药物剂量优化在持续置换治疗的重症儿童:从基本概念到床边模型的信息精确剂量优化
Mehdi Oualha1,2, Michael Thy2,3, Naïm Bouazza2
1Pediatric Intensive Care Unit, Necker Hospital, APHP-Centre, Université of Paris-Cité, Paris, France.
Expert opinion on drug metabolism & toxicology
|October 29, 2024
概括
优化持续脏替代疗法 (CRRT) 中的重症儿童的药物剂量是复杂的. 基于模型的精确剂量和治疗药物监测可以帮助个性化儿科CRRT药物治疗方案.
科学领域:
- 儿科重症监护药理学 儿科重症监护药理学
- 脏替代疗法治疗 脏替代疗法
- 药物动力学建模 药物动力学建模
背景情况:
- 在接受连续脏替代疗法 (CRRT) 的重症儿童中,药物剂量优化存在重大挑战,原因是药理动力学和药理动力学变化.
- 了解CRRT期间的药物消除机制对于避免处方错误至关重要,尽管患者之间的和患者内的变异性很高.
研究的目的:
- 审查目前的理解和方法,以优化药物剂量在接受CRRT的儿科患者.
- 突出先进的建模技术在实现精确剂量的作用.
主要方法:
- 在PubMed中进行了系统的文献搜索,使用与儿科CRRT,药理动力学,建模和治疗药物监测相关的特定关键词.
- 搜索包括到2024年1月发表的研究,无论语言或出版状况如何.
主要成果:
- 基于人群的药理动力学和生理学上的药理动力学模型是建议调整剂量方案的重要工具.
- 这些模型是从体外和体外研究中得出的,具有挑战性,但仍然是个性化剂量最合适的方法.
结论:
- 在治疗药物监测方面培养儿科重症专家,并实施像Model Informed Precision Dosing这样的个性化处方软件是一个关键的进步.
- 需要进一步的临床研究来最终证明这些精确剂量策略对患者的益处.
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