在体外连续脏替代疗法期间,埃多克萨班的药理动力学
Eric Wenzler1, Kaitlyn Dalton1,2, Lauren Andrews1,3
1Department of Pharmacy Practice, College of Pharmacy, MHPE, BCPS - AQ Cardiology, FCCM, FCCP, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886), Chicago, IL, 60612, USA.
BMC nephrology
|October 10, 2024
概括
连续脏替代疗法 (CRRT) 期间的埃多克萨班清除主要是由于过吸附. 在CRRT患者中,建议每天服用45毫克的埃多克萨班,以达到治疗水平.
科学领域:
- 药理动力学和药物新陈代谢
- 腎病學和重症醫療醫學 腎病學和重症醫學
- 抗凝固疗法 抗凝固疗法
背景情况:
- 持续的置换疗法 (CRRT) 对患有功能衰竭的重症患者至关重要.
- 埃多克萨班是一种直接的口服抗凝剂,对其在CRRT中的使用数据有限.
- 了解EDOXABAN在CRRT期间的行为对于安全有效的抗凝剂至关重要.
研究的目的:
- 为了评估在体外CRRT期间的edoxaban清除值.
- 为了评估edoxaban的蛋白质结合和电路吸附.
- 为CRRT患者提供埃多克萨班的初始剂量建议.
主要方法:
- 在体外实验中使用连续静脉静脉血过 (CVVH) 和血液透析 (CVVHD) 模式进行实验.
- 使用液体染色学-并联质谱法量化埃多克萨班和尿素度.
- 药理动力学分析和多变量模型来评估清除因子.
主要成果:
- 埃多克萨班清除主要通过血过吸附 (74%与HF1400,65%与M150).
- 平均蛋白质结合率为41%,CRRT模式,过器类型或稀释对清除没有显著影响.
- 估计每天30-45毫克的剂量可以在各种废水流速中达到目标暴露.
结论:
- 预计每日45毫克的埃多克萨班剂量可在CRRT患者中实现治疗性全身暴露.
- 这种剂量策略需要对安全性和有效性的进一步临床研究.
- 在CRRT期间,埃多克萨班的药物动力学概况可以根据废水流速来预测.
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