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(Chest. 1983;83:386-390.)
© 1983 American College of Chest Physicians

Pharmacokinetics and Pharmacodynamics of Clonidine in Varying States of Renal Function

David T. Lowenthal M.D.1; Melton B. Affrime Pharm. D.1; Alan Meyer M.D.1; Kwan E. Kim M.D.1; Bonita Falkner M.D.1; and Kurosh Sharif M.D.1

1 From the Likoff Cardiovascular Institute and Department of Medicine and Pediatrics, Hahnemann University and Alexian Brothers Hospital, Philadelphia, and Elizabeth, NJ

Previous studies have reported a therapeutic window of 0.8 to 2.0 ng/ml within which clonidine exerts its antihypertensive effect. This study was designed to investigate whether there was any loss of blood pressure control when plasma clonidine concentrations exceeded this window owing to its accumulation in renal insufficiency. The results indicate that clonidine concentrations of up to 30 ng/ml in patients with end-stage renal disease (ESRD) can be associated with a maintenance of blood pressure control. It remains to be learned whether this phenomenon of high concentrations and control of blood pressure in our ESRD patient population may be related to altered (decreased) peripheral agr-receptor sensitivity and inability to develop vasoconstriction. There is precedence for autonomic imbalance and altered tissue sensitivity in ESRD.






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Copyright © 1983 by the American College of Chest Physicians.