Article

OBJECTIVE: To review all pharmacological and physiological data available on
intrathecal baclofen (ITB) therapy and to evaluate its use in clinical practice
and future research. DATA SOURCES: PubMed was searched for relevant anatomic,
physiological, and pharmacological data available on ITB. STUDY SELECTION: All
currently available data on ITB pharmacokinetics (PKs) and pharmacodynamics (PDs)
in both human and animal studies were reviewed and combined with the anatomy and
physiology of the intrathecal space and cerebrospinal fluid flow. DATA
EXTRACTION: Only 4 studies reported PK data on ITB in humans. More studies
reported PD data on ITB; however, none were combined with PK data. More detailed
data on PK could be gathered from studies using an animal model. DATA SYNTHESIS:
ITB does not spread equally over the intrathecal space after injection, but it
diffuses according to a concentration gradient. ITB distribution can be
influenced by the location of the catheter tip and by changing the infusion mode.
CONCLUSIONS: The pharmacological and physiological data on ITB can be used to
support decisions in clinical practice concerning drug concentration, infusion
regimens, localization of the catheter tip, and management of tolerance; however,
some strategies have little evidence in humans.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS