在中国老年患者中,对linezolid的群体药理动力学和剂量优化
Yuanchen Li1, Qiu Fang2, Zejun Wu3
1Department of Pharmacy, Nanjing Drum Tower Hospital, China Pharmaceutical University, Nanjing, China.
European journal of clinical pharmacology
|May 27, 2024
概括
标准的线胺剂量可能会导致老年中国患者的过度暴露,特别是那些血清尿酸 (SUA) 高的人. 对于这些人来说,建议每12小时减少300毫克的剂量.
科学领域:
- 药理学 药理学是指药理学的学科.
- 老年医学 老年医学
- 传染性疾病 传染性疾病
背景情况:
- 利尼佐利德是治疗格拉姆阳性细菌感染的关键抗生素.
- 了解特定人群中linezolid的药理动力学和药理动力学对于优化治疗至关重要.
- 老年人可能表现出药物代谢和分泌的改变,需要调整剂量.
研究的目的:
- 评估linezolid在住院的中国老年患者中的药理动力学和药理动力学.
- 在这个人口群体中确定影响线化物处置的因素.
- 在老年患者中确定linezolid的最佳剂量策略.
主要方法:
- 60岁以上的住院患者接受静脉注射线索利德 (600毫克) 的回顾性分析.
- 使用非线性混合效应建模的人口药理动力学 (PPK) 建模.
- 通过适合性图表,引导分析和视觉预测检查来评估模型性能.
- 蒙特卡洛模拟以评估药理动力学目标的实现 (AUC0-24/MIC).
主要成果:
- 一个带有线性消除的单隔 PPK 模型准确地描述了linezolid 度.
- 莱涅佐利德清除值 (CL) 为4.22L/h,分布体积 (Vd) 为45.80L.
- 血清尿酸 (SUA) 被确定为影响线化物清除的显著共变量.
结论:
- 标准的线祖利德剂量在老年患者中存在过度暴露的风险,特别是那些SUA水平升高的患者.
- 建议每12小时减少300毫克的剂量,用于高SUA的老年患者,以减轻过度暴露.
- 基于SUA水平的个性化剂量可能有利于优化老年人群中线索利德治疗.
相关概念视频
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
124
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...
124
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
Renal Failure: Dose Adjustments
84
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...
84
Nonlinear Pharmacokinetics: Overview
352
Nonlinear or dose-dependent pharmacokinetics is a phenomenon that occurs when the pharmacokinetic parameters of certain drugs deviate from linear pharmacokinetics at higher doses. These drugs do not follow the expected first-order kinetics, where the rate of drug elimination is directly proportional to the drug concentration. Instead, they exhibit a nonlinear relationship, which can be attributed to several factors.
Nonlinearity can arise due to the saturation of plasma protein-binding or...
Nonlinearity can arise due to the saturation of plasma protein-binding or...
352
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
Rational Dosage Regimen: Maintenance Dose and Loading Dose
4.0K
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...
4.0K


