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  • 1
    Electronic Resource
    Electronic Resource
    Metabolism of amitriptyline in patients with chronic renal failure (1984)
    Springer
    European journal of clinical pharmacology 26 (1984), S. 227-232 
    Details
    ISSN: 1432-1041
    Keywords: amitriptyline ; kidney function ; uraemics ; biotransformation ; chronic renal failure ; urinary metabolites ; man ; depression ; nortryptyline ; hydroxymetabolites ; unconjugated metabolites ; clinical efficacy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The metabolism of amitriptyline (AMT) has been studied in two groups of depressed in-patients on long term AMT therapy: 11 patients with no other major disease and 8 patients with chronic renal failure, who were being dialysed. The patients with renal insufficiency had decreased concentrations of AMT, nortriptyline (NT) and their unconjugated hydroxymetabolites compared to patients with normal kidney function. The plasma levels of conjugated products were extremely high in the uraemics. The latter metabolites are probably inert. The reduced concentration of unconjugated hydroxymetabolites, which are active compounds, may decrease the clinical effectiveness of the drug.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00630290
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Biotransformation of amitriptyline in depressive patients: Urinary excretion of seven metabolites (1982)
    Springer
    European journal of clinical pharmacology 22 (1982), S. 239-245 
    Details
    ISSN: 1432-1041
    Keywords: depression ; amitriptyline ; biotransformation ; urinary metabolites ; man
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The urinary excretion of amitriptyline (AMT) and seven of its metabolites was studied by mass spectrometry in 10 depressive in-patients treated to steady-state condition with oral amitriptyline. An average of 68.3% of the dose was recovered in the urine, of which 68.6% was present as conjugates. Hydroxynortriptyline and its conjugate represented 54% of the total recovery. There was marked variation in metabolite pattern between patients. The variations were not due to concomitant medication with benzodiazepines. There was no correlation between the plasma and urine concentrations of AMT and its metabolites, except for amitriptyline conjugates. Two groups of patients could be distinguished — low and high excretors, who displayed alternative routes of metabolism. The disappearance rate of AMT from plasma was determined by the metabolic clearance of AMT to its metabolites. It varied considerably between patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00545222
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Interaction between amitriptyline and phenothiazine in man: Effect on plasma concentration of amitriptyline and its metabolite nortriptyline and the correlation with clinical response (1979)
    Springer
    Psychopharmacology 65 (1979), S. 187-190 
    Details
    ISSN: 1432-2072
    Keywords: Amitriptyline ; Nortriptyline ; Drug interaction ; Therapeutic plasma concentration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Amitriptyline (AT) and nortriptyline (NT) plasma levels were checked in 86 patients treated with AT by oral or IM administration. Fifty-six patients were also treated with a phenothiazine. In 20 of these patients receiving AT IM with a phenothiazine, the plasma levels of NT (and the variability of these levels between patients) were higher than in nine patients receiving the antidepressant drug alone at the same dosage and by the same route. In eleven patients receiving AT orally with a phenothiazine the plasma levels of NT (and the variability of these levels between patients) were higher, and the ratio of plasma levels of AT and NT were lower than in eight patients receiving the antidepressant drug alone at the same dosage and by the same route. These results suggest an increase of the demethylation of AT and/or a decrease of the hydroxylation of NT and/or a decrease of its elimination. The differences in the variability of the plasma levels of AT and NT could be due to a saturation of the enzymatic system of biotransformation of the antidepressant drug by phenothiazine and to a first-pass effect when the drug is given orally. The correlation between the plasma levels of AT and NT and the clinical effect has been studied in the 86 patients. The correlation between the NT plasma level and the clinical response seems to be more curvilinear when AT is associated with a phenothiazine. This suggests a potentialization of the post-synaptic alpha-receptor blocking effect of NT by the neuroleptic drug.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00433047
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    Paper (German National Licenses)
    Fulltext
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