Η ΑΙΜΟΔΥΝΑΜΙΚΗ ΦΑΡΜΑΚΙΝΗΤΙΚΗ ΜΕΛΕΤΗ ΤΗΣ FENOLDOPAM ΣΕ ΑΣΘΕΝΕΙΣ ΜΕ ΚΙΡΡΩΣΗ ΤΟΥ ΥΠΑΤΟΣ

Abstract

IN THE PRESENT STUDY THE HAEMODYNAMIC AND PHARMACODYNAMIC EFFECTS, AS WELL AS THE PHARMACOKYNETICS OF FENOLDOPAM, A SELECTIVE AGONIST OF THE POSTSYNAPTIC DOPAMINERGIC RECEPTORS WERE STUDIED, IN PATIENTS WITH LIVER CIRRHOSIS. A PILOT STUDY OF INTRAVENOUSLY ADMINISTERED FENOLDOPAM WAS INITIALLY CARRIED OUT IN 5 PATIENTS, IN INCREASING DOSES OD 0,05 TO 1,6 ΜG /KG/MIN. ON THE BASIS OF THE RESULTS, THE DOSE TO BE USED IN THE HAEMODYNAMIC STUDY (0,05, 0,5, 1 AND1,6 ΜG/KG.MIN) WAS DEFINED, EACH INFUSION LASTING FOR 30 MINUTES. IN THIS STUDY THE HAEMODYNAMIC EFFECT OF FENOLDPAM WAS ASSESSED, ON THE SYSTEMATIC ANDSPLANCHIC HAEMODYNAMIC PARAMETERS, IN 12 PATIENTS WITH CIRRHOSIS AND PORTALHYPERTENTION (IN 6 WITH COMPENSATED AND 6 WITH DECOMPENSATED LIVER DISEASE). FINALLY, A PHARMACOKINETIC ASSEAAMENT OF FENOLDOPAM WAS CARRIED OUT, IN ANOTHER 12 PATIENTS WITH COMPENSATED CIRRHOSIS. IN THESE PATIENTS FENOLDOPAM WAS GIVEN EITHER PER OS (50 MG) OR INTERAVENOUSLY (0,5 ΜG/KG/MIN FOR 2 HOURS) IN A RADOM ORDER IN TWO DIFFERENT DAYS AT LEAST ONE WEEK APART. INTRAVENOUS FENOLDOPAM ADMINISTRATION RESULTED IN DOSE DEPENDENT REDUCTION IN BLOOD PRESSURE AND REDUCTION OF THE SYSTEMIC VASCULAR RESISTANCE WITH CONCOMITANT INCREASE IN CARDIAC OUTPUT. THE PORTIAL PRESSURE WAS SIGNIFICANTLY INCREASED DUETO INCREASE IN PORTIAL BLOD FLOW, AS A RESULT OF SPLANCHNIC ATRERIAL VASODILATION. ALL THE HAEMODYNAMIC PARAMETRS WERE RAPIDLY RETURNED TO BASELINE, 30 MINUTES AFTER STOPPING THE DRUG INFUSION.ABSTRACT TRUNCATED