N. Pisanti

Lack of Effect of Gemfibrozil on Cyclosporine Blood Concentrations in Kidney-Transplanted Patients

Forty kidney-transplanted patients with hypertriglyceridemia, under treatment with cyclosporine alone or associated with other immunosuppressive drugs, were treated with gemfibrozil. This drug, for a long-term treatment (ranging from 4 to 6 months), was able to decrease hypertriglyceridemia and did not modify either polyclonal (P) and monoclonal (M) cyclosporine blood levels or P/M ratio. These data seem to exclude an effect of gemfibrozil on cyclosporine blood concentrations. Therefore, the use of gemfibrozil in kidney-transplanted patients does not require modifications of cyclosporine dose.

Is the sympathetic nervous system altered in children with familial history of arterial hypertension

The sympathetic nervous system has been investigated in 42 children with family history of arterial hypertension and 68 children of the same age without hypertensive relatives. Pressure responses to mental arithmetic and to isometric handgrip stress were measured in both groups, along with 24 h catecholamine excretion. Resting blood pressure and heart rate did not show any difference between groups. The increase in diastolic pressure during the mental arithmetic exercise was, however, significantly greater in children with family history of hypertension. A sharp increase in blood pressure and heart rate was observed during isometric handgrip in both groups without any significant difference. Twenty-four hour catecholamine urinary excretion was significantly higher in the group with family history of hypertension (31 +/- 15 vs. 23 +/- 13 micrograms/24 h; p less than 0.05). These results seem to indicate that an initial impairment of the sympathetic activity is already detectable in young offspring of hypertensive patients.

Effects of different routes of cyclosporin A administration on blood levels in patients undergoing bone marrow transplantation.

This follow-up study has been carried out on 15 bone marrow transplant recipients treated intravenously with cyclosporin A (CsA) as a bolus (1.25–2.5 mg/kg/12 h) or by continuous infusion (1–3 mg/kg/24 h) from −2 until the 21st day after transplantation. All patients were subsequently treated with CsA orally at a starting dose of 6.25 mg/kg/12 h; this starting dose was then adjusted on the basis of CsA blood levels until the 60th day after transplantation, followed by progressive reduction and withdrawal within 6–12 months. In whole blood, trough levels of polyclonal (P) and monoclonal (M) CsA were monitored by a FPIA method and the polyclonal/monoclonal ratio (P/M) was calculated. This ratio was lower during CsA administration as a bolus or by continuous infusion than during oral administration; the decrease was statistically significant. This difference was probably due to first-pass metabolism which occurs in the liver and gut after oral administration.

Effects of betamethasone on theophylline disposition in man are saliva values predictive of serum theophylline levels

The pharmacokinetic interaction between betamethasone (5 mg/day for 5 days) and theophylline (3.35 mg/kg orally before and after betamethasone treatment) was studied in 13 female patients evaluating saliva and serum theophylline concentrations by means of an enzyme multiplied immunoassay technique. Betamethasone treatment did not significantly change saliva and serum theophylline levels. As regards the potential usefulness of saliva theophylline levels in predicting the concomitant serum concentrations of the bronchodilator, in spite of the significant correlation found in our study (r = 0.758; P less than 0.001), we think that, using individual saliva values, there is a poor predictive value for serum theophylline concentrations.