PMID: 8968170Dec 1, 1996Paper

Effect of diltiazem on midazolam and alfentanil disposition in patients undergoing coronary artery bypass grafting

Anesthesiology
J AhonenP J Neuvonen

Abstract

Midazolam and alfentanil are desirable anesthetic adjuncts for cardiac anesthesia. They are metabolized by cytochrome P450 3A (CYP3A) enzymes. These isozymes are inhibited by concurrent medications, including the calcium channel antagonist diltiazem, which may have an effect on recovery from anesthesia. Thirty patients having coronary artery bypass grafting were randomly assigned to receive either diltiazem (60 mg orally 2 h before induction of anesthesia and an infusion of 0.1 mg.kg-1.h-1 started at induction and continued for 23 h) or placebo in a double-blind study. Anesthesia was induced with 0.1 mg/kg midazolam, 50 micrograms/kg alfentanil, and 20 to 80 mg propofol and maintained with infusions of 1 microgram.kg-1.min-1 of both midazolam and alfentanil supplemented with isoflurane. Plasma midazolam and alfentanil concentrations and areas under the plasma concentration-time curves were determined. The terminal half-life and the time for the drug plasma level to decrease 50% after cessation of the infusion (t50) were calculated for midazolam and alfentanil. Separation from mechanical ventilation and tracheal extubation were performed according to the study protocol. Diltiazem increased the mean concentration-time curves (fro...Continue Reading

References

Jan 1, 1991·European Journal of Clinical Pharmacology·M P Gascon, P Dayer
Jan 1, 1990·European Journal of Clinical Pharmacology·J BrockmöllerI Roots
Jul 1, 1989·Clinical Pharmacology and Therapeutics·R R BartkowskiT Boerner
Nov 1, 1981·Clinical Pharmacology and Therapeutics·H AllonenU Klotz
Nov 1, 1994·British Journal of Anaesthesia·C WandelE Martin
Mar 1, 1994·British Journal of Clinical Pharmacology·J T BackmanP J Neuvonen
Oct 1, 1993·Journal of Cardiothoracic and Vascular Anesthesia·M Newman, J G Reves
Feb 1, 1994·Anesthesia and Analgesia·C C HugS de Lange
Feb 1, 1994·Anesthesia and Analgesia·H R VinikI Kissin
Mar 1, 1993·Clinical Pharmacology and Therapeutics·K T OlkkolaP J Neuvonen

❮ Previous
Next ❯

Citations

Jun 1, 1997·The Annals of Thoracic Surgery·W S PetersT A Burdon
Sep 6, 2000·British Journal of Clinical Pharmacology·A L MasicaD R Jones
Feb 6, 2002·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·UNKNOWN American College of Critical Care Medicine of the Society of Critical Care Medicine, American Society of Health-System Pharm
Dec 31, 2008·American Journal of Therapeutics·Judy W M ChengWilbert S Aronow
May 23, 1998·Annual Review of Pharmacology and Toxicology·K E Thummel, G R Wilkinson
Mar 25, 2008·Therapeutics and Clinical Risk Management·Shufeng ZhouMin Huang
Mar 15, 2005·Clinical Pharmacokinetics·Shufeng ZhouHoward L McLeod
Jun 23, 1999·Seminars in Thoracic and Cardiovascular Surgery·P E Krucylak
Mar 28, 2003·Journal of Pharmaceutical Sciences·Toyohiro SawadaMasahiro Hayashi
Sep 25, 2001·Xenobiotica; the Fate of Foreign Compounds in Biological Systems·R J Weaver
Nov 30, 2010·General Hospital Psychiatry·Tomer T LevinTanya Nikolova
Mar 2, 2010·Disease-a-month : DM·Judy W M ChengWilbert S Aronow
Dec 12, 2007·Psychosomatics·Scott WilliamsNeil B Sandson
Dec 22, 2012·JACC. Cardiovascular Interventions·Steven P DunnDavid J Moliterno
May 20, 2003·Best Practice & Research. Clinical Anaesthesiology·Timothy G Short, Yatin Young
Nov 3, 1998·Clinical Pharmacology and Therapeutics·N E AzieS D Hall
Sep 13, 2003·World Journal of Gastroenterology : WJG·Li-Qun YangGuang-Shun Yang
Mar 21, 2002·Critical Care Medicine·Judith JacobiUNKNOWN Task Force of the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM), America
Oct 25, 2003·Der Anaesthesist·A S Milde, J Motsch
May 5, 2018·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Toby N WeingartenMichael L Kent

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.