PharmPK Discussion - TDM of flecainide and propafenone

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On 2 Feb 1999 at 20:21:18, thomas_rh06442_senderovitz.-at-.rh.dk sent the message


     Hello,

     Do any of you have some key references on therapeutic drug monitoring
     applied on flecainide as well as on propafenone? I am especially
     interested in how the therapeutic intervals for these drugs have been
     determined. Thanks.

     Thomas Senderovitz, M.D.
     Dpt. of Clinical Pharmacology Q7642
     University of Copenhagen
     Rigshospitalet
     Tagensvej 20
     DK-2200 Copenhagen N
     Denmark
     Phone: +45 35 45 69 44
     Fax: +45 35 45 27 45
     E-mail: senderovitz.-a-.rh.dk

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On 3 Feb 1999 at 22:22:45, David_Bourne (david.aaa.pharm.cpb.uokhsc.edu) sent the message

Date: Wed, 3 Feb 1999 01:17:18 -0700 (MST)
X-Sender: ml11439.aaa.pop.goodnet.com
Mime-Version: 1.0
To: PharmPK.-a-.pharm.cpb.uokhsc.edu
From: ml11439.-a-.goodnet.com (Michael J. Leibold)
Subject: Re: PharmPK TDM of flecainide and propafenone

Dr.Senderovitz,

    A key pharmacokinetic reference on flecainide is:

    Funck-Brentano, D., Becequemont, L., Buhl,K., et al., Variable dispostion
    kinetics and electrocardiogrphic effects of flecainide during repeated
    dosing in humans: contribution of genetic factors, dose-dependent
clearance,
    and interaction with amiodarone. Clinical Pharmacology and Therapeutics
    1994;55:256-269

    A key pharmacokinetic reference on propafenone is:

    Bryson, H.M., Palmer. K.J. et al., Propafenone:a reappraisal of its
    pharmacology, pharmacokinetics, and therapeutic use in cardiac arrhythmias.
    Drugs 1993;45:85-130

    These are two references from Goodman& Gilman's.

    Mike Leibold, PharmD, RPh
    ML11439.-at-.goodnet.com

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X-Sender: jelliffe.aaa.hsc.usc.edu (Unverified)
Date: Wed, 03 Feb 1999 11:36:01 -0800
To: PharmPK.-at-.pharm.cpb.uokhsc.edu
From: Roger Jelliffe 
Subject: Re: PharmPK TDM of flecainide and propafenone
Mime-Version: 1.0

Dear Tom:

	No, I don't, but I think you are on the right track. I am reninded that
the CAST study some years ago never had serum levels in it, now did it have
any attempt to find out what went wrong when patients had a proarrhythmic
adverse event. Good TDM of antiarrhythmic agents, and properly
individualized therspy, including the evaluation of each patient's clinical
sensivity to a given serum concentration, needs to be done.

Roger Jelliffe

Roger W. Jelliffe, M.D. Professor of Medicine, USC
USC Lab of Applied Pharmacokinetics
2250 Alcazar St, Los Angeles CA 90033, USA
Phone (323)442-1300, fax (323)442-1302, email=  jelliffe.-a-.hsc.usc.edu
Our web site=  www.usc.edu/hsc/lab_apk
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You might check our web site for information about our
HANDS-ON PK/PD WORKSHOP  here on February 26-27, 1999.
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