Effect of cardiopulmonary bypass on plasma levels of nifedipine.

Abstract:

:Blood levels of many medications are acutely lowered by cardiopulmonary bypass (CPB). Because nifedipine is often used to provide protection from coronary ischemia, a determination of the effect of CPB on plasma nifedipine levels might help to determine the potential clinical benefit of nifedipine during and after bypass. Four samples of blood were drawn from each of eight patients undergoing cardiac surgery: one before, two during, and one after CPB. Although plasma levels of nifedipine declined during and after bypass (P less than 0.05, analysis of variance), the time-course and slope of the decline indicate that this was an effect of normal metabolism of the drug rather than an effect of physiologic changes occurring during CPB. An important additional finding was that the majority of patients had subtherapeutic levels of nifedipine before bypass, suggesting that additional nifedipine given during and after surgery might be of benefit. The effect of the CPB circuit itself was also examined in vitro by mixing nifedipine into a pump prime solution that was then recirculated with 2 U of outdated blood while levels of nifedipine were measured for 3 h. Plasma levels did not change in either a CPB circuit exposed to light or kept in a darkened room.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Katz RI,Kanchuger MS,Patton KF,Eide TR

doi

10.1213/00000539-199010000-00016

subject

Has Abstract

pub_date

1990-10-01 00:00:00

pages

411-4

issue

4

eissn

0003-2999

issn

1526-7598

journal_volume

71

pub_type

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