Clinical Pharmacokinetics of Antibiotics in Patients with Impaired Renal Function

Peter, Wendy L. St.; Redic-Kill, Kimberly A.; Halstenson, Charles E.

doi:10.2165/00003088-199222030-00002

Cited by 57 publications

(19 citation statements)

References 452 publications

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“…Single dose gentamicin appears to be safe even in the presence of renal disease [17]; allergic reactions are extremely rare. Peak plasma concentrations are obtained 30–60 min after intramuscular administration at a dosage of 1 mg/kg body weight.…”

Section: Discussionmentioning

confidence: 99%

The Issue of Prophylactic Antibiotics prior to Flexible Cystoscopy

Rane¹,

Cahill

Saleemi

et al. 2001

European Urology

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Section: Discussionmentioning

confidence: 99%

The Issue of Prophylactic Antibiotics prior to Flexible Cystoscopy

Rane¹,

Cahill

Saleemi

et al. 2001

European Urology

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“… Note: Data from Nolin,3 Gabardi and Abramson,4 Nolin,5 Reidenberg and Drayer,6 St Peter et al,7 and Yeung et al8 Abbreviations: UGT, UDP-glucuronosyltransferase; NAT, N-acetyltransferase.…”

Section: Tablementioning

confidence: 99%

Pharmacotherapeutic considerations for chronic pain in chronic kidney and end-stage renal disease

Mathew¹,

Bettinger²,

Wegrzyn³

et al. 2016

JPR

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“…1, In Vivo Hemodialysis Study in Dogs Four beagles obtained from Narc (Chiba, Japan) were housed in a temperature-and humidity-controlled room with free access to water. The dogs were handled in accordance with the Guidelines of the Ethics Review Committee for Animal Experimentation of Sankyo Co., Ltd.…”

Section: Prediction Of Pharmacokinetics In Esrd Patientsmentioning

confidence: 99%

“…1,2) Although the distribution volumes of most drugs rise slightly because of water retention, these discrepancies were considerably smaller than the total volume of body fluid and as a result the influence of the pharmacokinetics would be limited. 4) A difference was also found in the protein binding due to the reduction of net protein content and accumulation of various kinds of uremic toxins in ESRD patients.…”

Section: Prediction Of Pharmacokinetics In Esrd Patientsmentioning

confidence: 99%

“…In contrast, hemodialysis sometimes results in an inadequate decrease of the plasma drug level from the therapeutic range. [1][2][3][4] Consequently, pharmacokinetic information for ESRD patients is requisite in the process of new drug development in order to ascertain the effect of renal failure on tolerability and exposure and to determine the dosage regimen. 5) However, the clinical study of ESRD patients has not often been performed due to difficulties with patient enrollment.…”

mentioning

confidence: 99%

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Prediction of Pharmacokinetics of Antibiotics in Patients with End-Stage Renal Disease

Tajima

Nagashima²,

Torii³

et al. 2006

Biological & Pharmaceutical Bulletin

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The pharmacokinetics in patients with end-stage renal disease (ESRD) is quite different from that in patients with normal renal function. Numerous approaches are undertaken to appropriately adjust the dosage regimens of renal excretory drugs in ESRD patients because the systemic exposure in this population unexpectedly increases and frequently causes adverse events. In contrast, hemodialysis sometimes results in an inadequate decrease of the plasma drug level from the therapeutic range.1-4) Consequently, pharmacokinetic information for ESRD patients is requisite in the process of new drug development in order to ascertain the effect of renal failure on tolerability and exposure and to determine the dosage regimen. 5)However, the clinical study of ESRD patients has not often been performed due to difficulties with patient enrollment. In such cases, prediction of the pharmacokinetics might be an alternative to clinical studies and provide useful information for optimizing the dosage regimen.Modeling and simulation have been explored by many scientists, 6,7) and recently virtual clinical trials based on pharmacokinetics and pharmacodynamics (PK/PD) modeling and subsequent simulation have been employed for decisionmaking in drug development prior to cost consuming phase III/IV trials. 8) In particular, this kind of methodology is informative for the development of antibiotic agents, since there is clear evidence that the pharmacological effect is well correlated to some PK/PD parameters. 9,10) Hemodialysis is a physical process that can be described by a mathematical model. 3,11) There are many factors affecting drug removal during hemodialysis, including molecular weight, lipid and water solubility, surface area, porosity of the dialysis membrane, blood and dialysate flow rates, protein binding and red blood cell partitioning. Even though some methods were previously developed considering these factors, they are complicated for clinical use. Thus, we are trying to develop a simple method based on several assumptions. Utilization of the chemical structure and pharmacokinetic relationship can be a useful approach for the prediction of pharmacokinetics.6) For example, apparent oral clearances in humans could be adequately extrapolated from animal data, while the structural parameters could be evaluated by a multivariate analysis of various drugs selected in view of their structure, molecular weight, partition coefficient, number of hydrogen bond acceptors, pharmacological activities, and pharmacokinetic characteristics.12) Antibiotics are suitable for this approach because they are diverse enough to evaluate the method in terms of various physicochemical and pharmacokinetic properties.13)The purpose of this study was to provide a new method for the prediction of pharmacokinetics in ESRD patients and to confirm its validity and applicability using an experimental renal failure model. A novel and convenient method to predict the pharmacokinetics of several kinds of antibiotic agents in patients with end-stage renal dise...

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Clinical Pharmacokinetics of Antibiotics in Patients with Impaired Renal Function

Cited by 57 publications

References 452 publications

The Issue of Prophylactic Antibiotics prior to Flexible Cystoscopy

The Issue of Prophylactic Antibiotics prior to Flexible Cystoscopy

Pharmacotherapeutic considerations for chronic pain in chronic kidney and end-stage renal disease

Prediction of Pharmacokinetics of Antibiotics in Patients with End-Stage Renal Disease

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