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应用药理动力学以改善新生儿和儿科重症监护病房的药理疗法:重点是正确的剂量选择
Dotan Shaniv1,2, Karel Allegaert3,4,5
1Pharmacy Services, Kaplan Medical Center, Clalit Health Services, Rehovot, Israel.
Archives of disease in childhood. Education and practice edition
|February 26, 2024
概括
新生儿和儿科重症监护室 (NICU/PICU) 的药物剂量需要仔细调整,因为成熟和非成熟因素. 建议采用精确的剂量策略,包括治疗药物监测,以优化重症儿童的药物暴露.
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
- 儿科 儿科 儿科
背景情况:
- 儿童的药物剂量受成熟变化 (体重,年龄,身体表面积) 的影响.
- 新生儿和儿科重症监护室 (NICU/PICU) 引入了影响药物暴露的非成熟因素,如败血症,心力衰竭,急性损伤,体外电路和药物相互作用 (DDI).
- 这些因素可能导致患者内和患者间药物暴露的显著变化,需要进行个别剂量调整.
研究的目的:
- 突出在NICU/PICU设置中药物剂量的复杂性.
- 强调需要对负载剂和维持剂量进行个性化剂量调整的需要.
- 为优化药物剂量选择在重症儿科患者群体提供建议.
主要方法:
- 在NICU/PICU患者中影响药物药理动学的因素的审查.
- 剂量挑战的插图,以诺巴比塔尔和万科米辛为例.
- 讨论优化剂量选择的策略.
主要成果:
- 成熟和非成熟因素在儿科重症监护中显著改变药物药理动力学.
- 为了管理药物暴露的变化,通常需要进行个别剂量调整.
- 芬诺巴比他和万科米辛的剂量作为这些复杂性的案例研究.
结论:
- 在NICU/PICU设置中优化药物剂量选择需要采用多方面的方法.
- 建议将治疗药物监测与基于模型的精确剂量结合起来.
- 利用儿科药物配方和DDI数据库,在儿科临床药理学家和药剂师的指导下,对于安全有效的药物治疗至关重要.
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