PubMed · 11004966
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J P Delahaye. 2000. [ELAN study].. https://pubmed.ncbi.nlm.nih.gov/11004966/
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A direct analytical method of pindolol enantiomers in body fluids was developed by means of column-switching semi-microcolumn liquid chromatography/tandem mass spectrometry (LC-MS/MS). A pre-column packed with a silica-based cation-exchanger was used for on-line sample cleanup. Subsequent enantioseparation was conducted with a phenylcarbamate-beta-cyclodextrin (ph-beta-CD) bonded semi-micro chiral column (2.0 mm inner diameter (i.d.)). A 25-microl aliquot of serum/urine samples was directly injected into the system after simple filtration with a membrane filter. Separated enantiomers were monitored with positive electrospray ionization (ESI) and selected reaction monitoring (SRM). R(+)- and S(-)-pindolol in serum and urine were determined separately within 16 min at a resolution factor of 1.9. The detection limits at a signal-to-noise (S/N) ratio of 5 were 0.13 ng ml(-1) for both enantiomers. The linearity of the method was in the range of 0.25-100 ng ml(-1) with regression coefficient greater than 0.997. Recoveries from spiked serum and urine samples, estimated by the external standard method, were between 94.8 and 117.6% with a relative standard deviation (RSD) ranging from 2.1 to 18%.
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Many of the estimated 50 million Americans with high blood pressure receive medications for hypertension and for other conditions, placing them at risk for adverse drug interactions. The risk for hypertension and for adverse drug reactions is highest in the elderly, who have the greatest need for pharmacologic therapy. The most important class of drug interactions involves the cytochrome P450 microsomal enzyme system, which handles a variety of xenobiotic substances. A potential for interactions with these enzymes exists with calcium channel blockers, beta-adrenergic blocking agents, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers but not with diuretic antihypertensives, which are renally eliminated and more vulnerable to drug interactions that occur in the kidney. This article reviews the cytochrome P450 enzyme system, identifies drugs and foods that have been implicated in metabolic interactions with antihypertensive agents, and suggests measures for reducing the risk of adverse events when drugs are coadministered.