Pharmacokinetic-pharmacodynamic relationships of apomorphine in patients with Parkinson's disease.

Abstract:

:In the treatment of patients with Parkinson's disease, apomorphine has an established place as a back-up therapy if other antiparkinsonian drugs, such as levodopa and oral dopamine agonists, have not controlled the existing response fluctuations. Apomorphine is a synthetic derivative of morphine, with a totally distinct pharmacological profile. It is a very lipophilic compound which is easily (auto)oxidised. This (auto)oxidation is the main metabolic route besides glucuronidation and sulphation, which are both responsible for about 10% of the metabolic transformation. Apomorphine quickly passes the nasal and intestinal mucosa as well as the blood-brain barrier (depending on the administration route). Many routes of administration have been explored, but subcutaneous, sublingual, nasal and rectal administration are used in clinical practice. The volume of distribution varies between 1 and 2 times bodyweight. The elimination half-life is very short (30 to 90 min) depending on the type of parenteral administration. Apomorphine is a high clearance drug (3 to 5 L/kg/h) and is mainly excreted and metabolised by the liver. Only 3 to 4% is excreted unchanged in the urine. The clinical effect of apomorphine can be linked directly to its concentration in the cerebrospinal fluid. Consequently, a 2-compartment model can be used to predict the clinical effects of apomorphine. The pharmacokinetic-pharmacodynamic data reflect the clinical observations of steep dose-effect curves if apomorphine is used in patients with random 'on-off' fluctuations. These dose-effect curves are less steep in stable or 'wearing-off' (end-of-dose deterioration) patients. Intravenous infusions of apomorphine in combination with timed motor assessments can be used clinically to characterise the therapeutic window of a particular patient if dyskinesia persists after single injections of apomorphine. If more population data become available, the population pharmacokinetics-pharmacodynamics of apomorphine could be helpful in predicting the clinical effects of apomorphine in the several subgroups of patients with Parkinson's disease.

journal_name

Clin Pharmacokinet

authors

Neef C,van Laar T

doi

10.2165/00003088-199937030-00004

keywords:

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

257-71

issue

3

eissn

0312-5963

issn

1179-1926

journal_volume

37

pub_type

杂志文章,评审
  • Clinical pharmacokinetics of the salicylates.

    abstract::The use of salicylates in rheumatic diseases has been established for over 100 years. The more recent recognition of their modification of platelet and endothelial cell function has lead to their use in other areas of medicine. Aspirin (acetylsalicylic acid) is still the most commonly used salicylate. After oral admin...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-198510020-00004

    authors: Needs CJ,Brooks PM

    更新日期:1985-03-01 00:00:00

  • Pharmacokinetic optimisation of vancomycin therapy.

    abstract::Renewed interest in vancomycin over the past decade has led to an abundance of data concerning the pharmacokinetics of vancomycin, and its dosage selection and concentration-response relationships. No definitive data exist that correlate vancomycin serum concentrations with clinical outcomes. However, inconsistencies ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-199528040-00005

    authors: Leader WG,Chandler MH,Castiglia M

    更新日期:1995-04-01 00:00:00

  • Pharmacokinetic and pharmacodynamic properties of metoprolol in patients with impaired renal function.

    abstract::The pharmacokinetics of metoprolol have been studied in a group of patients with varying degrees of renal impairment and in healthy subjects after administration of 20 mg of metoprolol tartrate intravenously and 50 mg orally in a single dose and during steady-state conditions. There were no significant differences in ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-198005020-00004

    authors: Jordö L,Attman PO,Aurell M,Johansson L,Johnsson G,Regårdh CG

    更新日期:1980-03-01 00:00:00

  • Clinical pharmacokinetics of lignocaine.

    abstract::Lignocaine is widely used as a local anaesthetic and antiarrhythmic drug. It is commonly administered to patients with acute myocardial infarction as prophylaxis for ventricular fibrillation, although its efficacy in preventing primary ventricular fibrillation is still debated. Toxicity, sometimes with serious clinica...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-197803030-00001

    authors: Benowitz NL,Meister W

    更新日期:1978-05-01 00:00:00

  • Pharmacokinetics of cetirizine in tear fluid after a single oral dose.

    abstract:BACKGROUND:Antihistamines (histamine H(1) receptor antagonists) are effective and convenient drugs for the treatment of allergic conjunctivitis. Because of the short duration of action generally observed for drugs administered topically to the eye, the oral route is often preferred. However, the presence of a selective...

    journal_title:Clinical pharmacokinetics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00003088-200241070-00006

    authors: Grumetto L,Cennamo G,Del Prete A,La Rotonda MI,Barbato F

    更新日期:2002-01-01 00:00:00

  • Drug-Drug Interaction Studies of Elagolix with Oral and Transdermal Low-Dose Hormonal Add-Back Therapy.

    abstract:BACKGROUND AND OBJECTIVE:Elagolix is an oral, non-peptide, gonadotropin-releasing hormone receptor antagonist. It is approved for the treatment of moderate-to-severe pain associated with endometriosis and is being investigated for the treatment of heavy menstrual bleeding associated with uterine fibroids. Use of low-do...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.1007/s40262-020-00921-y

    authors: Nader A,Mostafa NM,Ali F,Shebley M

    更新日期:2021-01-01 00:00:00

  • Therapeutic drug monitoring of clozapine treatment. Therapeutic threshold value for serum clozapine concentrations.

    abstract::It has been suggested that the minimum effective serum clozapine concentration for an acceptable clinical response (threshold value) is about 400 micrograms/L. This article argues against the use of therapeutic drug monitoring (TDM) as a tool to obtain clozapine concentrations of > or = 400 micrograms/L in the individ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-199834060-00005

    authors: Olesen OV

    更新日期:1998-06-01 00:00:00

  • Clinical pharmacokinetics in the 21st century. Does the evidence support definitive outcomes?

    abstract::Clinical pharmacokinetics emerged as a clinical discipline in the late 1960s and early 1970s. Clinical pharmacokinetic monitoring (CPM) helped many pharmacists to enter the clinical arena, but the focus was more on the pharmacists and tools. With the widespread acceptance of pharmaceutical care and patient-focused pha...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-199834040-00001

    authors: Ensom MH,Davis GA,Cropp CD,Ensom RJ

    更新日期:1998-04-01 00:00:00

  • The fentanyl HCl patient-controlled transdermal system (PCTS): an alternative to intravenous patient-controlled analgesia in the postoperative setting.

    abstract::Inadequate pain control in the postoperative period not only contributes to patient discomfort, but also causes physiological changes that may result in increased risk of myocardial ischaemia, deep vein thrombosis and pulmonary embolism. These events complicate postoperative recovery and may lead to longer hospital st...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-200544001-00002

    authors: Sinatra R

    更新日期:2005-01-01 00:00:00

  • Pharmacokinetics of taurolidine following repeated intravenous infusions measured by HPLC-ESI-MS/MS of the derivatives taurultame and taurinamide in glioblastoma patients.

    abstract:BACKGROUND AND OBJECTIVE:Taurolidine is known to have antimicrobial activity. Furthermore, at lower concentrations, it has been found to exert a selective antineoplastic effect in vitro and in vivo. The aim of this study was to investigate the pharmacokinetics of taurolidine in vivo following repeated intravenous infus...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-200746060-00005

    authors: Stendel R,Scheurer L,Schlatterer K,Stalder U,Pfirrmann RW,Fiss I,Möhler H,Bigler L

    更新日期:2007-01-01 00:00:00

  • Central nervous system penetration of antiretroviral drugs: pharmacokinetic, pharmacodynamic and pharmacogenomic considerations.

    abstract::The prevalence of HIV-associated neurocognitive disorder (HAND) is increasing despite the widespread use of combination antiretroviral therapy (ART). Initial reports suggest that the use of antiretrovirals with good central nervous system (CNS) penetration leads to better neurocognitive outcomes, but this has not yet ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.1007/s40262-015-0257-3

    authors: Decloedt EH,Rosenkranz B,Maartens G,Joska J

    更新日期:2015-06-01 00:00:00

  • Older Age is Associated with Higher Dolutegravir Exposure in Plasma and Cerebrospinal Fluid of People Living with HIV.

    abstract:BACKGROUND:People living with human immunodeficiency virus are ageing under combination antiretroviral treatments but data on drug exposure in serum and cerebrospinal fluid are limited. Dolutegravir is a widely used second-generation integrase strand transfer inhibitor: conflicting data suggest that neuropsychiatric si...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.1007/s40262-020-00916-9

    authors: Calcagno A,Moltó J,Borghetti A,Gervasoni C,Milesi M,Valle M,Avataneo V,Alcantarini C,Pla-Junca F,Trunfio M,D'Avolio A,Di Giambenedetto S,Cattaneo D,Di Perri G,Bonora S

    更新日期:2021-01-01 00:00:00

  • Pharmacokinetics of antibiotics in pregnancy and labour.

    abstract::Few of the articles published on antibiotics and pregnancy are concerned with pharmacokinetics. It is particularly difficult to evaluate possible alterations in pharmacokinetic parameters that may be due to pregnancy. Most data available have been obtained in connection with abortion or delivery. Such data may not be ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-197904040-00003

    authors: Philipson A

    更新日期:1979-07-01 00:00:00

  • Random-effects linear modeling and sample size tables for two special crossover designs of average bioequivalence studies: the four-period, two-sequence, two-formulation and six-period, three-sequence, three-formulation designs.

    abstract::Due to concern and debate in the epilepsy medical community and to the current interest of the US Food and Drug Administration (FDA) in revising approaches to the approval of generic drugs, the FDA is currently supporting ongoing bioequivalence studies of antiepileptic drugs, the EQUIGEN studies. During the design of ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.1007/s40262-013-0103-4

    authors: Diaz FJ,Berg MJ,Krebill R,Welty T,Gidal BE,Alloway R,Privitera M

    更新日期:2013-12-01 00:00:00

  • A Compartmental Analysis for Morphine and Its Metabolites in Young Children After a Single Oral Dose.

    abstract:BACKGROUND AND OBJECTIVES:Currently, the majority of the surgical procedures performed in paediatric hospitals are done on a day care basis, with post-operative pain being managed by caregivers at home. Pain after discharge of these post-operative children has historically been managed with oral codeine in combination ...

    journal_title:Clinical pharmacokinetics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/s40262-015-0256-4

    authors: Velez de Mendizabal N,Jimenez-Mendez R,Cooke E,Montgomery CJ,Dawes J,Rieder MJ,Aleksa K,Koren G,Jacobo-Cabral CO,Gonzalez-Ramirez R,Castañeda-Hernandez G,Carleton BC

    更新日期:2015-10-01 00:00:00

  • New insulin analogues and routes of delivery: pharmacodynamic and clinical considerations.

    abstract::Analogues of human insulin have been developed to more closely replicate the physiology of meal-related and basal insulin secretion. Three rapid-acting analogues and two basal analogues are available for clinical use. Insulin aspart and insulin lispro have nearly identical pharmacokinetic and pharmacodynamic profiles ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-200847090-00003

    authors: Roach P

    更新日期:2008-01-01 00:00:00

  • Jejunal Infusion of levodopa-carbidopa intestinal gel versus oral administration of levodopa-carbidopa tablets in japanese subjects with advanced Parkinson's disease: pharmacokinetics and pilot efficacy and safety.

    abstract:BACKGROUND AND OBJECTIVE:Oral levodopa-carbidopa (LC-oral) treatment in advanced Parkinson's disease (PD) is associated with motor complications due to large fluctuations in levodopa plasma concentrations. Levodopa-carbidopa intestinal gel (LCIG) provides individualized continuous levodopa-carbidopa delivery through in...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s40262-015-0265-3

    authors: Othman AA,Chatamra K,Mohamed ME,Dutta S,Benesh J,Yanagawa M,Nagai M

    更新日期:2015-09-01 00:00:00

  • Famotidine and theophylline pharmacokinetics. An unexpected cimetidine-like interaction in patients with chronic obstructive pulmonary disease.

    abstract::The results of research studies conducted to date in vitro and in healthy volunteers are practically all concordant in demonstrating the lack of any kind of interference between famotidine and microsomal oxidative metabolism. The pharmacokinetics (elimination half-life, area under the plasma concentration-time curve, ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-199324030-00006

    authors: Dal Negro R,Pomari C,Turco P

    更新日期:1993-03-01 00:00:00

  • Development of Population and Bayesian Models for Applied Use in Patients Receiving Cefepime.

    abstract:BACKGROUND AND OBJECTIVE:Understanding pharmacokinetic disposition of cefepime, a β-lactam antibiotic, is crucial for developing regimens to achieve optimal exposure and improved clinical outcomes. This study sought to develop and evaluate a unified population pharmacokinetic model in both pediatric and adult patients ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.1007/s40262-020-00873-3

    authors: Liu J,Neely M,Lipman J,Sime F,Roberts JA,Kiel PJ,Avedissian SN,Rhodes NJ,Scheetz MH

    更新日期:2020-08-01 00:00:00

  • Steady-state kinetics and dosage requirements of cimetidine in renal failure.

    abstract::25 patients with different degrees of chronic stable renal failure received oral treatment with cimetidine over 6 days and a final dose in the morning of day 7. The doses of cimetidine were reduced according to the degree of renal failure. Plasma concentrations of cimetidine were determined before the morning dose on ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-198106040-00006

    authors: Larsson R,Norlander B,Bodemar G,Walan A

    更新日期:1981-07-01 00:00:00

  • Role of cytochrome P450 activity in the fate of anticancer agents and in drug resistance: focus on tamoxifen, paclitaxel and imatinib metabolism.

    abstract::Although activity of cytochrome P450 isoenzymes (CYPs) plays a major role in the fate of anticancer agents in patients, there are relatively few clinical studies that evaluate drug metabolism with therapeutic outcome. Nevertheless, many clinical reports in various non-oncology fields have shown the dramatic importance...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-200544040-00002

    authors: Rochat B

    更新日期:2005-01-01 00:00:00

  • Drugs and Diseases Interacting with Cigarette Smoking in US Prescription Drug Labelling.

    abstract::The US Food and Drug Administration (FDA) draft guidance for industry on drug interaction studies recommends, but does not mandate, that both cigarette smokers and non-smokers can be used to study drug metabolism in clinical trials, and that important results related to smoking should be included in drug labelling to ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.1007/s40262-015-0246-6

    authors: Li H,Shi Q

    更新日期:2015-05-01 00:00:00

  • Pharmacokinetics of pancuronium in patients undergoing coronary artery surgery with and without low dose dopamine.

    abstract::Pancuronium is frequently used in coronary artery surgery, but its pharmacokinetics in these patients are still unknown. It is possible that dopamine, administered to prevent renal impairment induced by the surgery, might promote the elimination of pancuronium. Therefore, the pharmacokinetics of a bolus dose of pancur...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-199019060-00005

    authors: Wierda JM,van der Starre PJ,Scaf AH,Kloppenburg WD,Proost JH,Agoston S

    更新日期:1990-12-01 00:00:00

  • Pharmacokinetics following intraventricular administration of chemotherapy in patients with neoplastic meningitis.

    abstract::Intraventricular administration of chemotherapy is one approach to overcoming the limited distribution of anticancer drugs and their active metabolites into the CNS. This form of regional chemotherapy has led to effective treatment of occult and overt meningeal leukaemia in humans. In contrast, the efficacy of this th...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-200544010-00001

    authors: Fleischhack G,Jaehde U,Bode U

    更新日期:2005-01-01 00:00:00

  • Pharmacokinetics of long acting propranolol. Implications for therapeutic use.

    abstract::Beta-adrenoceptor antagonists are among the most commonly prescribed classes of drugs. They are indicated for the treatment of diseases such as hypertension and angina pectoris, in which long term therapy is often required. Since many beta-adrenoceptor antagonists have short plasma elimination half-lives, divided dail...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-198713010-00003

    authors: Nace GS,Wood AJ

    更新日期:1987-07-01 00:00:00

  • Influence of gestational age and body weight on the pharmacokinetics of labetalol in pregnancy.

    abstract:BACKGROUND AND OBJECTIVES:Labetalol is frequently prescribed for the treatment of hypertension during pregnancy; however, the influence of pregnancy on labetalol pharmacokinetics is uncertain, with inconsistent findings reported by previous studies. This study examined the population pharmacokinetics of oral labetalol ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.1007/s40262-013-0123-0

    authors: Fischer JH,Sarto GE,Hardman J,Endres L,Jenkins TM,Kilpatrick SJ,Jeong H,Geller S,Deyo K,Fischer PA,Rodvold KA

    更新日期:2014-04-01 00:00:00

  • Reliability of antiarrhythmic drug plasma concentration monitoring.

    abstract::Measurement of drug levels is becoming increasingly popular to optimise the dosage of various drugs. In the case of antiarrhythmic drugs, the narrow therapeutic margin of most of these agents and a direct relationship between their pharmacological effects and plasma concentrations would justify more widespread use of ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-198308010-00004

    authors: Follath F,Ganzinger U,Schuetz E

    更新日期:1983-01-01 00:00:00

  • Clinical pharmacokinetics and dose optimisation of carboplatin.

    abstract::Carboplatin shares some of the therapeutic advantages of cisplatin, but without a significant incidence of the dose-limiting neurotoxicity and nephrotoxicity which is experienced with cisplatin. However, its use is associated with dose-limiting bone marrow suppression. Carboplatin is present in the blood as 3 distinct...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-199733030-00002

    authors: Duffull SB,Robinson BA

    更新日期:1997-09-01 00:00:00

  • Clinical pharmacokinetics of mifepristone.

    abstract::Mifepristone is a steroidal antiprogestin and antiglucocorticoid acting at the receptor level. The aromatic dimethylaminophenyl side chain in position 11 of the steroid structure is essential for the antagonistic properties of mifepristone. The pharmacokinetics of mifepristone are characterised by rapid absorption, a ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-199733010-00002

    authors: Heikinheimo O

    更新日期:1997-07-01 00:00:00

  • Blockade of the High-Affinity Interleukin-2 Receptors with Daclizumab High-Yield Process: Pharmacokinetic/Pharmacodynamic Analysis of Single- and Multiple-Dose Phase I Trials.

    abstract:BACKGROUND AND OBJECTIVE:Daclizumab high-yield process (DAC HYP) is a humanized monoclonal antibody that selectively blocks the α-subunit (CD25) of the high-affinity interleukin-2 receptors, and has shown robust efficacy as a treatment for multiple sclerosis (MS). This work quantitatively characterized the relationship...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s40262-015-0305-z

    authors: Minocha M,Tran JQ,Sheridan JP,Othman AA

    更新日期:2016-01-01 00:00:00