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    Elimination of alfentanil delivered by infusion is not altered by the chronic administration of atorvastatin.

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    Authors
    McDonnell, C G
    Malkan, D
    Van Pelt, F D
    Shorten, G D
    Affiliation
    Cork University Hospital, Department of Anaesthesia and Intensive Care Medicine, , Wilton, Cork, Ireland. conormcdonnell@hotmail.com
    Issue Date
    2012-02-03T15:09:09Z
    MeSH
    Adult
    Aged
    Alfentanil/blood/*pharmacokinetics
    Analgesics, Opioid/blood/*pharmacokinetics
    Anticholesteremic Agents/administration & dosage/*pharmacology
    Area Under Curve
    Chromatography, Gas
    Drug Interactions/physiology
    Female
    Heptanoic Acids/administration & dosage/*pharmacology
    Humans
    Hypercholesterolemia/drug therapy
    Infusions, Intravenous
    Male
    Middle Aged
    Pyrroles/administration & dosage/*pharmacology
    Time Factors
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    Citation
    Eur J Anaesthesiol. 2003 Aug;20(8):662-7.
    Journal
    European journal of anaesthesiology
    URI
    http://hdl.handle.net/10147/208983
    PubMed ID
    12932070
    Abstract
    BACKGROUND AND OBJECTIVE: Statins are prescribed for patients with hypercholesterolemia. Atorvastatin is metabolized by cytochrome P4503A4 and inhibits P4503A4 activity in vitro. Alfentanil is a potent opioid used in clinical anaesthetic practice and is also metabolized by P4503A4. This study tested the hypothesis that chronic atorvastatin administration inhibits the metabolism of alfentanil. METHODS: Sixteen patients undergoing elective surgery were studied as matched pairs. One member of each pair was maintained on standard doses of atorvastatin for at least 4 months. Each patient received an alfentanil bolus (80 microg kg(-1)) intravenously (i.v.), followed by an alfentanil infusion (0.67 microg kg(-1) min(-1)) for 90 min. Serial plasma alfentanil concentrations were measured using gas chromatography-nitrogen phosphorous detection. Pharmacokinetic parameters were calculated using two-compartment linear modelling. RESULTS: One patient and the corresponding match were excluded from the analysis. The elimination half-life of alfentanil was similar in the control and atorvastatin groups (98.8 +/- 12.4 versus 98.3 +/- 11.3 min, respectively). The clearance (Cl), volume of distribution at steady-state (Vdss) and area under the curve (AUC) were similar in the two groups (Cl = 0.20 (+/- 0.06) and 0.22 (+/- 0.04) L min(-1), Vdss = 0.38 (+/- 0.07) and 0.39 (+/- 0.07) L kg(-1), AUC = 0.05 (+/- 0.02) and 0.04 (+/- 0.01) mg min mL(-1)). CONCLUSIONS: Concurrent atorvastatin administration does not alter the pharmacokinetics of alfentanil in patients undergoing elective surgery.
    Language
    eng
    ISSN
    0265-0215 (Print)
    0265-0215 (Linking)
    Collections
    Cork University Hospital

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