在儿科心脏外科手术后患者中优化万科米辛的剂量:人口药理动力学建模研究
J Kamp1, D J E Wannet2, E P Buddingh3
1Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Clinical pharmacokinetics
|December 22, 2024
概括
针对儿科心脏外科手术患者,使用人口药理动力学模型实现了优化万科米辛剂量. 这种模型受功能和体重的影响,可实现精确的剂量定量,改善治疗结果.
科学领域:
- 药理学 药理学 是一个学科.
- 儿科重症监护 儿科重症监护
- 抗生素管理局 抗生素管理局
背景情况:
- 范科米辛对于严重的格拉姆阳性感染至关重要.
- 在心脏手术后的儿科重症监护室 (PICU) 患者中优化万科米辛的剂量仍然具有挑战性.
- 诸如流体状况变化,功能和ECMO等因素使剂量复杂化.
研究的目的:
- 在儿科心脏外科手术患者中表征万科米辛的药理动力学 (PK).
- 为这个人群完善万科米辛的剂量策略.
- 评估模型对基于模型的精确剂量 (MIPD) 的实用性.
主要方法:
- 193名PICU患者的回顾性队列研究 (2020年1月至2023年12月).
- 开发了一个使用NONMEM的2分区人群PK模型.
- 评估了包括功能和体重 (BW) 在内的共变量;使用蒙特卡洛模拟来优化剂量.
主要成果:
- 分析了193名患者和706个万科米辛样本.
- 功能和BW显著影响了万科米辛PK.
- 非线性剂量算法以较低的每公斤剂量为较高的BW建议是最佳的.
结论:
- 在儿科心脏手术患者中成功开发了万科米辛的种群PK模型.
- 血清肌素和BW是万科米辛PK的关键决定因素.
- 该模型支持以模型为基础的精确剂量定量,以在这个队列中改进万科米辛治疗.
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