在患有肝功能障碍的患者中,polymyxin B的群体药理动力学
Xueyong Li1,2, Yu Cheng1, Bo Chen1,2
1Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.
这项研究在肝功能障碍患者中开发了聚米辛B (PMB) 的种群药动力学模型. 和肝功能可能不需要初始剂量调整,强调治疗药物监测以获得最佳的PMB剂量.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
- 传染性疾病 传染性疾病
背景情况:
- 聚米辛B (PMB) 对于治疗多药耐药的格拉姆阴性感染至关重要.
- 对于肝功能障碍患者的PMB,药理动力学数据有限.
研究的目的:
- 在患有肝功能障碍的患者中开发PMB的人口药理学 (PopPK) 模型.
- 在这个人群中确定影响PMB药理动学的因素.
主要方法:
- 对136名具有不同肝功能的成年患者进行了回顾性药理动力学研究.
- 非线性混合效应建模以建立PopPK模型.
- 蒙特卡洛模拟用于剂量方案设计.
主要成果:
- 一个单间模型描述了PMB的药理动力学.
- 肌素清除率 (CrCL) 和Child-Pugh类影响了PMB参数,但剂量正常化的暴露变化没有临床意义.
- 推剂量:MIC ≤0.5 mg/L的40-75 mg/12小时;剂量>100 mg/12小时增加了毒性风险.
结论:
- 为肝功能障碍患者提供PMB必需的药理动力学数据.
- 对于和肝功能障碍的初始剂量调整可能不需要.
- 治疗药物监测 (TDM) 比PopPK引导的调整更为关键,以优化PMB在治疗窗口内的剂量.
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