plasma half-life (t1/2beta) was 7.8+/-0.7 h, the volume of distribution (Vd) was 3.0+/-0.5 liters/kg, and the total body clearance was 4.8+/-0.8 ml/min/kg. After oral administration, 87+/-7% (mean+/-SEM) was available to the systemic circulation. Quinidine was removed primarily by hepatic metabolism, with the renal clearance averaging only 1.0+/-0.2 ml/min/kg. Mean quinidine concentrations were estimated in 42 patients on chronic therapy by averaging blood levels during a dosing interval. In patients without heart failure, these corresponded well to mean drug levels predicted from the pharmacokinetic parameters measured after a single intravenous dose, but in patients with heart failure, the values for mean quinidine concentrations were higher than predicted. This suggests that impaired elimination of the drug or a decreased volume of its distribution, or both, may develop in heart failure.
