Video Experimental Relacionado

Updated: May 27, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Relación entre las concentraciones plasmáticas de polimixina B y el daño renal agudo en pacientes ancianos en estado

Changyun Zhao¹, Wenchao Mao¹, Feifei Ye¹

¹Department of Critical Care Medicine, Zhejiang Hospital, Zhejiang, China.

The Journal of international medical research

|February 16, 2025

Objetivo:

El objetivo de este estudio fue determinar la relación entre la concentración plasmática de polimixina B y la función renal en pacientes ancianos.

MéTodos:

Este estudio prospectivo, observacional, de casos y controles incluyó pacientes ancianos que recibieron terapia con polimixina B y que fueron divididos en un grupo con lesión renal aguda (LRA) y un grupo sin LRA según su función renal. Monitoreamos la farmacocinética y la farmacodinámica de la polimixina B, incluyendo la concentración plasmática mínima (C_min), concentración media de fármaco en sangre en estado estacionario (C_ss,avg) y área bajo la curva de concentración-tiempo durante 24 h en estado estacionario (AUC_ss,24h) en ambos grupos de estudio. La concentración plasmática de polimixina se determinó mediante cromatografía líquida de alta eficacia con espectrometría de masas en tándem.

Resultados:

Las dosis de carga, C_min, C_ss,avgy AUC_ss,24hfueron significativamente más altos en el grupo con ICA que en el grupo sin ICA (p< 0,05). El análisis de la curva característica de operación del receptor mostró que los valores de corte óptimos para predecir la lesión renal aguda fueron 2,94 mg/L para C_min, 4,14 mg/L para C_ss,avg, y 99,35 mg·h/L para el AUC_ss,24h, con sensibilidades y especificidades correspondientes que oscilan entre 78,57 % y 82,14 %.

ConclusióN:

El monitoreo de las concentraciones plasmáticas de polimixina B es esencial en pacientes ancianos. Mantener la C_minpor debajo de 2,94 mg/L, el C_ss,avgpor debajo de 4,14 mg/L, y el AUC_ss,24hpor debajo de 99,35 mg h/L puede ayudar a prevenir la IRA en esta población.

Palabras clave:

Polimixina B lesión renal aguda pacientes ancianos farmacodinamia farmacocinética monitorización terapéutica de fármacos

Más Videos Relacionados

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Published on: May 6, 2018

Videos de Conceptos Relacionados

Renal Failure: Dose Adjustments

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...

Factors Affecting Renal Clearance: Renal Impairment

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...

Factors Affecting Renal Clearance: Drug's Physicochemical Properties and Plasma Levels

Factors Affecting Renal Clearance: Drug's Physicochemical Properties and Plasma Levels

Renal clearance of a drug is influenced by various factors, including its physicochemical properties and plasma levels. These factors play a significant role in determining how efficiently the kidneys eliminate a drug.
One important factor is the drug's molecular size. The kidneys readily excrete smaller molecules below 300 Daltons (Da). On the other hand, molecules weighing between 300 and 500 Da are excreted through both urine and bile. Larger molecules above 500 Da tend to be excreted...

Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions

Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions

Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...

Drug Distribution: Plasma Protein Binding

Drug Distribution: Plasma Protein Binding

Drugs predominantly attach to plasma proteins, with only a small percentage remaining unbound. The unbound portion can be calculated as one minus the bound fraction. Acidic drugs form large, inactive complexes by reversibly binding to plasma albumin, which prevents them from diffusing across biological barriers. These drug-protein complexes act as reservoirs for the drugs. As the concentration of unbound drugs decreases, these complexes quickly dissociate to release the free drug, maintaining...

Factors Affecting Protein-Drug Binding: Patient-Related Factors

Factors Affecting Protein-Drug Binding: Patient-Related Factors

Protein-drug binding, a pivotal aspect of pharmacokinetics, is subject to considerable variability influenced by an array of patient-related factors. The intricate interplay of age, individual differences, and pathological conditions significantly impact the binding dynamics and subsequent pharmacological effects.
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...