优化剂量和达到儿童中万科米的目标
Alessia Cafaro1, Manuela Stella2, Alessio Mesini3
1Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina, Gaslini, Genova, Italy.
Clinical biochemistry
|February 7, 2024
概括
在儿童中优化万科米辛剂量至关重要. 曲线下的面积 (AUC) 导向的治疗药物监测 (TDM),特别是贝叶斯预测,提高了儿科患者的药物疗效和安全性.
科学领域:
- 药理学 药理学是指药理学的学科.
- 儿童传染病 儿童传染病
- 临床药房 临床药房
背景情况:
- 范科米辛是治疗格拉姆阳性感染的关键抗生素,已经使用了70多年.
- 在儿科人群中达到最佳剂量和药理动力学/药理动力学 (PK/PD) 目标仍然具有挑战性.
- 当前儿童治疗药物监测 (TDM) 实践需要对万科米辛治疗进行改进.
研究的目的:
- 审查当前关于儿童患者使用万科米辛的文献.
- 总结关于优化万科米辛剂量的知识,以便在特殊儿科群体中实现目标.
- 突出AUC引导的TDM和贝叶斯预测对儿童的万科米辛治疗的好处.
主要方法:
- 对儿科万科米辛研究的文献综述.
- 对儿童的药理动力学/药理动力学 (PK/PD) 数据的分析.
- 评估治疗药物监测 (TDM) 策略,包括以AUC为导向和只有谷部监测.
- 对贝叶斯预测用于预测万科米辛暴露的评估.
主要成果:
- 建议使用曲线下的面积 (AUC) 指导的TDM,而不是在儿童中使用万科米辛的TDM.
- 以AUC指导的TDM增强了PK/PD目标的实现 (AUC0-24h/MIC>400600) 并降低了急性损伤的风险.
- 贝叶斯预测提高了预测儿科患者个体万科米辛度和总暴露的准确性.
结论:
- 建议在所有儿科年龄组和特殊人群中采用AUC引导的TDM,理想情况下采用贝叶斯预测.
- 这种方法优化了万科米辛的疗效和安全性,确保了更好的治疗结果.
- 进一步的研究和先进的TDM策略的临床实施是为儿科万科迈辛治疗的必要.
相关概念视频
Rational Dosage Regimen: Maintenance Dose and Loading Dose
4.1K
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...
4.1K
Drug Dosage Regimen: Overview
3.5K
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...
3.5K
Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K
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
Renal Failure: Dose Adjustments
89
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...
89
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
138
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
138


