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Pharmacokinetics and pharmacodynamics of d-tubocurarine and metocurine in the elderly.

Abstract

The effects of age (older than 70 yr) on the pharmacokinetics and pharmacodynamics of d-tubocurarine (dTc) and metocurine (MTc) were evaluated in studies of 21 patients aged 70-87 and 21 patients aged 29-59. There was a significant difference in the pharmacokinetic parameters of all elderly patients compared with younger controls. With both dTc and MTc, the elderly exhibited a decreased plasma clearance, decreased initial volume of distribution, decreased volume of distribution, and a prolonged elimination half-life. After 0.3 mg/kg of dTc, the times for 50% return of twitch and recovery index (25-75% return of twitch response) in the elderly were significantly longer than in the young (P less than 0.02). A similar observation was made for the elderly patients receiving 0.15 mg/kg of MTc. No significant difference was seen in the log plasma concentration-twitch response relationship between 20-80% paralysis in young and in elderly patients receiving dTc. There was a similar lack of significant difference between the log plasma concentration-twitch response lines for elderly and young patients receiving MTc. Because there was no difference between the plasma concentration-response relationships in the elderly and young, altered sensitivity to dTc or MTc cannot explain the longer duration of action seen in the elderly. The most likely explanation for this difference is the altered pharmacokinetics of these two drugs in the elderly.

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  • Authors

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    Source

    Anesthesia and analgesia 64:1 1985 Jan pg 23-9

    MeSH

    Adult
    Age Factors
    Aged
    Dose-Response Relationship, Drug
    Humans
    Kinetics
    Middle Aged
    Muscle Contraction
    Neuromuscular Blocking Agents
    Tubocurarine

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    3966648

    Citation

    Matteo, R S., et al. "Pharmacokinetics and Pharmacodynamics of D-tubocurarine and Metocurine in the Elderly." Anesthesia and Analgesia, vol. 64, no. 1, 1985, pp. 23-9.
    Matteo RS, Backus WW, McDaniel DD, et al. Pharmacokinetics and pharmacodynamics of d-tubocurarine and metocurine in the elderly. Anesth Analg. 1985;64(1):23-9.
    Matteo, R. S., Backus, W. W., McDaniel, D. D., Brotherton, W. P., Abraham, R., & Diaz, J. (1985). Pharmacokinetics and pharmacodynamics of d-tubocurarine and metocurine in the elderly. Anesthesia and Analgesia, 64(1), pp. 23-9.
    Matteo RS, et al. Pharmacokinetics and Pharmacodynamics of D-tubocurarine and Metocurine in the Elderly. Anesth Analg. 1985;64(1):23-9. PubMed PMID: 3966648.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Pharmacokinetics and pharmacodynamics of d-tubocurarine and metocurine in the elderly. AU - Matteo,R S, AU - Backus,W W, AU - McDaniel,D D, AU - Brotherton,W P, AU - Abraham,R, AU - Diaz,J, PY - 1985/1/1/pubmed PY - 1985/1/1/medline PY - 1985/1/1/entrez SP - 23 EP - 9 JF - Anesthesia and analgesia JO - Anesth. Analg. VL - 64 IS - 1 N2 - The effects of age (older than 70 yr) on the pharmacokinetics and pharmacodynamics of d-tubocurarine (dTc) and metocurine (MTc) were evaluated in studies of 21 patients aged 70-87 and 21 patients aged 29-59. There was a significant difference in the pharmacokinetic parameters of all elderly patients compared with younger controls. With both dTc and MTc, the elderly exhibited a decreased plasma clearance, decreased initial volume of distribution, decreased volume of distribution, and a prolonged elimination half-life. After 0.3 mg/kg of dTc, the times for 50% return of twitch and recovery index (25-75% return of twitch response) in the elderly were significantly longer than in the young (P less than 0.02). A similar observation was made for the elderly patients receiving 0.15 mg/kg of MTc. No significant difference was seen in the log plasma concentration-twitch response relationship between 20-80% paralysis in young and in elderly patients receiving dTc. There was a similar lack of significant difference between the log plasma concentration-twitch response lines for elderly and young patients receiving MTc. Because there was no difference between the plasma concentration-response relationships in the elderly and young, altered sensitivity to dTc or MTc cannot explain the longer duration of action seen in the elderly. The most likely explanation for this difference is the altered pharmacokinetics of these two drugs in the elderly. SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/3966648/Pharmacokinetics_and_pharmacodynamics_of_d_tubocurarine_and_metocurine_in_the_elderly_ L2 - http://Insights.ovid.com/pubmed?pmid=3966648 DB - PRIME DP - Unbound Medicine ER -