The pharmacokinetics of quinidine and the O-desmethyl metabolite 6'-hydroxycinchonine were studied in rabbits. After intravenous bolus injections of equimolar doses, the blood concentration-time curves of each agent declined biexponentially, which was characteristic of a two-compartment open model. A significant difference between quinidine and 6'-hydroxycinchonine was observed for the following parameters: t1/2 alpha, beta, t1/w beta, k12, Vd beta, and the intercompartmental distribution ratio, k12/k21. The results showed that the distribution of the metabolite was slower than quinidine and suggested that it also was less extensive. The Vd beta value for 6'-hydroxycinchonine was approximately one-half of the value observed for quinidine, and its k12/k21 ration was about one-fourth of the quinidine value. The terminal half-lives for quinidine and the metabolite were 132.4 +/- 27.1 and 65.4 +/- 34.4 min, respectively. Total body clearance was similar for both compounds. The findings of this study could be explained by the greater polarity or greater water solubility of 6'-hydroxycinchonine. The limited data in humans coupled with the results of this investigation suggest that, although it is intrinsically active, the O-demethylated metabolite probably contributed little to the antiarrhythmic effects seen after quinidine administration in humans.
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http://dx.doi.org/10.1002/jps.2600691212 | DOI Listing |
Clin Transl Sci
February 2025
Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida College of Pharmacy, Gainesville, Florida, USA.
Tramadol, the 41st most prescribed drug in the United States in 2021 is a prodrug activated by CYP2D6, which is highly polymorphic. Previous studies showed enzyme-inhibitor affinity varied between different CYP2D6 allelic variants with dextromethorphan and atomoxetine metabolism. However, no study has compared tramadol metabolism in different CYP2D6 alleles with different CYP2D6 inhibitors.
View Article and Find Full Text PDFJ Cardiovasc Pharmacol
January 2025
Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Positive inotropic responses upon administration of milrinone, an inhibitor of the phosphodiesterase enzyme (PDE), involve a well-pronounced positive chronotropic effect. Here we tested whether milrinone evokes this chronotropic response solely by PDE inhibition or by a concerted action that involve additional pharmacological targets. Milrinone stimulated increases in heart rate were studied in right atrial preparations of guinea pig in the presence or absence of inhibitors of putative ancillary molecular pathways or ion channels: i.
View Article and Find Full Text PDFHeart Rhythm
January 2025
Dante Pazzanese Institute of Cardiology, Department of Electrophysiology, São Paulo, Brazil.
Background: Brugada syndrome (BrS) is a genetic heart disease that predisposes individuals to ventricular arrhythmias and sudden cardiac death. Although implantable cardioverter-defibrillators (ICDs) and quinidine are primary treatments, recurrent BrS-triggered ventricular arrhythmias can persist. In this setting, epicardial substrate ablation has emerged as a promising alternative for symptomatic patients.
View Article and Find Full Text PDFJ Korean Med Sci
January 2025
Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Background: The ionic mechanism underlying Brugada syndrome (BrS) arises from an imbalance in transient outward current flow between the epicardium and endocardium. Previous studies report that artemisinin, originally derived from a Chinese herb for antimalarial use, inhibits the Ito current in canines. In a prior study, we showed the antiarrhythmic effects of artemisinin in BrS wedge preparation models.
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