膜过对于药物剂量的药理动力学意义
Carmine Zoccali1,2,3, Francesca Mallamaci4, Raffaele De Caterina5,6
1Renal Research Institute, New York, NY, USA.
Clinical kidney journal
|October 2, 2023
概括
淋巴细胞过可以增加药物清除,危及重症患者的治疗失败. 剂量监测至关重要,但对于心房患者的非维生素K抗剂口服抗凝剂,不需要进行调整.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临界护理医学 临界护理医学
背景情况:
- 功能变化,特别是低过或高过,显著影响患者的药物清除.
- 过可以导致脏清除药物的脏分泌量增加,可能导致次治疗水平.
- 了解这些药理动力学变化对于优化各种患者群体的药物治疗至关重要.
研究的目的:
- 审查膜过对药物清除的影响.
- 为了确定过是否需要在临床实践中调整剂量.
- 在经历过度过的特定患者群体中分析药物药理动力学.
主要方法:
- 文献综述侧重于研究过和药物药理动力学的研究.
- 对过患者药物清除和血度数据的分析.
- 对非维生素K对抗剂口服抗凝剂 (NOACs) 在过的心房患者的系统综述.
主要成果:
- 过增强了水友药物的去除,增加了治疗失败的危急病,败血症和烧伤患者的风险.
- 肥胖个体通常表现出更高的药物清除率,但这受身体尺寸调整的影响.
- 在过肥胖患者和2型糖尿病患者中没有发现一致的药物动力学变化.
- 一些研究表明,高过的心房患者的NOAC度较低,但没有增加栓塞风险.
结论:
- 过在重症监护病房中很常见,需要对药物水平进行监测,以防止剂量不足和治疗失败.
- 虽然过发生在肥胖和2型糖尿病中,但没有确立一致的药理动力学变化.
- 目前没有NOAC剂量调整适用于过的心房患者.
相关概念视频
01:02Renal Drug Excretion: Glomerular Filtration
300
The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production occurs. A nephron has two main components: a renal corpuscle and a renal tubule.
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....
300
01:31Factors Affecting Renal Clearance: Drug's Physicochemical Properties and Plasma Levels
258
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...
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...
258
01:11Renal Failure: Dose Adjustments
109
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...
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...
109
01:09Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions
154
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...
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...
154
01:17Drug Elimination by Renal Route: Glomerular Filtration
5.7K
The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production takes place. A nephron has two main components: a renal corpuscle and a renal tubule. Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent...
5.7K
01:17Factors Affecting Renal Clearance: Renal Impairment
114
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...
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...
114