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An International Symposium "Catecholamines and the Heart" was held
in Munich in May 1981, which was organized in cooperation with the
Council on Cardiac Metabolism of the International Society and
Federation of Cardiology and with the Microcirculation Working
Group of the European Society of Cardiology. It was the aim of the
organizers to evaluate in this Symposium the recent advances made
in the field of sympathetic control of heart function. Particular
attention was given to neural sympathetic pathways, to mechanisms
and consequences of adrenoceptor stimulation and blockade as well
as to clinically relevant implications mainly regarding the
significance of catecholamines and of adrenoceptors in various
heart diseases. The broad scope was covered in 34 papers presented
by physiologists, pharmacologists and cardiologists during a two
day meeting which was attended by an international audience. This
book includes all papers as well as the discussions following each
presentation. To accomplish rapid publication the manuscripts are
published as submitted by the authors. The discussions were edited
making use of the written questions and answers of the discussants.
The Symposium was generously sponsored by Astra Chemicals GmbH,
Wedell Holstein, Germany, which thus made possible a very fruitful
exchange of information, ideas and concepts between specialists in
various disciplines. The organizers gratefully acknowledge this
support once again and would like to thank Dr. T. Kreuzer, the
representative of Astra Chemicals, for his personal engagement.
Microcirculation is a rather new field which has been of
predominant interest to basic scientists, linking togeth~r
technical, hemodynamic, and biochemical aspects. The fmdings
elaborated, however, are not only of theoretical interest, but bear
in addition great clinical implications. In clinical cardiology
this became quite evident by the use of tracers in order to study
myocardial perfuSion and by the deSCription of certain clinical
entities - such as angina with normal coro nary arteries - which
are best explained by "disturbed microcirculation". With respect to
this new developing theoretical and clinical field of cardiac
microcirculation it was the aim of the Microcirculation Working
Group of the European Society of Cardiology to have a symposium on
which all different but clinically relevant aspects of cardiac
microcirculation will be covered. This symposium, held in
Heidelberg in January 1980, was planned not only for the exchange
of concepts and ideas, but was expected to be in addition partially
a teaching session; the basic scientists should be directed toward
a better under standing of the clinical problems, and the
clinicians should learn more about the basic mechanisms regulating
substrate and ion exchange in such an impor tant organ as the
heart, and furthermore the theoretical limitations of some of the
diagnostic and therapeutical procedures should be taught. Without a
lot of help we would never have succeeded in organizing the sym
posium and editing its results.
This is a little book with no great pretensions. The authors do not
claim it to be world-startling nor Nobel- or
Pulitzer-prize-winning. It is a valuable primer for
pharmacokinetics for those desiring a proper initiation into
previously assumed mysteries. It is fully intended as an
introduction to the basic concept of pharmacokinetics and will be
welcomed by all who wish to apply its principles to their own
disciplines, whether in life sciences or medicine, without being
confused by excess mathematics. It is edited by two well-known
German scientists who are primarily practicing pediatricians and
who use pharmacokinetics in their daily work, in a field of
medicine where the proper adjustment of doses for infants and
children is a delicate and life-preserving art. They were trained
as pediatricians and as pharmacokinetists by the world-renowned
Profes sor F. HARTMUT DOST, who uniquely synthesized these two
disciplines and who, as a pioneer in this field, published the
first book on pharmacokine tics in 1953. In their own right, the
editors have conducted excellent and unique research on the effect
and fate of drugs and have followed up the unexpected changes in
drug action accompanying the rapid developments encountered in the
initial hours, days, and weeks after birth. You will find some
interesting Germanisms in this book a la Professor DOST. I
personally feel that these will give some spice to their
renditions.
Dieses Buch bietet eine exzellente Zusammenfassung des Standes der
Forschung und deren klinische Anwendung zu Beta-Blockern. Der
Einsatz von Beta-Blockern bei verschiedenen koronaren Erkrankungen
wird ausfuhrlich beschrieben. Grenzen und Abgrenzungen zu anderen
Therapiemoglichkeiten werden diskutiert."
2. Elimination . . . . . . . . . 102 a) Krankhafte Veranderungen
des eliminierenden Organs 102 b) Altersabhangige Veranderungen der
Elimination . . . 104 c) Pharmakogenetische Faktoren. . . . . . . .
. . . 105 d) Abhangigkeit der Eliminationsgeschwindigkeit vom
Saure-Basen- Haushalt . . . . . . . . . . . . . . . . . . . 106 e)
Cicadiane Rhythmik der Eliminationsgeschwindigkeit . 108 f)
Wasserdiurese und Eliminationsgeschwindigkeit 108 g)
Loesungsmittelmangel . . . . . . . . . . . . . . 108 h)
Enzyminduktion . . . . . . . . . . . . . . . . 109 i) Hemmung der
Elimination durch toxische Wirkung. 113 cx) Verdrangung aus der
Eiweissbindung . . . . . . 113 ss) Clearancedepression . . . . . .
. . . . . . . 114 y) Beschleunigung der Elimination durch enteral
verabreichte Komplexbildner und Adsorbentien 114 3.
Verteilungsvolumen . . . . . . 115 a) Dehydratation - Hydratation
115 b) Hydropische Zustande 116 4. Schlussbemerkung . . . . . . 116
IX. Verwendung von Analog-Rechnern in der Pharmakokinetik . 118 1.
Einfuhrung . . . . . . . . . . . . . 118 2. Arbeitsprinzip des
Analogrechners. . . . 119 3. Die Programmierung des Analogrechners
. 122 4. Anwendung . . . . . . . . . . . . . 124 x. Praktische
Anwendung pharmakokinetischer Verfahren . . . . . . . . 130 (Von W.
-H. Wagner) 1. Einleitung. . . . . . 130 2. Messverfahren . . . .
130 130 a) Mikrobiologische Methode 131 b) Chemisch-analytische
Methode. c) Nachweis mittels radioaktiv markierter Substanz 131 3.
Bewertung der Ergebnisse von Tierversuchen . . . 132 4. Gewinnung
pharmakokinetischer Groessen und Konstanten . 133 a) Bestimmung aus
der graphischen Darstellung . . . . 133 b) Verwendung
programmierter Verfahren. . . . . . . . 133 5. Mathematische
Grundlagen der programmierten Verfahren. 134 XI a) Verteilung einer
Substanz in mehreren Kompartimenten. 134 b) Blutspiegelverlaufe bei
reiner Invasion. . . . . . . . . 135 c) Blutspiegelverlaufe bei
reiner Elimination . . . . . . . 137 d) Blutspiegelverlaufe bei
gleichzeitiger Invasion und Elimination (Bateman-Funktion) . . 137
e) Kumulation, Grenzkurve 142 f) Dosierungsschema 142 6.
Auswertungsbeispiele . 143 Weiterfuhrende Literatur. 154
Sachverzeichnis . . . .
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