Charles D. Sands

Theophylline Disposition in Korean Patients with Congestive Heart Failure

OBJECTIVE: This study proposed to determine the systemic disposition on of theophyllinein Korean adult patients during decompensated congestive heart failure compared with disposition after recovery. DESIGN: An experimental, prospective, self-controlled, non randomized design was used. SETTING: The study was performed in a general communityhospital located in Pusan, Korea. PATIENTS: Eight nonsmoking elderly Korean patients with decompensated congestive heart failure presenting to the emergency department were included in the study. Consecutive patients who met entrance criteria were selected. All patients completed the study. INTERVENTIONS: A single dose of aminophylline 6 mg/kg was administered by intravenous infusion over 30 minutes. Standard methods of congestive heart failure therapy were used in each patient, including bed rest, restriction of sodium, and drug therapy including digoxin. After compensation of congestive heart failure was achieved the theophylline infusion was repeated. OUTCOME MEASURES: Serum theophylline concentrations were measured at 2, 6, 12, and 18 hours after completion of the dose at base line and following treatment. RESULTS: A clinically and statistically significant improvement in mean theophylline total body clearance was demonstrated following treatment (from 21.7 ± 2.8 to 43.4 ± 4.7 mL/kg/h [mean ± SEM]; p<0.01). Comparison of these results with a computer model based on literature averages of peoples of all nationalities showed significant underprediction of theophylline clearance both before (p<0.05)and after (p<0.01) treatment. The theophylline elimination half-life prior to treatment was 18.2 ± 2.2 hours and decreased to 9.1 ± 0.8 hours following treatment(p<0.O1). There was no statistical difference between the computer-model predicted initial theophylline half-life and the measured value, but the model significantly underpredicted the improvement following treatment. CONCLUSIONS: The improvement in theophylline clearance demonstrated in this study appears to be greater than that reported for Western patients. This has practical application to the calculation of appropriate theophylline maintenance dosage regimens in Korean patients with cardiac failure. These data support the need for consideration of racial differences in individualizing dosage regimens. We suggest that all kinetic models, whether software supported or not, should consider incorporating ethnic origin as a demographic factor that helps select the proper model for individual patients.

Effects of doxazosin and hydrochlorothiazide on lipid levels in Korean patients with essential hypertension.

Summary Because none of the major studies used to document adverse or beneficial metabolic effects of antihypertensive drugs were made of non-Western patients with a non-Western diet, we compared doxazosin and hydrochlorothiazide in Korean patients receiving a Korean diet to determine if one regimen is superior to the other in terms of efficacy, adverse metabolic effects, or both. The randomized, double-blind, parallel study of Korean hypertensive patients compared the effects of oral doxazosin (mean

Treatment of Essential Hypertension in Asians: Enalapril as Monotherapy versus Combination Therapy with Hydrochlorothiazide

pM SD dose, 10.3

Effect of Ranitidine on Theophylline Metabolism in Healthy Koreans Living in China

pM 6.3 mg/day) and oral hydrochlorothiazide (44.0 + 11.0 mg/day) on blood pressure (BP) and lipid metabolism. The results of 48 patients treated for 20 weeks are reported here. Systolic (p < 0.001) and diastolic (p < 0.001) BP (SBP, DBF) were significantly lower in both groups at the end of the treatment period. Doxazosin significantly increased high-density-lipoprotein (HDL) cholesterol from a baseline of 1.10

Lack of Effect of Hydrocholorthiazide on Total Cholesterol

pM 0.31 to 1.27

Captopril versus captopril plus hydrochlorothiazide for essential hypertension in Koreans

pM 0.30 mM (p < 0.05) and HDL/total cholesterol from 0.25

High Blood Pressure : Knowledge and Behavior in Asia

pM 0.1 to 0.28

Prescription Impossible: By Mike Richards PhD DSc. Published by Xulon Press, Longwood, FL, 2004. ISBN 1-594677-76-X. Paperbound, viii + 299 pp. (20.5 x 12.5 cm),

pM 0.1 mM (p < 0.01). Hydrochlorothiazide significantly increased triglyceride from a baseline of 1.63

17.99. www.xulonpress.com

pM 0.71 to 2.02

Book Review: Critical Issues in Global Health

pM 0.87 mM (p < 0.05). In contrast to Western studies, hydrochlorothiazide demonstrated no adverse effect on total, low-density-lipoprotein (LDL), or HDL cholesterol, or on HDL/total cholesterol. Indeed, HDL cholesterol was increased by 0.16 mM (p < 0.01). As in Western patients, doxazosin is effective for treatment of essential hypertension in Koreans and has no adverse effects but some beneficial effects on lipids. Hydrochlorothiazide is effective for treatment of essential hypertension and, in this study, in contrast to Western studies, hydrochlorothiazide appeared to have no adverse effects on cholesterol in Korean hypertensive patients receiving a Korean diet. Adherence to a cholesterol-lowering diet in Asia may be important in accounting for this important difference from Western studies.