Title: Pharmacokinetic Changes in Congestive Heart Failure
Authors: Htet Htet, Saint Nway Aye, Lwin Mie Aye, Kyan Aung
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.71
Abstract
Pharmacokinetic processes are recognized as “liberation, absorption (A), distribution (D), metabolism (M) and excretion (E)”. Published ADME data for each drug are usually observed on healthy individuals. It serves as an indispensable guide to prescribers. LADME guides highlight the significant role of the gastroenterology system, hepato-biliary system, cardiovascular system and renal system. Any changes in the structure and function of these systems would lead to variations in the ADME system. The existence of individual differences and pathophysiological status of major organs further affects the clinical pharmacokinetic profile of drugs. Therefore, unpredictable variations in pharmacokinetic parameters may exist in patients suffering from diseases of the heart, the liver or the kidneys. Most importantly, the deviation of pharmacokinetic parameters could affect the outcome of the management of the disease. Of these organs, the heart is a very crucial one as the circulation is the main transport route for the passage of drugs through the body. Congestive heart failure is a common cardiac disease in both the well-developed and the developing countries. The pathophysiology of congestive heart failure has already been complicated with hemodynamic abnormalities, neurohumoral mechanisms and the damage to the cardiac muscle itself. As congestive heart failure is more commonly seen in the elderly patients, age-related changes should also be considered. The objective of this article is to facilitate the better management of congestive heart failure, based on evidence-based information on pharmacokinetic changes, to make dosage adjustment of the right drug for the right patient, with minimal adverse effects.
Keywords – clinical pharmacokinetic, congestive heart failure, pharmacokinetic changes, drug metabolism, drug absorption, drug elimination.
