通过以模型为基础的贝叶斯剂量方法提供单个化的万科米辛,以维持重症患者的AUC24目标
Zhi Rao1,2, Si-Ming Guo3, Yan-Ming Wei4
1College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, China, caesar-731@163.com.
这项研究开发了中国重症患者中万科米辛的种群药理动力学 (PPK) 模型. 基于模型的贝叶斯估计成功地个性化了万科米辛剂量,以达到目标AUC24水平,改善治疗结果.
科学领域:
- 药理动力学和药理动力学
- 关键护理医学 关键护理医学
- 临床药房 临床药房
背景情况:
- 更新的指导方针建议对万科米辛治疗药物监测 (TDM) 的AUC24监测.
- 旺科米辛的药理动力学在重症患者中具有很高的变化.
- 对于中国重病人群而言,存在有限的人口药理动力学 (PPK) 模型.
研究的目的:
- 在中国重症患者中开发Vancomycin的PPK模型.
- 通过使用基于模型的贝叶斯估计来个性化万科米辛剂量.
- 为了达到400-650 mg*h/L的推AUC24目标.
主要方法:
- 在48-72小时内静脉输入万科米辛和TDM.
- 用高性能液体染色学测量的万科米辛度.
- 非线性混合效应建模 (NONMEM®) 用于PPK分析.
- 个人PK参数估计的经验贝叶斯方法.
主要成果:
- 建立了一个单隔离的万科米辛PPK模型,其中肌素清除率作为一个共变量.
- 该模型表现出良好的精度,稳定性和预测性能.
- 基于模型的贝叶斯估计有效预测了AUC24并指导了剂量调整.
- 通过保持AUC24在目标范围内,可以实现治疗效果.
结论:
- 一种万科米辛PPK模型已成功为中国重症患者开发.
- 基于模型的贝叶斯估计使得个性化的万科米辛剂量能够达到AUC24的目标.
- 这种方法显示出成功的临床应用,并支持其在万科米辛治疗中继续使用.
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