Pharmacokinetics and pulmonary extraction of clevidipine, a new vasodilating ultrashort-acting dihydropyridine, during cardiopulmonary bypass.

Abstract:

:Clevidipine is a new vascular-selective, calcium channel antagonist of the dihydropyridine type with an ester side chain susceptible to esterase metabolism. In healthy volunteers, it has high clearance (0.069 litres min-1 kg-1) with a small volume of distribution at steady state (0.19 litres kg-1). The half-lives of the two initial rapid phases, accounting for approximately 95% of the area under the curve after an i.v. bolus, are 0.7 and 2.3 min, respectively. The aims of this study were to determine the pharmacokinetics and the pulmonary extraction ratio of clevidipine in patients undergoing cardiac surgery. Seventeen patients received clevidipine as an i.v. infusion before cardiopulmonary bypass (CPB), and eight of these patients were also given clevidipine during hypothermic CPB. Mixed venous and arterial blood samples were taken for pharmacokinetic analysis and calculation of pulmonary extraction ratio. A two-compartment pharmacokinetic model with zero-order input was used to describe the pharmacokinetics of clevidipine before and during CPB. Virtually identical concentrations in mixed venous and arterial blood suggest negligible pulmonary metabolism of clevidipine. The total blood clearance of clevidipine is extremely high (0.055 litres min-1 kg-1). During CPB, clearance of clevidipine was significantly reduced, to 0.03 litres min-1 kg-1 (P < 0.005), probably as a consequence of reduced body temperature.

journal_name

Br J Anaesth

authors

Vuylsteke A,Milner Q,Ericsson H,Mur D,Dunning J,Jolin-Mellgård A,Nordlander M,Latimer R

doi

10.1093/bja/85.5.683

subject

Has Abstract

pub_date

2000-11-01 00:00:00

pages

683-9

issue

5

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)36852-6

journal_volume

85

pub_type

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