Læknablaðið : fylgirit - 01.05.1978, Page 71

Læknablaðið : fylgirit - 01.05.1978, Page 71
L. Helleberg, J. Gylding-Sabroe and J. Sylvest Department of pharmacology, University of Copenhagen Departments of rheumatology and physical medicine in Glostrup and Bispebjerg, Copenhagen THE EFFECT OF ASPIRIN ON THE PHYSIOLOGICAL DISPOSITION OF INDOMETHACIN IN MAN i In the treatment of arthritic conditions two or more drugs are often administered concurrently assuming that the beneficial effects of the individual drugs are intensified without a similar intensification of the side effects. Thus in the treatment with indomethacin aspirin is p.t. often prescribed for additional pain relief. However, it has been claimed that aspirin antagonizes the antirheumatic effect of indomathacin.*>2 In an attempt to solve this issue several authors8.4,5,6 have investigated the effect of aspirin on the serum concentrations of indo- methacin. The results have however bcen conflicting - possibly because various non-specific assay techniques have been applied for indomethacin in serum. As a gas chromatographic method7 has been developed by which it has become possible to obtain reliable estimations of small amounts of indomethacin in biological fluids without inter- ference from drugs or metabolites of indo- methacin we have found it appropriate to investi- gate the effect of chronically administered aspirin on the physioiogical disposition of indo- methacin. TWO-COMPARTMENT OPEN MODEL RAPID INTRAVENOUS INJECTION ►V, - r ^2 h21-« fi-oC t_«t hn-/a oC-fi ■e-/1*) ( Eq.1) Material and methods Eight healthy volimteers of either sex and between 15 and 37 years old participated in the study. Indomethacin was injected intravenously before or after oral treatment with 500 mg or 1000 mg aspirin b.i.d. for one week. Blood samples for determination of the serum concen- tration of indomethacin were taken by venipuncture at various times during 24 hours. Indomethacin for intravenous injection was kindly prepared by Dumex, Copenhagen. Each dose consisted of 25 mg indomethacin freshly dissolved in 5 ml phosphate buffer which was injected over a one- minute-period. In order to establish the pharmacokinetic para- meters the serum concentration vs time curves for each person were analyzed according to the two-compartmental qpen model.8 Fig. 1 shows a scheme of the model as well as some of its implications. The model describes the kinetic behaviour of a drug on the k»'TÍf k«' V*-V, -Ja- (Eq.2.JM) AUC0_t •-£-■ (i. JL .(l-,-/11) (Eq.5) assumption that it is distributed between two volumes: a central compartment with a small apparent volume and a peripherial compartment of a larger apparent volume. Drugs enter the system only via the central compartment and are eliminated exclusively from the central compart- ment. Reversible transfer occurs between the central and the peripherial spaces. Another assumption applies for this model i.e. that the rate at which a drug is removed from a compartment is proportional to its concentra- tion in the compartment, i.e. that first-order kinetics describe the exit of drug from both . compartments. It should be stressed that this model is a purely mathematical tool, it does not necessarily correspond to specific anatomic or 69
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