Influence of Hemodynamic Variations on the Pharmacokinetics of Landiolol in Patients Undergoing Cardiovascular Surgery

Although landiolol is useful in the emergency management of atrial fibrillation, atrial flutter, and tachycardia, as well as in perioperative arrhythmia control, the influence of hemodynamic changes on the pharmacokinetics of landiolol is unknown. We investigated the influence of hemodynamic variati...

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Bibliographic Details
Published in:Biological & pharmaceutical bulletin 2012/10/01, Vol.35(10), pp.1655-1660
Main Authors: Matsumoto, Naoki, Aomori, Tohru, Kanamoto, Masafumi, Usui, Tadashi, Shiga, Tatsuya, Yamamoto, Koujirou, Saito, Shigeru
Format: Article
Language:English
Subjects:
Aged
Anti-Arrhythmia Agents - administration & dosage
Anti-Arrhythmia Agents - blood
Anti-Arrhythmia Agents - pharmacokinetics
Anticoagulants - administration & dosage
cardiac index
Cardiac Surgical Procedures
Female
Hemodynamics
heparin
Heparin - administration & dosage
hepatic venous blood flow
HPLC
Humans
landiolol
Liver - blood supply
Male
Middle Aged
Morpholines - administration & dosage
Morpholines - blood
Morpholines - pharmacokinetics
pseudocholinesterase
Regional Blood Flow
Urea - administration & dosage
Urea - analogs & derivatives
Urea - blood
Urea - pharmacokinetics
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Summary:Although landiolol is useful in the emergency management of atrial fibrillation, atrial flutter, and tachycardia, as well as in perioperative arrhythmia control, the influence of hemodynamic changes on the pharmacokinetics of landiolol is unknown. We investigated the influence of hemodynamic variation and the following hepatocirculatory changes after systemic heparinization on the pharmacokinetics of landiolol in patients undergoing cardiovascular surgery under cardiopulmonary bypass. Cardiac output and cardiac index (CI) were continuously monitored in 19 patients using an arterial pressure-based cardiac output monitor. The middle and right hepatic venous blood flow indexes (mHVBFI and rHVBFI) were measured by transesophageal echocardiography, and hemodynamic data were collected at points (T1-T3) as follows: T1, before administration of heparin and after sternotomy; T2, just before systemic heparinization (300 U/kg); T3, 10 min after T2. The plasma concentration of landiolol was measured by HPLC at the same point. After administration of heparin, mean arterial blood pressure, CI, mHVBFI, and rHVBFI were significantly decreased (
ISSN:0918-6158
1347-5215
DOI:10.1248/bpb.b110727