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D Khenfer

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Pharmacokinetics of diltiazem in severe renal failure.

The acute effects of a single dose of diltiazem (Tildiem), a calcium antagonist, were studied in 9 patients with severely impaired renal function (GFR between 0.03 and 0.87 ml/s/1.73 m2). Control measurements were made of inulin and PAH clearance, creatinine, blood pressure, heart rate and ECG. Following administration of diltiazem 120 mg, 7 blood samples were collected in the first 12 h and after 24 h, 32 h, 48 h; urine was collected for the first 12 h, 12-24 h and 24-48 h, and blood pressure, heart rate and ECG were recorded after 6 h. Diltiazem and its main metabolite, desacetyldiltiazem, had a pharmacokinetic profile similar to that in patients with normal renal function (peak plasma concentration, half-life and urinary excretion). Diltiazem is normally eliminated in the urine to a small extent, because it is metabolized, and this also applies to desacetyldiltiazem, which is probably further metabolized.

Adult

Pharmacokinetics of caffeine during and after pregnancy.

The pharmacokinetic parameters of caffeine were measured in 9 pregnant women and 4 women 4 days post partum. The results show a significant prolongation of caffeine elimination in pregnant women. Normal pharmacokinetic parameters seem to be restored as soon as 4 days post partum. Steroids hormones (estriol, estradiol, and progesterone) were measured in both cases.

Adult