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Titolo:
Clinical pharmacokinetics of glucocorticoids
Autore:
van de Lagemaat, S; Nagel, JD; Bode, U;
Indirizzi:
Univ Bonn, Dept Paediat Haematol & Oncol, D-53113 Bonn, Germany Univ BonnBonn Germany D-53113 t Haematol & Oncol, D-53113 Bonn, Germany
Titolo Testata:
INTERNATIONAL JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY
fascicolo: 4, volume: 6, anno: 1999,
pagine: 261 - 274
SICI:
1070-2903(1999)6:4<261:CPOG>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE LYMPHOBLASTIC-LEUKEMIA; RENAL-TRANSPLANT PATIENTS; PLASMA-PROTEIN BINDING; PREDNISOLONE DISPOSITION; CEREBROSPINAL-FLUID; MENINGEAL LEUKEMIA; CHILDHOOD LEUKEMIA; CROHNS-DISEASE; LIVER-FUNCTION; METABOLISM;
Keywords:
glucocorticoids; prednisone; prednisolone; methylprednisolone; dexamethasone; pharmacokinetics;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
102
Recensione:
Indirizzi per estratti:
Indirizzo: Bode, U Univ Bonn, Dept Paediat Haematol & Oncol, Adenauerallee 119, D-53113 Bonn,Germany Univ Bonn Adenauerallee 119 Bonn Germany D-53113 113 Bonn,Germany
Citazione:
S. van de Lagemaat et al., "Clinical pharmacokinetics of glucocorticoids", INT J PED H, 6(4), 1999, pp. 261-274

Abstract

Glucocorticoids have been demonstrated to be effective in the treatment ofleukemias and lymphomas. This article gives an overview of the pharmacokinetics of the four most commonly used glucocorticoids prednisone, prednisolone, methylprednisolone and dexamethasone. Absorption, distribution, plasma protein binding, Area Under the Curve (AUC), cerebrospinal fluid concentration and elimination are described and the impact of drugs and diseases on the pharmacokinetics is discussed. Recommendations for glucocorticoid dose adjustment are given in case of impairment of liver function, a hyperfunctioning thyroid, cystic fibrosis or the concomitant use of anticonvulsants, rifampicin, aminophylline, estrogens or ketoconazole. Prednisolone tablets are preferable to prednisone. An optimal glucocorticoid dosage scheme of 1/4-1/4-1/4-1/4 is proposed. Oral glucocorticoid doses have to be corrected fortheir bioavailability compared to intravenous doses. Very high cerebrospinal fluid concentrations can be achieved by intrathecal injection. The use of dexamethasone instead of prednisolone in treating leukemia is recommended. Finally, a comparison of pharmacokinetics in adults and children is carried out. In low birth weight infants dexamethasone doses have to be reduced;in children less than 2 years a small glucocorticoid dose reduction is advisable.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 02:56:32