Drug metabolism in malnourished children: a study with antipyrine.

A systematic review of pharmacokinetics studies in children with protein-energy malnutrition

“…1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 Table 4 shows the effect of PEM on the total clearance and half-life of seven drugs that are primarily metabolised in the liver. The total clearance of five drugs was significantly decreased with a correspondingly increased half-life [18,26,40,[42][43][44]. The total clearance of quinine was significantly decreased in two studies involving poorly categorised malnourished children [51] and kwashiorkor [30], but significantly increased in another study involving children with all categories of PEM except kwashiorkor [21].…”

“…The volume of distribution (Vd) of 13 drugs was evaluated in 19 studies (Table 3) [16,18,19,21,22,[40][41][42][43][44][45][46][47][48][49][50][51][52]. There were contrasting results for four drugs (gentamicin, quinine, streptomycin and theophylline).…”

Impact of nutrition on pharmacokinetics of anti-neoplastic agents

“…In children with poor nutritional status, antipyrine half-life decreased and clearance increased when patients were shifted from a low-protein diet to a diet high in protein; these parameters were not similarly affected by high-fat or high-carbohydrate diets (Narang et al, 1977;Buchanan et al, 1979a;Homeida et al, 1979;Krishnaswamy, 1989).…”

“…Studies of hepatic oxidative metabolism in malnourished patients have been performed using markers including antipyrine and acetanilide (Table II) (Narang et al, 1977;Buchanan et al, 1979aBuchanan et al, , 1980Homeida et al, 1979;Mehlá, 1990). In all of these studies, the half-life of the marker compound was increased and clearance decreased, suggesting that malnutrition decreased hepatic oxidative metabolism.…”

Kinetics of sulphafurazole in undernutrition.

“…In recent years there have been a number of reports on the influence of malnutrition on drug metabolism in man (Shastri & Krishnaswamy, 1976;Krishnaswamy & Naidu, 1977;Mehta, Kalsi, Jayaraman & Mathur, 1975; Shastri & Krishnaswamy, 1979;Homeida, Karrar & Roberts 1979). These studies have emphasised the importance of considering nutritional status in the planning of therapeutic regimen.…”