A single dose pharmacokinetic study of Gastrobid Continus and Maxolon in the perioperative period.

Abstract

1 A single dose pharmacokinetic comparison of Gastrobid Continus and Maxolon was carried out perioperatively in two groups of 12 gynaecological patients; each group comprised six patients for major surgery and six patients for minor surgery. 2 The areas under the plasma drug concentration-time curves were similar after both preparations. 3 In the minor surgery group after Gastrobid Continus the plasma drug concentrationtime curve was wider at half Cmax (P < 0.01), Cmax was reduced (P < 0.05) and delayed (median (range) 4 (3-6) vs 2.5 (2-4) h) compared with Maxolon, and the log of the metoclopramide concentration did not have a linear relationship with time from 2-9 h. 4 A flattening of the plasma drug concentration-time curve was the only difference between the two preparations in the major surgery groups. 5 The plasma drug concentration-time curve was wider (P < 0.05) at half Cmax in the minor compared with the major surgery groups receiving Gastrobid Continus. 6 Pharmacokinetic parameters were similar for Maxolon in both surgical groups. 7 Sustained release pharmacokinetic characteristics were most pronounced in the minor surgery group which did not receive opiate medication but in which there were more moderately anxious patients prior to induction and in whom anxiety may have delayed gastric emptying.

Pharmacokinetic Optimisation of Antiemetic Therapy

“…The drug is poorly bioavailable intranasally (Ward et al 1989). A number of slow release formulations are available, which seem to have adequate bioavailability (Beckett et al 1987;Madej et al 1988); these preparations produce lower peak plasma concentrations (Cmax). In volunteers, Cmax values may correlate with adverse effects, particularly akathisia (Bateman et al 1979), but there is no clear correlation between the low plasma concentrations obtained and therapeutic effects in patients with nausea.…”