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Sultan K, Zamir A, Ashraf W, Imran I, Saeed H, Rehman AU, Majeed A, Rasool MF. Clinical pharmacokinetics of terbutaline in humans: a systematic review. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:213-227. [PMID: 36227333 DOI: 10.1007/s00210-022-02304-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/05/2022] [Indexed: 01/29/2023]
Abstract
Terbutaline is used for the management of bronchospasm associated with asthma, bronchitis, emphysema, and chronic obstructive pulmonary disease. A systematic review would be beneficial to assess the impact of routes of administration, stereoisomerism, disease states, smoking, age, exercise, and chronobiology on pharmacokinetics (PK) of terbutaline in humans. PubMed and Google Scholar databases were searched to screen all the relevant articles consisting of at least one of the PK parameters after administration of oral, inhaled, and intravenous (IV) terbutaline in humans. Oral studies of terbutaline depicted a linear relationship between plasma concentration (Cp) and the administered dose. The IV studies demonstrated multi-exponential behavior for disposition and renal clearance. Higher systemic availability was observed with inhaled as compared to oral route, and chrono-pharmacokinetic behavior was notable. Time to reach maximum plasma concentration (Tmax) was prolonged, and maximum plasma concentration (Cmax) was lowered after exercise. The primary route of excretion in chronic kidney disease (CKD) patients is reported to be nonrenal. In pregnant women, the Cp of terbutaline is lowered and clearance is increased. The addition of theophylline to terbutaline did not affect the PK of terbutaline; hence, both can be used without dose adjustment. This review summarizes all the available PK parameters of terbutaline, and it may be helpful for researchers in the development and evaluation of PK models as well as in designing optimal dosage regimens in different clinical conditions.
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Affiliation(s)
- Khadeeja Sultan
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - Ammara Zamir
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - Waseem Ashraf
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - Imran Imran
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - Hamid Saeed
- Allama Iqbal Campus, University College of Pharmacy, University of the Punjab, Lahore, 54000, Pakistan
| | - Anees Ur Rehman
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - Abdul Majeed
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan.
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Dai X, Ding W, Li H, Xu P, Huang Z, Zhu W, Liu J. Associations of Serum Lipids and Deep Venous Thrombosis Risk After Total Knee Arthroplasty in Patients With Primary Knee Osteoarthritis. INT J LOW EXTR WOUND 2019; 19:51-56. [PMID: 31409158 DOI: 10.1177/1534734619868123] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Deep venous thrombosis (DVT) of the lower extremities is a common complication after total knee arthroplasty (TKA). This study aimed to investigate the potential associations between serum lipids and the risk of DVT after TKA in patients with primary knee osteoarthritis (OA). A total of 431 patients who received TKA caused by primary knee OA were randomly enrolled. According to the results of the color Doppler ultrasound of bilateral lower extremities deep veins on the third day postoperatively, patients were divided into DVT and non-DVT groups. Comparisons of preoperative serum levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1, and apolipoprotein B were then performed by the Student’s t test, χ2 test, and multivariate logistic regression analysis. For females, DVT patients had a higher serum LDL-C level at baseline ( P = .043) compared with non-DVT patients. A higher LDL-C value was significantly associated with an elevated DVT risk following TKA in female patients ( P = .037). In female patients with primary knee OA, preoperative serum LDL-C level may have an association with DVT risk after TKA. The relatively small male sample size may limit the accuracy of the findings.
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Affiliation(s)
- Xiaoyu Dai
- The First People’s Hospital of Changzhou Affiliated to Soochow University, Changzhou, Jiangsu, People’s Republic of China
| | - Wenge Ding
- The First People’s Hospital of Changzhou Affiliated to Soochow University, Changzhou, Jiangsu, People’s Republic of China
| | - Huan Li
- The First People’s Hospital of Changzhou Affiliated to Soochow University, Changzhou, Jiangsu, People’s Republic of China
| | - Peng Xu
- The First People’s Hospital of Changzhou Affiliated to Soochow University, Changzhou, Jiangsu, People’s Republic of China
| | - Zhihui Huang
- The First People’s Hospital of Changzhou Affiliated to Soochow University, Changzhou, Jiangsu, People’s Republic of China
| | - Wenjun Zhu
- The First People’s Hospital of Changzhou Affiliated to Soochow University, Changzhou, Jiangsu, People’s Republic of China
| | - Jinbo Liu
- The First People’s Hospital of Changzhou Affiliated to Soochow University, Changzhou, Jiangsu, People’s Republic of China
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Yang Z, Liu H, Li D, Xie X, Qin T, Ma J, Kang P. The efficacy of statins in preventing glucocorticoid-related osteonecrosis in animal models: A meta-analysis. Bone Joint Res 2016; 5:393-402. [PMID: 27660333 PMCID: PMC5032300 DOI: 10.1302/2046-3758.59.2000500] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objectives The primary purpose of this meta-analysis was to determine whether statin usage could reduce the risk of glucocorticoid-related osteonecrosis in animal models. Methods A systematic literature search up to May 2015 was carried out using the PubMed, Ovid, EBM reviews, ISI Web of Science, EBSCO, CBM, CNKI databases with the term and boolean operators: statins and osteonecrosis in all fields. Risk ratio (RR), as the risk estimate of specific outcome, was calculated along with 95% confidence intervals (CI). The methodological quality of individual studies was assessed using a quantitative tool based on the updated Stroke Therapy Academic Industry Roundtable (STAIR) recommendations. Results A total of 11 eligible studies were included according to predetermined criteria. The pooled data demonstrated that animals with statin usage, either alone or combined with other treatments, were at a decreased risk of developing glucocorticoid-related osteonecrosis (RR = 2.06, 95% confidence interval (CI) 1.71 to 2.50). Moreover, subgroup analysis revealed that compared with statins alone, statins combined with other treatments significantly decreased the risk of osteonecrosis (RR = 1.23, 95% CI 1.02 to 1.47). However, we could find no significant risk difference for different gender, or for different time points. Conclusions The present study suggests that statins combined with other treatments are efficient in preventing the development of glucocorticoid-related osteonecrosis in animals. These results might shed light on clinical practice when glucocorticoids are prescribed, and could be further investigated in high-quality clinical trials. Cite this article: Z. Yang, H. Liu, D. Li, X. Xie, T. Qin, J. Ma, P. Kang. The efficacy of statins in preventing glucocorticoid-related osteonecrosis in animal models: A meta-analysis. Bone Joint Res 2016;5:393–402. DOI: 10.1302/2046-3758.59.2000500.
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Affiliation(s)
- Z Yang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - H Liu
- Department of Rehabilitation Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - D Li
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - X Xie
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - T Qin
- Chinese Evidence-Based Medicine Centre/Cochrane Center, West China Hospital, Chengdu, China
| | - J Ma
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - P Kang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
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Xu Z, Dai X, Yao Y, Shi D, Chen D, Dai J, Teng H, Jiang Q. Higher Levels of Serum Triglycerides were Associated with Postoperative Deep Vein Thrombosis After Total Hip Arthroplasty in Patients with Nontraumatic Osteonecrosis of the Femoral Head. INT J LOW EXTR WOUND 2015; 15:41-4. [PMID: 26032948 DOI: 10.1177/1534734615580017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This retrospective study aimed to evaluate the association of serum lipids and deep vein thrombosis (DVT) risk following total hip arthroplasty (THA) in patients with nontraumatic osteonecrosis of the femoral head (ONFH). A total of 224 nontraumatic ONFH patients were enrolled. Serum levels of triglycerides (TG), total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were detected preoperatively. All the patients underwent unilateral lower extremity venography on postoperative days 3 to 5 for DVT screening. In females, patients who were venogram positive for DVT had a higher serum TG level than those who were venogram negative for DVT (P = .029) and a higher TG level was associated with an increased DVT risk (P = .042). Serum TG levels considerably affect DVT risk after THA in female nontraumatic ONFH patients.
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Affiliation(s)
- Zhihong Xu
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Xiaoyu Dai
- The First People's Hospital of Changzhou Affiliated to Soochow University, Changzhou, Jiangsu, People's Republic of China
| | - Yao Yao
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Dongquan Shi
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Dongyang Chen
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Jin Dai
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Huajian Teng
- Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Qing Jiang
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China Nanjing University, Nanjing, Jiangsu, People's Republic of China
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Schmidt SL, Bessesen DH, Stotz S, Peelor FF, Miller BF, Horton TJ. Adrenergic control of lipolysis in women compared with men. J Appl Physiol (1985) 2014; 117:1008-19. [PMID: 25190743 DOI: 10.1152/japplphysiol.00003.2014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Data suggest women are more sensitive to the lipolytic action of epinephrine compared with men while maintaining similar glucoregulatory effects (Horton et al. J Appl Physiol 107: 200-210, 2009). This study aimed to determine the specific adrenergic receptor(s) that may mediate these sex differences. Lean women (n = 14) and men (n = 16) were studied on 4 nonconsecutive days during the following treatment infusions: saline (S: control), epinephrine [E: mixed β-adrenergic (lipolytic) and α2-adrenergic (antilipolytic) stimulation], epinephrine + phentolamine (E + P: mixed β-adrenergic stimulation only), and terbutaline (T: selective β2-adrenergic stimulation). Tracer infusions of glycerol, palmitate, and glucose were administered to determine systemic lipolysis, free fatty acid (FFA) release, and glucose turnover, respectively. Following basal measurements, substrate and hormone concentrations were measured in all subjects over 90 min of treatment and tracer infusion. Women had greater increases in glycerol and FFA concentrations with all three hormone infusions compared with men (P < 0.01). Glycerol and palmitate rate of appearance (Ra) and rate of disappearance (Rd) per kilogram body weight were greater with E infusion in women compared with men (P < 0.05), whereas no sex differences were observed with other treatments. Glucose concentration and kinetics were not different between sexes with any infusion. In conclusion, these data support the hypothesis that the greater rate of lipolysis in women with infusion of E was likely due to lesser α2 antilipolytic activation. These findings may help explain why women have greater lipolysis and fat oxidation during exercise, a time when epinephrine concentration is elevated.
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Affiliation(s)
- Stacy L Schmidt
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado; The Obesity Treatment Foundation, Aurora, Colorado
| | - Daniel H Bessesen
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Denver Health Medical Center, Denver, Colorado
| | - Sarah Stotz
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Frederick F Peelor
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado; and
| | - Benjamin F Miller
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado; and
| | - Tracy J Horton
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Zhao L, Yang F, Xu K, Cao H, Zheng GY, Zhang Y, Li J, Cui H, Chen X, Zhu Z, He H, Mo X, Kennedy BK, Suh Y, Zeng Y, Tian XL. Common genetic variants of the β2-adrenergic receptor affect its translational efficiency and are associated with human longevity. Aging Cell 2012; 11:1094-101. [PMID: 23020224 DOI: 10.1111/acel.12011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2012] [Indexed: 02/05/2023] Open
Abstract
β-adrenoceptors are the common pharmacological targets for the treatment of cardiovascular diseases and asthma. Genetic modifications of β-adrenergic system in engineered mice affect their lifespan. Here, we tested whether genes encoding for key components of the β-adrenergic signaling pathway are associated with human longevity. We performed a 10-year follow-up study of the Chinese longitudinal healthy longevity survey. The Han Chinese population in this study consisted of 963 long-lived and 1028 geography-matched young individuals. Sixteen SNPs from ADRB1, ADRB2, ADCY5, ADCY6, and MAPK1 were selected and genotyped. Two SNPs, rs1042718 (C/A) and rs1042719 (G/C), of ADRB2 in linkage disequilibrium (D' = 1.0; r2 = 0.67) were found to be associated with enhanced longevity in men in two geographically isolated populations. Bonferroni-corrected P-values in a combined analysis were 0.00053-0.010. Men with haplotype A-C showed an increased probability to become centenarians (the frequency of A-C in long-lived and young individuals are 0.332 and 0.250, respectively, OR = 1.49, CI 95% = 1.17-1.88, P = 0.0007), in contrast to those with haplotype C-G (the frequency of C-G in long-lived and young individuals are 0.523 and 0.635, respectively, OR = 0.63, CI 95% = 0.51-0.78, P = 0.000018). The permuted P-values were 0.00005 and 0.0009, respectively. ADRB2 encodes the β2-adrenergic receptor; the haplotype A-C markedly reduced its translational efficiency compared with C-G (P = 0.002) in transfected HEK293 cells. Thus, our data indicate that enhanced production of β2-adrenergic receptors caused by genetic variants is inversely associated with human lifespan.
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Affiliation(s)
- Ling Zhao
- Department of Human Population Genetics; Institute of Molecular Medicine; Peking University; 5 Yiheyuan Road; Beijing; 100871; China
| | - Fan Yang
- Department of Human Population Genetics; Institute of Molecular Medicine; Peking University; 5 Yiheyuan Road; Beijing; 100871; China
| | - Ke Xu
- Department of Human Population Genetics; Institute of Molecular Medicine; Peking University; 5 Yiheyuan Road; Beijing; 100871; China
| | - Huiqing Cao
- Department of Human Population Genetics; Institute of Molecular Medicine; Peking University; 5 Yiheyuan Road; Beijing; 100871; China
| | - Gu-Yan Zheng
- Department of Human Population Genetics; Institute of Molecular Medicine; Peking University; 5 Yiheyuan Road; Beijing; 100871; China
| | - Yan Zhang
- Department of Human Population Genetics; Institute of Molecular Medicine; Peking University; 5 Yiheyuan Road; Beijing; 100871; China
| | - Jianxin Li
- Department of Sociology; Peking University; 5 Yiheyuan Road; Beijing; 100871; China
| | - Hanbin Cui
- Key Laboratory of Ningbo First Hospital and Cardiovascular Center of Ningbo First Hospital; Ningbo University; 59 Liuting Street; Ningbo; 315010; China
| | - Xiaomin Chen
- Key Laboratory of Ningbo First Hospital and Cardiovascular Center of Ningbo First Hospital; Ningbo University; 59 Liuting Street; Ningbo; 315010; China
| | - Zhiming Zhu
- Center for Hypertension and Metabolic Diseases; Department of Hypertension and Endocrinology; Daping Hospital; Chongqing Institute of Hypertension; Third Military Medical University; Chongqing; 400042; China
| | - Hongbo He
- Center for Hypertension and Metabolic Diseases; Department of Hypertension and Endocrinology; Daping Hospital; Chongqing Institute of Hypertension; Third Military Medical University; Chongqing; 400042; China
| | - Xianming Mo
- Department of Geriatrics; West China Hospital; West China Medical School; Sichuan University; Chengdu; 610041; China
| | | | - Yousin Suh
- Departments of Medicine and Genetics; Albert Einstein College of Medicine; Bronx; NY; 10461; USA
| | | | - Xiao-Li Tian
- Department of Human Population Genetics; Institute of Molecular Medicine; Peking University; 5 Yiheyuan Road; Beijing; 100871; China
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Ajmal M, Matas A, Kuskowski M, Cheng EY. Does statin usage reduce the risk of corticosteroid-related osteonecrosis in renal transplant population? Orthop Clin North Am 2009; 40:235-9. [PMID: 19358908 PMCID: PMC2801433 DOI: 10.1016/j.ocl.2009.01.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The relationship between corticosteroids and osteonecrosis is well known. Limited data suggest that statins modulate cholesterol metabolism and may protect against osteonecrosis. The authors analyzed their prospective renal transplant database to determine if statin usage reduces the incidence of corticosteroid-related osteonecrosis and identified 2,881 renal transplantation patients who met the entry criteria. Among 338 patients on statins, 15 (4.4%) developed osteonecrosis, versus 180 of 2,543 (7%) patients who were not on statins. Osteonecrosis-free survival was similar in patients with and without statin exposure.
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Affiliation(s)
- Muhammad Ajmal
- Department of Orthopaedic Surgery, VA Hospital, Nashville, Affiliated with University of Vanderbilt, 1310 24 Ave. South, Nashville, TN 37212, Phone: 615-327-5356, Fax: 615-321-6342
| | - A.J. Matas
- Department of Surgery, University of Minnesota, Minneapolis, MN 55457, Phone: 612-625-6460, Fax: 612-624-7168
| | - M. Kuskowski
- Minneapolis VA Medical Center, 1 Veteran Drive, Minneapolis, MN 55417, Phone: 612-725-2000
| | - Edward Y. Cheng
- Department of Orthopaedic Surgery, Mairs Family Professor, University of Minnesota, 2512 South 7th Street, Suite 200, Minneapolis, MN 55454, Phone: 612-273-7951, Fax: 612-273-7959
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