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Narcissus and Daffodil

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338 D. Brown<br />

Metabolism <strong>and</strong> excretion<br />

Clearly, the metabolism of any drug that is used in an elderly population needs to<br />

be characterised, given the potential effects of age on liver function.<br />

In the study by Westra et al. (1986), approximately 30% of the intravenous<br />

galanthamine dose was excreted in the urine unchanged. Biliary excretion was<br />

negligible <strong>and</strong> there was no evidence of conjugation with glucuronide or sulphation.<br />

Mihailova et al. (1989) detected the metabolites epigalanthamine (the stereo<br />

isomer of galanthamine – see Figure 13.2) <strong>and</strong> galanthaminone in plasma <strong>and</strong><br />

urine; these metabolites possess only very weak anticholinesterase activity (

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