在药剂师管理的万科米辛剂量协议中实施AUC监测:回顾性队列研究
Brandon L S Robinson1, Blake Bennie1, Mahmoud Nasiri1
1HCA Houston Healthcare Kingwood, Kingwood, TX.
HCA healthcare journal of medicine
|July 10, 2023
概括
与低谷监测相比,对万科米辛的曲线下面面积 (AUC) 监测并没有降低急性损伤 (AKI) 率. 然而,AUC监测在第一次随访时改善了治疗药物水平,而没有增加死亡率或停留时间.
科学领域:
- 药理学和临床药学 药理学和临床药学
- 腎病學和重症醫療醫學 腎病學和重症醫學
背景情况:
- 2020年共识指南建议对万科米辛治疗进行曲线下的区域 (AUC) 监测,以优化疗效和安全.
- 传统的以低谷为基础的监测可能不如监测万科米辛剂量的AUC有效.
研究的目的:
- 为了评估面积在曲线下 (AUC) 监测是否会降低接受万科米辛的成年患者急性损伤 (AKI) 率.
- 在以AUC为指导的和以低谷为指导的万科米辛剂量策略之间比较AKI的发病率.
主要方法:
- 对接受药剂师管理的万科米辛治疗的成年患者进行了回顾性研究.
- 患者被分为两组:AUC监测和低谷监测.
- 排除标准包括治疗时间少于48小时,功能不稳定或基线血液透析.
主要成果:
- 在AUC (16.5%) 和低谷 (14.9%) 监测组 (P = .61) 之间,AKI率没有显著差异.
- AUC监测导致在第一次随访时达到治疗药物水平的比率更高 (43.2%对33.9%,P = .03).
- 对AUC的监测导致了较低的低谷值和总每日剂量,但没有影响死亡率或停留时间.
结论:
- 与低谷监测相比,曲线下的面积 (AUC) 监测没有降低急性损伤 (AKI) 率.
- AUC监测有效地实现了康胺的目标暴露 (400-600毫克*小时/升),并且没有增加不良结果.
相关概念视频
Drug Dosage Regimen: Overview
3.6K
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
3.6K
Pharmacovigilance
901
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
901
Rational Dosage Regimen: Maintenance Dose and Loading Dose
4.2K
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
4.2K
Dosage Regimen: Fixed Dose
1.9K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
1.9K
One-Compartment Open Model: Wagner-Nelson and Loo Riegelman Method for ka Estimation
578
This lesson introduces two critical methods in pharmacokinetics, the Wagner-Nelson and Loo-Riegelman methods, used for estimating the absorption rate constant (ka) for drugs administered via non-intravenous routes. The Wagner-Nelson method relates ka to the plasma concentration derived from the slope of a semilog percent unabsorbed time plot. However, it is limited to drugs with one-compartment kinetics and can be impacted by factors like gastrointestinal motility or enzymatic degradation.
On...
On...
578
One-Compartment Open Model for IV Bolus Administration: General Considerations
252
The one-compartment model is a pharmacokinetic tool that models the body as a single, uniform compartment, facilitating the understanding of drug distribution and elimination. This model is particularly beneficial for intravenous (IV) bolus administration, where the drug rapidly circulates throughout the body.
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
252


