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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 51 (1973), S. 1081-1090 
    ISSN: 1432-1440
    Keywords: Anticoagulants ; coumarins ; drug interaction ; protein binding ; enzyme induction ; enzyme inhibition ; Antikoagulantien ; Cumarine ; Arneimittelwechselwirkung ; Interaktion ; Eiweißbindung ; Enzyminduktion ; Enzymhemmung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Eine große Zahl von Medikamenten tritt bei gleichzeitiger Gabe in Interaktion mit Cumarinderivaten. Wesentliche Mechanismen sind dabei Resorptionshemmung, Verdrängung aus der Plasmaeiweißbindung, Hemmung oder Induktion des metabolisierenden Enzymsystems sowie Beeinflussung von Synthese oder Abbau der Vitamin Kabhängigen Gerinnungsfaktoren. Auch die Cumarine selbst sind in der Lage, die Metabolisierung anderer Pharmaka hemmend zu beeinflussen. Es ergibt sich die Notwendigkeit, neu einzuführende Medikamente auf die Interaktion mit Cumarinen zu testen. Eine sorgfältige Überwachung des Patienten ist bei Beginn oder Beendigung jeder Therapie mit einem in Kombination mit Cumarinen eingesetzten Pharmakon angezeigt.
    Notes: Summary Many drugs are known to modify the pharmacological action of coumarin anticoagulants when administered simultaneously. Mechanisms of interaction may consist in inhibition of absorption, displacement from protein binding sites, inhibition or induction of drug metabolizing enzymes in liver microsomes, and effect on synthesis and metabolization of the vitamin K-dependent clotting factors. Coumarins also may inhibit the metabolic degradation of other drugs. It is therefore necessary to test new compounds for a possible interaction with coumarin agents. Patients treated with coumarin anticoagulants should be controled carefully for changes in the hypoprothrombinaemic action when additional drugs are given or when these are discontinued.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 19 (1981), S. 343-347 
    ISSN: 1432-1041
    Keywords: cimetidine ; phenobarbital ; gastro-intestinal absorption ; bioavailability ; renal clearance ; non-renal clearance ; enzyme induction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The pharmacokinetics of orally administered cimetidine was studied in 8 healthy subjects before and after 3 weeks of treatment with phenobarbital 100 mg daily, and in a separate study 4 subjects received cimetidine intravenously before and after the administration of phenobarbital. There was no change in the volume of distribution, but total plasma clearance was increased by a mean of 18%, mainly due to a 37% increase in nonrenal clearance. Renal clearance and half-life were not significantly altered. The area under the plasma concentration-time curve after oral administration was significantly (P≪0.05) reduced by a mean of 15% after phenobarbital treatment. The amount of cimetidine excreted in urine and its sulphoxide metabolite were significantly (P〈0.05) reduced, on average by 34% and 26%, respectively by phenobarbital treatment. The data indicate that an apparent 20% reduction in the absorption of cimetidine was due to induction of gastrointestinal metabolism of cimetidine, with some contribution also from hepatic metabolism. Reduced absorption per se could not be totally excluded. Although the magnitude of the change was small, the finding of an 11% decrease in the time to achieve an effective plasma level of cimetidine after phenobarbital treatment may contribute to the ineffectiveness of cimetidine in certain patients.
    Type of Medium: Electronic Resource
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