去甲万古霉素在SICU重症患者的药动学

孙娜 张振宇 安友仲 张春燕 顾健

中国药学杂志 ›› 2011, Vol. 46 ›› Issue (3) : 221-223.

PDF(517 KB)
PDF(517 KB)
中国药学杂志 ›› 2011, Vol. 46 ›› Issue (3) : 221-223.
论著

去甲万古霉素在SICU重症患者的药动学

  • 孙娜1,2,张振宇3,安友仲3,张春燕1,顾健1*
作者信息 +

Pharmacokinetics of Norvancomycin of SICU Patients

  • SUN Na1,2,ZHANG Zhen-yu3,AN You-zhong3,ZHANG Chun-yan1,GU Jian1*
Author information +
文章历史 +

摘要

目的 研究去甲万古霉素在肝肾功能正常的重症患者体内的药动学过程。方法 9名肝肾功正常的SICU重症患者单剂量给予去甲万古霉素0.4 g静脉滴注,用高效液相色谱法测定患者血浆和尿中去甲万古霉素的药物浓度,并用Winnonlin软件处理统计药动学数据。结果 血药数据结果显示,药物的平均t1/2β为(4.79±2.61 h,t1/2α为(0.69±0.33 h,Vd为(0.41±0.44 L·kg-1,k10为(0.45±0.26 h-1,ρmax为(23.46±13.69 mg·L-1,CL/F为(88.66±69.04 mL·min-1;尿药数据显示t1/2β为(3.48±0.92 h, k为(0.21±0.06 h-1,12 h药物累积排泄率为(22.08±21.55%。结论 去甲万古霉素在SICU重症患者体内的药动学过程与文献报道的健康人群存在差异。对此类患者的用药应注意药物浓度的监测,适时调整给药方案,以保证用药安全有效。

Abstract

OBJECTIVE To study pharmacokinetics of norvancomycin in SICU severe patients without liver or renal dysfunction. METHODS 9 SICU severe patients were given a single dose of 0.4 g iv norvancomycin. The plasma and urine concentrations were determined with HPLC, and PK parameters were analyzed by WINNONLIN. RESULTS The pharmacokinetic parameters in plasma were as followed:t1/2β(4.79±2.61 h,t1/2α ( 0.69±0.33 h,Vd(0.41±0.44 L·kg-1,k10(0.45±0.26 h-1,ρmax(23.46±13.69 mg·L-1,and CL(88.66±69.04 mL·min-1 . The pharmacokinetic parameters in urine were as followed:t1/2β (3.48±0.92 h, k(0.21±0.06 h-1, 12 h accumulation of excretion percentage was (22.08±21.55%. CONCLUSION The pharmacokinetic profiles in SICU severe patients were different from pharmacokinetic profiles of normal population reported by researches before. SICU severe patients should be administrated individually with TDM,and the treatment should be adjusted timely, to guarantee safety and validity.

关键词

去甲万古霉素 / 外科重症监护室 / 重症患者 / 药动学 / 高效液相色谱法

Key words

norvancomycin / SICU / severe patients / pharmacokinetics / HPLC

引用本文

导出引用
孙娜 张振宇 安友仲 张春燕 顾健. 去甲万古霉素在SICU重症患者的药动学[J]. 中国药学杂志, 2011, 46(3): 221-223
SUN N;ZHNG Zhen-yu;N You-zhong;ZHNG Chun-yn;GU Jin. Pharmacokinetics of Norvancomycin of SICU Patients[J]. Chinese Pharmaceutical Journal, 2011, 46(3): 221-223

参考文献


[1] WANG B,JIANG H,LI X Q,et al. The effect of norvancomycin on the infections of MRS and the evaluation of the bacteriolagical investigation[J]. Chin J Antibiot(中国抗生素杂志,2001, 26(3:187.
[2] WU L W. Therapeutic Drug Monitoring(治疗药物监测 [M]. Beijing:People′s Medical Publishing House,1989:410.
[3] SUN H. Treatment of surgical severe patients[J]. Chin J Pract Surg(中华实用外科学杂志, 2001,21(4:235-237.
[4] BALRAM C,LIM B L,LEE E J,et al. Validity of bayesian forecasting programme in therapeutic drug monitoring of vancomycin in a surgical intensive care unit:a prospective evaluation[J]. Ann Acad Med Singapore,1996,25(4:492-495.
[5] WAN L L,YU Q,LI Y,et al. Dtermination of vancomycin and norvancomycin in serum[J]. Chin Pharm J(中国药学杂志,2008,11(8:998-1000.
[6] LIN C,LIU S Q,DAI Q, et al. Determination of demethylvancomycin in renal dialysate effluent in burns with continuous renal replacement therapy[J]. Pharm J Chin PLA(解放军药学学报,2004,20(1:73-74.
[7] ZHANG X L. Clinical Drug Reference(药物临床信息参考 [M]. Vol 4. Sichuan:Sichuan Science and Technology Publishing House,2006:192.
[8] LI W S,WANG G L,YU Y H. Clinical Fluid Therapy(临床液体治疗学[M]. Beijing:Chemical Industry Press,2007:103.
[9] ZHANG C,ZHAI S D,LIU F. Necessarity of therapeutic drug monitoring of vancomycin in clinical use:a systematic review[J]. Chin J Clin Pharmacol(中国临床药理学杂志,2009,25(4:329-333.
[10] LEE P,DIPERSIO D,JEROME R N,et al. Approaching and analyzing a large literature on vancomycin monitoring and pharmacokinetics[J]. J Med Libr Assoc,2007,95(4:374-380.
PDF(517 KB)

Accesses

Citation

Detail

段落导航
相关文章

/