C 005: PHARMACOKINETIC CHANGES INDUCED BY SPINAL CORD INJURY

J Pharm Pharmacogn Res 2(Suppl. 1): S21, 2014

Special supplement with the abstract book of LATINFARMA 2013

Conference

C 005: PHARMACOKINETIC CHANGES INDUCED BY SPINAL CORD INJURY

Castañeda G.

Departamento de Farmacología. Centro de investigación y de Estudios Avanzados del Instituto Politécnico Nacional. Av. Instituto Politécnico Nacional 2508, 07360 México, D.F.
Abstract

Spinal cord injury (SCI) is a life-threatening event that not only results in a sensory-motor loss below the site of lesion, but also causes autonomic alterations including gastrointestinal and hemodynamic changes. These changes are known to modify drug availability. Significant changes in drug absorption, volume of distribution and clearance have been reported in patients after cord lesion and it has been suggested that these changes could have an impact on the efficacy and safety of a variety of drugs in this population. Characterization of the physiopathological alterations underlying pharmacokinetic changes that occur in patients with SCI has been complicated because of the important variability induced by differences in injury characteristics, as well as in the individual conditions of each patient. Moreover, not all drugs exhibit altered disposition after SCI. Therefore, depending on which physiological mechanisms are involved in the absorption, distribution and elimination of a given drug, SCI will or will not change its pharmacokinetic parameters. There is evidence suggesting that the magnitude of the pharmacokinetic changes will depend on variables related to the injury itself: site of injury, intensity and the time elapsed after lesion. However, at present we do not have enough information to propose a rational strategy for drug dosing in patients with spinal cord injury. Doses are selected on empirical bases, often resulting in therapeutic failure. Thus, systematic research is required to fully elucidate this issue. Hence, our group has used animal models, where the lesion can be standardized, to characterize and understand the impact of spinal cord injury on drug disposition.