Impact of plasmapheresis on disopyramide elimination.
The impact of plasmapheresis on the disposition of disopyramide was investigated in a 16-year-old female with systemic lupus erythematosus. Determination of total disopyramide plasma concentrations immediately prior to and following a 4-h plasmapheresis treatment revealed a significant reduction (i.e., 1.77 to 0.7 mg/l or approximately 60%). However, reassessment of the total serum concentration after 1.5 h (i.e., post equilibrium) revealed a rebounding of the value to 1.64 mg/l. Associated with this reduction in total serum levels was a decrease in the protein-bound fraction of disopyramide from 69.5% (pre treatment) to 48.6% (post treatment) that corresponded to a commensurate reduction in the concentration of alpha1-acid glycoprotein (i.e., 119 mg/dl pre treatment to 48.9 mg/dl post treatment). Despite these alterations in disopyramide concentrations, the procedure removed only 2.7% of the disopyramide dose and was not associated with the appearance of a cardiac dysrhythmia.
Martin
S G
SG
Department of Pediatrics, University of Missouri-Kansas City, Children's Mercy Hospital, 64108, USA.
Kearns
G L
GL
Brod
M
M
Austin
G
G
Vaughan
B C
BC
D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000097:blood* / Q000627:therapeutic use; D004206:Disopyramide / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000188:drug therapy / Q000628:therapy; D010956:Plasmapheresis / Q000009:adverse effects
D000889:Anti-Arrhythmia Agents; D004206:Disopyramide