Pharmacodynamic and pharmacokinetic study of propranolol in patients with cirrhosis and portal hypertension.

  • Cales P
  • Grasset D
  • Ravaud A
 et al. 
  • 7

    Readers

    Mendeley users who have this article in their library.
  • 17

    Citations

    Citations of this article.

Abstract

The aim of this study was to investigate the pharmacokinetics and the β-adrenoceptor blocking activity according to time of conventional (C) and long acting (LA) propranolol in cirrhotic patients. Twenty-four patients with alcoholic cirrhosis and oesoghageal varices were randomly assigned to receive either 160 mg C propranolol, 160 mg LA propranolol or placebo acutely and then following repeated administration (acute and chronic phases). Thereafter propranolol concentrations and β-adrenoceptor blockade (resting and exercise heart rates) were measured at different intervals. The C(max) was significantly higher with C propranolol in both phases. The time of C(max) was significantly later with LA propranolol in both phases. The AUCs were significantly higher after chronic administration with both formulations of propranolol. The exercise peaks of β-adrenergic blockade were similar between the two formulations and between the two phases of administration of propranolol. The duration of effective β-adrenoceptor blockade was significantly longer in the chronic phase and seemed to be longer with LA than with C propranolol although this was not significant (72 ± 31 vs 48 ± 18 h, respectively). There was a significant correlation between the log propranolol concentration and exercise heart rate but not with resting heart rate. No correlation could be demonstrated between pharmacological data and the Child Pugh score. We conclude that in cirrhotic patients exercise testing was a reliable method in the assessment of β-adrenoceptor blockade. Pharmacology of propranolol was found to be different according to the formulation or to the phase of administration.

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document

Authors

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free