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Evaluation of nucleoside reverse transcriptase inhibitor dosing during continuous veno-venous hemofiltration
Milena M McLaughlin1,2, Inela Masic3, Lana Gerzenshtein4
1Department of Pharmacy Practice, Chicago College of Pharmacy, Midwestern University, 555 31st Street, Downers Grove, IL, 60515, USA. milgriff@nm.org.
International Journal of Clinical Pharmacy
|November 27, 2016
Summary
Continuous veno-venous hemofiltration (CVVH) may affect nucleoside reverse transcriptase inhibitor (NRTI) drug levels. Most NRTI doses studied were potentially suboptimal for patients undergoing CVVH.
Area of Science:
- Pharmacokinetics
- Pharmacology
- HIV Medicine
Background:
- Unpredictable drug concentrations of nucleoside reverse transcriptase inhibitors (NRTIs) can occur during continuous veno-venous hemofiltration (CVVH).
- Suboptimal NRTI exposure may reduce antiretroviral efficacy and potentially accelerate HIV disease progression.
Purpose of the Study:
- To compare administered NRTI doses with calculated doses for patients on CVVH.
- To assess the likelihood of favorable pharmacokinetic exposure profiles under CVVH conditions.
Main Methods:
- NRTI doses were compared against a recommendation table.
- Calculations were based on a mathematical formula estimating drug removal during CVVH.
Main Results:
- Twelve patients received 27 different NRTI doses.
- Only 11 (41%) of the NRTI doses were predicted to yield favorable pharmacokinetic profiles based on calculations.
Conclusions:
- The majority of NRTI doses administered to patients on CVVH may not be optimal.
- Further pharmacokinetic studies are needed to guide NRTI dosing during CVVH.
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