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D‐glucaric acid excretion in critical care patients‐comparison with 6 beta‐hydroxycortisol excretion and serum gamma‐glutamyltranspeptidase activity and relation to multiple drug therapy.
Author(s) -
Heinemeyer G,
Roots I,
Lestau P,
Klaiber HR,
Dennhardt R
Publication year - 1986
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.1986.tb02817.x
Subject(s) - excretion , medicine , endocrinology , chemistry , urine , urinary system , beta (programming language) , pharmacology , computer science , programming language
The incidence of increased drug metabolism activity as a consequence of multiple drug therapy at a surgical intensive care ward has been studied non‐invasively by determinations of daily urinary D‐glucaric acid (GA) excretion rates. Among 165 randomly selected patients, GA excretion was stimulated in 76 cases (= 46%). Exploratory data analysis showed that increases in GA excretion are primarily due to administration of barbiturates (pentobarbitone, Nembutal), miconazole (Daktar) and, to a lesser extent, neuroleptics. Surprisingly, the large number of simultaneously administered additional drugs failed to increase GA excretion. Urinary 6 beta‐hydroxycortisol (6 beta‐OHF) and 17‐hydroxycorticosteroid (17‐OHCS) excretion rates were correlated in 34 patients with GA excretion; patients not receiving known enzyme inducers showed low GA values but high 6 beta‐OHF and 17‐OHCS values, however, with a ratio of 6 beta‐OHF/17‐OHCS in the normal range. Patients receiving high dose pentobarbitone treatment failed to exhibit significantly increased 6 beta‐OHF and 17‐OHCS or 6 beta‐OHF/17‐OHCS values. Miconazole treatment resulted in a significantly increased ratio of 6 beta‐OHF/17‐OHCS. gamma‐Glutamyltranspeptidase activity in serum showed no correlation with GA excretion (n = 91).