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Vol. 300, Issue 2, 688-694, February 2002
Section of Pharmacokinetics, Department of Pharmacology, Martin
Luther University Halle-Wittenberg, Halle, Germany
Little is known about cardiac uptake kinetics of idarubicin, including
a possible protective role of P-glycoprotein (Pgp)-mediated transport.
This study therefore investigated uptake and negative inotropic action
of idarubicin in the single-pass isolated perfused rat heart by using a
pharmacokinetic/pharmacodynamic modeling approach. Idarubicin was
administered as a 10-min constant infusion of 0.5 mg followed by a
70-min washout period in the absence and presence of the Pgp
antagonists verapamil or amiodarone. Outflow concentration and left
ventricular developed pressure were measured and the model parameters
were estimated by simultaneous nonlinear regression. The results
indicate the existence of a saturable, Michaelis-Menten type uptake
process into the heart (Km = 3.06 µM,
Vmax = 46.0 µM/min). Verapamil and
amiodarone significantly enhanced the influx rate
(Vmax increased 1.8-fold), suggesting that
idarubicin is transported by Pgp directly out of the membrane before it
gets into the cell. Verapamil and amiodarone attenuated the negative
inotropic action of idarubicin, which was linked to the intracellular
concentration of idarubicin.
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