在儿科患者中使用一级药理动力学方法估计万科米辛AUC0-24
Hope H Brandon1, David S Burgess2, Katie L Wallace1,2
1Department of Pharmacy, University of Kentucky HealthCare, Lexington, Kentucky, USA.
Pharmacotherapy
|March 27, 2024
概括
儿童的万科米辛剂量需要更好的监测. 这项研究表明,最小度 (Cmin) 是曲线下的治疗面积 (AUC0-24) 的一个糟糕的预测指标,支持基于AUC的儿科范科米辛监测.
科学领域:
- 药理动力学和药理动力学
- 儿童传染病 儿童传染病
- 药物剂量和治疗药物监测
背景情况:
- 在儿科患者中,最佳的万科米辛剂量和监测仍然具有挑战性,在24小时内,曲线下的面积 (AUC0-24) 转移到最低度 (Cmin) 上.
- 有限的现实世界的数据存在于使用两个度动力学和第一阶方程的可行性,以估计儿童群体中的万科米辛AUC0-24.
研究的目的:
- 调查万科米辛剂量,AUC0-24和Cmin之间的关系.
- 评估第一阶方程在四个儿科年龄组中估计万科米辛AUC0-24的有用性.
- 评估Cmin和AUC0-24之间的相关性,用于监测儿童的万科米辛治疗.
主要方法:
- 儿科患者 (<18岁) 接受静脉注射万科米辛 (2020-2022) 的回顾性队列研究.
- 纳入标准:≥24小时的万科米辛治疗,在96小时内获得两种度;排除基线功能障碍的患者.
- 患者分为四个年龄组:新生儿,婴儿,儿童和青少年;用第一阶方程估计的药理动力学参数和AUC0-24.
主要成果:
- 分析了219名儿科患者;中位数年龄为6岁. 旺科米辛的每日剂量因年龄组而异.
- 中位数Cmin为8.68 mg/L,中位数AUC0-24为505 mg*h/L. 观察到的AUC0-24值高于治疗前值,低于治疗后值.
- 观察到Cmin和AUC0-24之间的非最佳相关性;71%的Cmin为5-10 mg/L的患者具有治疗性AUC0-24. 92%的超治疗性AUC0-24病例的Cmin≥15 mg/L. 10%的人经历了急性损伤.
结论:
- 第一阶方程可用于估计儿科患者使用两个稳定状态度的万科米辛AUC0-24.
- AUC0-24和Cmin之间的亚最佳相关性表明Cmin不是儿科治疗AUC0-24的可靠替代品.
- 建议对儿童患者的万科米辛疗效和安全进行AUC0-24监测,并与当前的指导方针保持一致.
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