Limits...
Pharmacokinetics of Levodopa before and after Gastrointestinal Resection in Parkinson's Disease.

Nagayama H, Kajimoto Y, Kumagai T, Nishiyama Y, Mishina M, Kimura K - Case Rep Neurol (2015)

Bottom Line: Because LD is absorbed in the duodenum and jejunum, we checked his pharmacokinetics again after the operation.The results before the operation were almost similar; however, in comparison, the area under the curve and peak drug concentration was reduced, and the time-to-peak drug concentration and elimination halftime were elongated after the operation.Physicians must pay attention to the change of LD pharmacokinetics after gastrointestinal operation.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.

ABSTRACT

Introduction: Levodopa (LD) is important in the clinical treatment of Parkinson's disease (PD), and the changes of its pharmacokinetics may affect the clinical outcome. LD is mainly absorbed in the upper intestine; thus, the pharmacokinetics of LD may change after gastrointestinal operation. Here, we present the case of a patient who underwent resection of the intestine and compared his LD pharmacokinetics before and after resection.

Case presentation: A 72-year-old Japanese male PD patient developed jaundice and was diagnosed with cholangiocarcinoma. Pancreaticoduodenectomy was performed and part of the stomach, total duodenum, and part of the jejunum were resected. The patient had been treated with LD, and his pharmacokinetics was checked twice at the age of 68 years. Because LD is absorbed in the duodenum and jejunum, we checked his pharmacokinetics again after the operation. The results before the operation were almost similar; however, in comparison, the area under the curve and peak drug concentration was reduced, and the time-to-peak drug concentration and elimination halftime were elongated after the operation.

Conclusion: Physicians must pay attention to the change of LD pharmacokinetics after gastrointestinal operation.

No MeSH data available.


Related in: MedlinePlus

LD pharmacokinetics before and after gastrointestinal resection. Solid black line represents the results at 72 years 4 months. Solid and broken gray lines represent the results at 68 years 11 months and 68 years 1 month, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4608656&req=5

Figure 2: LD pharmacokinetics before and after gastrointestinal resection. Solid black line represents the results at 72 years 4 months. Solid and broken gray lines represent the results at 68 years 11 months and 68 years 1 month, respectively.

Mentions: In his LD pharmacokinetics at the ages of 68 years 11 months (and 68 years 1 month), body weight was 64.2 (and 64.8) kg, AUC was 1,782.5 (and 1,825.0) mg·h/ml, Cmax was 1,500 (and 1,500) mg/ml, Tmax was 30 (and 30) min, and T1/2 was 48 (and 47) min. In the postoperative assessment (at the age of 72 years 4 months), AUC was 1,148.8 mg·h/ml, Cmax was 450 mg/ml, Tmax was 60 min, and T1/2 was >120 min (fig. 2).


Pharmacokinetics of Levodopa before and after Gastrointestinal Resection in Parkinson's Disease.

Nagayama H, Kajimoto Y, Kumagai T, Nishiyama Y, Mishina M, Kimura K - Case Rep Neurol (2015)

LD pharmacokinetics before and after gastrointestinal resection. Solid black line represents the results at 72 years 4 months. Solid and broken gray lines represent the results at 68 years 11 months and 68 years 1 month, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608656&req=5

Figure 2: LD pharmacokinetics before and after gastrointestinal resection. Solid black line represents the results at 72 years 4 months. Solid and broken gray lines represent the results at 68 years 11 months and 68 years 1 month, respectively.
Mentions: In his LD pharmacokinetics at the ages of 68 years 11 months (and 68 years 1 month), body weight was 64.2 (and 64.8) kg, AUC was 1,782.5 (and 1,825.0) mg·h/ml, Cmax was 1,500 (and 1,500) mg/ml, Tmax was 30 (and 30) min, and T1/2 was 48 (and 47) min. In the postoperative assessment (at the age of 72 years 4 months), AUC was 1,148.8 mg·h/ml, Cmax was 450 mg/ml, Tmax was 60 min, and T1/2 was >120 min (fig. 2).

Bottom Line: Because LD is absorbed in the duodenum and jejunum, we checked his pharmacokinetics again after the operation.The results before the operation were almost similar; however, in comparison, the area under the curve and peak drug concentration was reduced, and the time-to-peak drug concentration and elimination halftime were elongated after the operation.Physicians must pay attention to the change of LD pharmacokinetics after gastrointestinal operation.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.

ABSTRACT

Introduction: Levodopa (LD) is important in the clinical treatment of Parkinson's disease (PD), and the changes of its pharmacokinetics may affect the clinical outcome. LD is mainly absorbed in the upper intestine; thus, the pharmacokinetics of LD may change after gastrointestinal operation. Here, we present the case of a patient who underwent resection of the intestine and compared his LD pharmacokinetics before and after resection.

Case presentation: A 72-year-old Japanese male PD patient developed jaundice and was diagnosed with cholangiocarcinoma. Pancreaticoduodenectomy was performed and part of the stomach, total duodenum, and part of the jejunum were resected. The patient had been treated with LD, and his pharmacokinetics was checked twice at the age of 68 years. Because LD is absorbed in the duodenum and jejunum, we checked his pharmacokinetics again after the operation. The results before the operation were almost similar; however, in comparison, the area under the curve and peak drug concentration was reduced, and the time-to-peak drug concentration and elimination halftime were elongated after the operation.

Conclusion: Physicians must pay attention to the change of LD pharmacokinetics after gastrointestinal operation.

No MeSH data available.


Related in: MedlinePlus