对于接受连续脏置换治疗的重症患者,提格环素的种群药理学
Shuping Song1, Jieqiong Liu2,3, Wei Su1
1Intensive Care Unit, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Drug design, development and therapy
|October 11, 2024
概括
这项研究开发了持续置换疗法 (CRRT) 患者的tigecycline的药理动力学模型. 推对tigecycline进行优化剂量方案,以治疗CRRT治疗的重症患者的多药耐药性感染.
科学领域:
- 药理动力学 药理动力学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 提格环素是治疗多药耐药性细菌感染的关键最后手段抗生素.
- 持续置换疗法 (CRRT) 在危急病患者中很常见.
- 在接受CRRT的患者中,对于tigecycline的药理动力学数据有限.
研究的目的:
- 在接受CRRT的重症患者中开发tigecycline的种群药理学 (PPK) 模型.
- 评估在CRRT患者中对tigecycline剂量调整的需要.
- 为了提供tigecycline的最佳剂量建议.
主要方法:
- 一个单中心前性临床研究,采用密集采样.
- 开发和评估一个两部分人群的药理动力学模型.
- 药理动力学/药理动力学目标的实现和累积反应分数分析.
主要成果:
- 一个两部分的模型描述了21名患者的tigecycline度.
- 确定了典型的药理动力学参数 (CL,Q,V1,V2).
- 标准的tigecycline剂量 (50 mg/12h) 适用于大多数感染,但对于特定的感染,如Acinetobacter baumannii和Klebsiella pneumoniae肺炎或皮肤感染,可能需要更高的剂量 (100 mg/12h).
结论:
- 一个tigecycline人群的药理动力学模型,用于CRRT的重症患者成功开发.
- 针对各种感染,建议优化剂量方案.
- 这项研究有助于在一个脆弱的患者群体中适当地使用tigecycline.
相关概念视频
01:30Continuous Renal Replacement Therapy
2
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
2
01:11Renal Failure: Dose Adjustments
68
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...
68
01:20Acute Kidney Injury V: Interprofessional Care
2
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
2
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
2
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
2
01:15Drug Elimination by Renal Route: Tubular Secretion
2.2K
Once the process of glomerular filtration is completed, blood carrying unfiltered drug molecules traverses through efferent arterioles and makes its way into the peritubular capillaries in the proximal tubule. A variety of carriers play a pivotal role in actively secreting drugs from these peritubular capillaries into the tubular fluid. The organic anion transporter transfers acidic drugs, against an electrochemical gradient, from the peritubular capillaries into the renal tubule cells and...
2.2K
01:28Renal Drug Excretion: Tubular Secretion
147
Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
147