Influence of physical exercise on clinical pharmacokinetics: theoretical aspects and practical examples

摘要

The influence of sport on the pharmacokinetics has gained increasing importance. As a rule, physical activity may have an effect on different levels of LADME (liberation, absorption, distribution, metabolism, elimination). However, it is difficult to assess the individual contribution of each level. The physico-chemical properties of a drug and the mode of administration are decisive factors which determine the overall influence of sport on pharmacokinetics. The clinical relevance of this effect is particularly due to the width of the therapeutic window. Drugs with a narrow therapeutic window such as digitalis, theophyllin, insulin, anti-arrhythmic or anti-epileptic drugs may show substantially changed blood levels after physical activity. Experimental trials and simulations of concentrations vs. time curves may improve safety and tolerability of long-term drug therapy in those who have integrated sport as part of their lifestyle.