caa a22 4500 606216154 CHVBK 20210128105229.0 cr unu---uuuuu 210128e20150501xx s 000 0 eng 10.1007/s00701-015-2369-9 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2369-9 Serum levels of nimodipine in enteral and parenteral administration in patients with aneurysmal subarachnoid hemorrhage [Elektronische Daten] [Tammam Abboud, Hilke Andresen, Johannes Koeppen, Patrick Czorlich, Lasse Duehrsen, Justus Stenzig, Manfred Westphal, Jan Regelsberger] Background: The aim of this study was to evaluate serum nimodipine concentrations in patients with aneurysmal subarachnoid hemorrhage (SAH) after parenteral therapy and a following course of enteral administration. Methods: SAH patients were treated with intravenous nimodipine (2mg/h) during the 1st week after hemorrhage, and on day 8, we switched over to enteral administration (60mg/4h), either orally or by gavage. Serum nimodipine concentrations were measured on days 3, 5, 8, 9 and 12. Area under the curve (AUC) was calculated during parenteral and enteral therapy. The data of 15 patients were analyzed retrospectively. Results: In this study, 157 blood samples were obtained. In seven samples, during the administration by gavage to two patients with high-grade SAH, the serum nimodipine concentrations were negligible. The AUC values during parenteral administration (median 149.3ng-h/ml) were significantly higher than during oral administration on days 9 (median 92.1ng-h/ml) and 12 (median 44.1ng-h/ml) in seven patients (p = 0.030 and p = 0.016, respectively). The AUC values during parenteral administration were significantly higher than during administration by gavage on day 9 in eight patients (median 87.9 and 34ng-h/ml, respectively, p = 0.001). The AUC values during enteral administration were higher in patients who received nimodine orally than in those who received it by gavage (median 52.3 and 23.1ng-h/ml, respectively, p = 0.006). Conclusions: Enteral administration of nimodipine showed lower bioavailability during the 2nd week after SAH compared to parenteral application during the 1st week. Negligible serum concentrations were even expected when nimodipine was given by gavage in patients with high-grade SAH, thus suggesting that parenteral administration may be the better route in these patients. Springer-Verlag Wien, 2015 Nimodipine nationallicence Calcium antagonist nationallicence Subarachnoid hemorrhage nationallicence Enteral administration nationallicence Parenteral administration nationallicence Abboud Tammam Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut Andresen Hilke Institute of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Koeppen Johannes Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut Czorlich Patrick Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut Duehrsen Lasse Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut Stenzig Justus Institute of Experimental and Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany aut Westphal Manfred Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut Regelsberger Jan Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut Acta Neurochirurgica Springer Vienna 157/5(2015-05-01), 763-767 0001-6268 157:5<763 2015 157 701 https://doi.org/10.1007/s00701-015-2369-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2369-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Abboud Tammam Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Andresen Hilke Institute of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Koeppen Johannes Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Czorlich Patrick Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Duehrsen Lasse Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Stenzig Justus Institute of Experimental and Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Westphal Manfred Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Regelsberger Jan Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/5(2015-05-01), 763-767 0001-6268 157:5<763 2015 157 701 SWISSBIB 606214380