Abstract
A standard format for a Clinical Pharmacokinetic Summary is proposed. It consists of a heading, table, notes, and references for each drug reviewed. The table presents a unified and logical set of clinically useful population pharmacokinetic parameters. They concern four major areas: absorption, distribution, elimination, and the relationship of concentration to effect. Within each major group, parameters dealing with extents and rates of processes are given. Each such parameter is really two: a population mean value (for example, average volume of distribution) and the standard deviation of individual values about this mean. The first value allows individual predictions of dosage or drug level to be made; the second allows computation of the likely proximity of subsequently observed quantities to those predictions. The table presents single consensus values for each population parameter, rather than a list of values. A procedure for computing these consensus values, and for revising them in the light of new data, or reinterpreted old data, is given. Examples of Summaries are given. The method appears applicable to a variety of drugs. We suggest our approach as a standard one for preparing Clinical Pharmacokinetic Summaries, and urge our colleagues to consider it for that purpose.
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Alprenolol references
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Clofibrate references
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Digitoxin: supplementary references
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Digoxin references
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S. Rubenfeld, V. E. Silverman, K. M. A. Welch, L. E. Mallette, and P. O. Kohler. Variable plasma propranolol levels in thyrotoxicosis. Med. Intelligence300:353–354 (1979).
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E. A. Taylor, T. L. Kaspi, and P. Turner. The pH dependent absorption of propranolol and indomethacin by parafilm, a stimulant of salivary secretion.J. Pharm. Pharmacol. 30:813–814 (1978).
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J. Vasiliades, T. Turner, and C. Owens. A modified sensitive spectrofluorometric method for the determination of propranolol in serum.Am. J. Clin. Pathol. 70:793–799 (1977).
R. E. Vestal, D. M. Kornhauser, J. W. Hollifield, and D. G. Shand. Inhibition of propranolol metabolism by chlorpromazine.Clin. Pharmacol. Ther. 25:19–24 (1979).
R. E. Vestal, A. J. J. Wood, R. A. Branch, D. G. Shand, and G. R. Wilkinson. Effects of age and cigarette smoking on propranolol disposition.Clin. Pharmacol. Ther. 26:8–15 (1979).
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Propranolol: additional references
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R. A. Branch and D. G. Shand. Propranolol disposition in chronic liver disease: a physiological approach.Clin. Pharmacokin. 1:264–279 (1976).
M. F. Cuthbert and R. F. Collins. Plasma levels and beta adrenoceptor blockade with acebutolol, practolol and propranolol in man.Br. J. Clin. Pharmacol. 2:49–55 (1975).
J. F. DePlaen, A. Amery, and T. Reybrouck. Comparative potency of atenolol and propranolol as beta-adrenergic blocking agents in man.Eur. J. Clin. Pharmacol. 10:297–303 (1976).
C. F. George, T. Fenyvesi, M. E. Conolly, and C. T. Dollery. Pharmacokinetics of dextro-laevo- and racemic propranolol in man.Eur. J. Clin. Pharmacol. 4:74–76 (1972).
C. F. George, M. L. Orme, P. Buranapong, D. Macerlean, A. M. Breckenridge, and C. T. Dollery. Contribution of the liver to overall elimination of propranolol.J. Pharmacokin. Biopharm. 4:17–27 (1976).
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D. J. Hetherington, M. B. Comerford, G. Nyberg, and M. M. Besterman. Comparison of two adrenergic beta-receptor blocking agents, alprenolol and propranolol, in treatment of angina pectoris.Br. Heart J. 35:320–333 (1973).
D. C. Hicks, A. G. Arbab, P. Turner, and M. Hills. A comparison of intravenous pindolol and propranolol in normal man.J. Clin. Pharmacol. 12:212–216 (1972).
B. Holland and N. M. Kaplan. Propranolol in the treatment of hypertension.N. Engl. J. Med. 294:930–935 (1976).
J. W. Hollifield, K. Sherman, R. V. Zwagg, and D. G. Shand. Proposed mechanisms of propranolol's antihypertensive effect in essential hypertension.N. Engl. J. Med. 294:68–73 (1976).
J. Kanto, T. Kleimola, R. Mantyla, and E. Syvalahti. Pharmacological effect of propranolol after a single oral dose.Acta. Pharmacol. Toxicol. 39:573–576 (1976).
B. E. Karlberg, B. Kagedal, L. Tegler, and K. Tolagen. Renin concentrations and effects of propranolol and spironolactone in patients with hypertension.Br. Med. J. 1:251–254 (1976).
R. E. Kates. Absorption kinetics of sublingually administered propranolol.J. Med. 8:393–402 (1977).
J. Koch-Weser. Serum drug concentrations as therapeutic guides.N. Engl. J. Med. 287:227–231 (1972).
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D. T. Lowenthal. Pharmacokinetics of propranolol, quinidine, procainamide and lidocaine in chronic renal disease.Am. J. Med. 62:532–538 (1977).
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C. E. McLean and B. C. Deane. Propranolol dose determinants including blood level studies.Angiology 21:536–545 (1970).
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Supported in part by National Institutes of Health, Grants GM 26691 and GM 26676.
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Sheiner, L.B., Benet, L.Z. & Pagliaro, L.A. A standard approach to compiling clinical pharmacokinetic data. Journal of Pharmacokinetics and Biopharmaceutics 9, 59–127 (1981). https://doi.org/10.1007/BF01059343
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DOI: https://doi.org/10.1007/BF01059343