在血液吸附治疗期间体外评估药物吸附概况
Andreas Körtge1,2, Christoph Kamper1,2, Gerd Klinkmann1,3
1Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology IZI, Rostock, Germany.
Blood purification
|March 20, 2025
概括
血液吸附装置显著降低了重症监护中的许多药物水平. 瓦尔酸盐和甲胺的清除率较低,因此需要在治疗期间仔细监测药物和调整剂量.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 生物材料科学 生物材料科学
背景情况:
- 血液吸附装置越来越多地用于治疗严重疾病,如败血症和细胞因子释放综合征.
- 一个主要的担忧是,这些设备有可能降低并发药物的血水平,从而危及亚治疗疗效.
- 这项研究解决了了解药物吸附剂相互作用的需要,以优化患者治疗.
研究的目的:
- 为了研究各种药物的体外吸附,使用血液吸附装置.
- 量化药物清除率和血清除率.
- 提供数据,以优化在血液吸收治疗期间的药物剂量策略.
主要方法:
- 使用人体全血和CytoSorb吸附剂的体外血吸模式被采用.
- 该研究评估了10种药物的清除率和血清除率,包括抗凝剂,抗剂和其他药物.
- 在通过吸附剂重新循环血液时,对药物度进行了监测.
主要成果:
- 大多数测试药物 (阿皮克萨班,阿格拉特罗班,卡巴马泽平等) 呈现出显著的去除 (75-100%) 和高初始清除 (10-25毫升/分钟).
- 瓦尔酸盐显示中度清除 (~40%) 和低清除 (~5毫升/分钟).
- 甲福明的清除率很小 (约15%),清除率非常低 (约1毫升/分钟).
结论:
- 在血液吸收中存在显著的药物间变异性,一些药物对去除非常敏感.
- 瓦尔酸盐和甲胺的去除效率较低,但仍然受到影响.
- 进一步的体内研究是必不可少的,以证实这些发现,并指导临床实践在血液吸收期间安全有效的药物管理.
相关概念视频
01:16Methods for Studying Drug Absorption: In vitro
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In vitro experiments are crucial for understanding the transport and absorption of drugs through biological materials. These studies employ varied methods such as the diffusion cell method, the everted sac technique, and the everted ring technique.
The diffusion cell method uses a two-compartment cell, including a donor compartment with the drug solution, which simulates the environment where the drug is applied, and a receptor compartment with a buffer solution, which simulates the environment...
The diffusion cell method uses a two-compartment cell, including a donor compartment with the drug solution, which simulates the environment where the drug is applied, and a receptor compartment with a buffer solution, which simulates the environment...
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01:09Methods for Studying Drug Absorption: In situ
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In situ experiments, such as the Doluisio method and Single-Pass Perfusion technique, provide critical insights into drug uptake by simulating in vivo conditions for drug absorption.
The Doluisio method involves perfusing a prepared segment of a rat's small intestine with a solution of radiolabeled drug and a non-absorbable marker. This helps to differentiate between absorbed and non-absorbed drug concentrations. The intestinal segment is connected at both ends using tubing and syringes,...
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01:30Drug Binding to Blood Components
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When drugs enter systemic circulation, they interact with various components of the blood, including proteins such as human serum albumin (HSA), α1-acid glycoprotein (AAG), lipoproteins, globulins, and red blood cells (RBCs).
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100
01:23Drug Concentrations: Measurements
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Drug concentration is the quantity of a drug present in a biological sample. Measuring drug amounts in biological samples allows the clinician to understand how a drug is absorbed, distributed, metabolized, and excreted. Samples can be obtained through invasive or non-invasive methods. Invasive techniques involve surgical or parenteral interventions to gather blood, cerebrospinal fluid, or tissue biopsy. Conversely, non-invasive approaches provide samples like urine, feces, and saliva.
Plasma...
Plasma...
302
01:09Hepatic Drug Clearance: Effect of Protein Binding
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For low-extraction-ratio drugs that are less than 80% protein-bound, minor changes in protein binding...
For low-extraction-ratio drugs that are less than 80% protein-bound, minor changes in protein binding...
131
01:22Factors Influencing Drug Absorption: Physicochemical Parameters
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199