在接受万科米治疗的患者中,早期急性损伤的潜在风险因素
Aiju Endo1, Kazumi Hanawa2, Daiki Asakawa1
1Department of Pharmacy, Yamanashi Prefectural Central Hospital, Kofu, 400-8506, Yamanashi, Japan.
概括
范科米辛诱导的急性损伤 (AKI) 可以发生在早期. 监测万科米辛的血度,并以AUC0-48低于910.2μg/mL·h为目标,可能有助于预防早期的AKI.
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.
- 临床药房 临床药房
背景情况:
- 范科米辛 (VCM) 是治疗严重的格拉姆阳性细菌感染的关键抗生素.
- 急性损伤 (AKI) 是众所周知的万科米辛的副作用,通常与其血液度有关.
- 与万科米辛相关的早期AKI需要了解度依赖性毒性和识别预测标记.
研究的目的:
- 调查接受万科米的患者早期AKI的发生率.
- 确定新的指标来预测和潜在地避免早期的万科米辛诱导的AKI.
- 确定与早期AKI相关的血度-时间曲线 (AUC) 下面区域的值.
主要方法:
- 参与了接受万科米辛超过4天的成年患者.
- 监测了血清肌素和万科米辛的最低水平.
- 分析了各种AUC间隔与早期AKI (7天内) 之间的关联,并确定了AUC截止值.
主要成果:
- 在164名患者中,21人患有早期AKI,最常见的是4日.
- 所有评估的AUC间隔 (AUC0-24,AUC24-48,AUC48-72,AUC0-48,AUC24-72,AUC0-72) 都与早期的AKI显著相关.
- 确定了早期AKI的特定AUC截止值,包括AUC0-48的910.2μg/mL·h.
结论:
- 范科米辛的累积毒性是AKI的潜在原因.
- 早期监测万科米辛血度至关重要.
- 保持AUC0-48低于910.2μg/mL·h可能会降低早期AKI的风险.
相关概念视频
01:11Renal Failure: Dose Adjustments
88
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...
88
01:17Factors Affecting Renal Clearance: Renal Impairment
91
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...
91
01:09Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions
128
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...
128
01:31Factors Affecting Renal Clearance: Drug's Physicochemical Properties and Plasma Levels
222
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...
222
01:27Dialysis
309
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
309
01:22Renal Drug Excretion: Effect of Urine pH, Flow Rate, and Drug pKa
166
The pH of urine, the drug's pKa, and the urine flow rate are vital parameters for drug reabsorption and excretion. Urinary pH varies between 4.6 and 8.0 and is influenced by diet, drug intake, and the patient's pathophysiology. It affects a drug's ionization state and reabsorption. For instance, carbohydrate-rich food produces alkaline urine promoting drug excretion, while proteins and certain medications like ascorbic acid lead to acidic urine enhancing reabsorption.
The pKa of a...
The pKa of a...
166