Predicted Plasma Vancomycin Concentration on Intermittent Intravenous Drip Infusion of Vancomycin Hydrochloride by Baysian Method: Effect of Population Based Initial Estimates on Predictive Performance.

Maeda, Yorinobu; Kiribayashi, Yoshie; Konishi, Toshio; Yokote, Tiaki; Funakoshi, Satiyo; Nii, Keiko; Tsukiai, Satsuki; Takahashi, Makoto; Eno, Shin; Maruhashi, Akira

doi:10.5649/jjphcs1975.20.279

Cited by 3 publications

(3 citation statements)

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“…When target vancomycin levels (25-40 mg W mL for peak and 5-15 mg W mL for trough) 14) were not achieved within 7 days on either dosage regimen, the dosage regimen was altered to the Bayesian method. 10) Patients shifted to the Bayesian method were omitted from the analysis of results in the present study.…”

Section: Methodsmentioning

confidence: 99%

“…regimen of vancomycin therapy, including Moellering's nomogram, 6) Matzke's nomogram, 8) the population mean method 9) and the Bayesian method. 10,11) Previously, we proposed a simple nomogram, or Maeda's nomogram, for setting the initial dosage regimen in vancomycin therapy. Maeda's nomogram xes the vancomycin dose at 1,000 mg and varies the dosing interval based on individual CLcr values.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Clinical Efficacy of Maeda’s Nomogram for Vancomycin Dosage Adjustment in Adult Japanese MRSA Pneumonia Patients

Maeda

Omoda

Fukuhara

et al. 2006

Drug Metabolism and Pharmacokinetics

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The clinical efficacy of Maeda's nomogram for vancomycin dosage adjustment was evaluated by comparison with a standard dosage regimen (package insert information: vancomycin dose reduced in elderly patients and patients with renal dysfunction, with Moellering's nomogram used for renal-dysfunction patients) in adult Japanese MRSA pneumonia patients. Using Maeda's nomogram, the vancomycin dose is fixed at 1,000 mg while the dosing interval is varied in accordance with individual creatinine clearance. Using a standard dosage regimen, 5 patients out of 27 (18.5%) achieved target plasma levels of vancomycin (25-40 microg/mL for peak and 5-15 microg/mL for trough) within 2-6 days. Using Maeda's nomogram, 38 patients out of 53 (71.7%) achieved target levels in that time. A higher clinical response (complete resolution of all signs and symptoms of MRSA infection) to vancomycin therapy was also obtained with Maeda's nomogram when evaluated approximately 2-weeks after discontinuation of vancomycin therapy (43.4% versus 18.5% for the standard regimen). In conclusion, the Maeda's nomogram regimen with a 1,000 mg vancomycin dose was shown to achieve target plasma levels of vancomycin at a higher rate and provide higher clinical efficacy in vancomycin therapy of MRSA pneumonia patients, as compared with the currently available standard dosage regimen.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Clinical Efficacy of Maeda’s Nomogram for Vancomycin Dosage Adjustment in Adult Japanese MRSA Pneumonia Patients

Maeda

Omoda

Fukuhara

et al. 2006

Drug Metabolism and Pharmacokinetics

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“…The Bayesian method can be used to predict serum VCM concentrations based on a few blood sampling times, and the dose can be adjusted according to the patient's individual pharmacokinetic parameters. [3][4][5] Application of the Bayesian method for VCM therapy has been evaluated from the viewpoints of using population pharmacokinetic parameters, 6,7) the influence of some coadministered drugs with important hemodynamic effects on VCM pharmacokinetics 8) and the difference between initial and steady state levels. 9) Because serum VCM concentrations, especially in geriatric patients, could not be predicted precisely, Sato et al suggested that serum VCM concentration should be measured as soon as possible after starting dosage regimens and the dose should be adjusted on the basis of the measured concentrations.…”

mentioning

confidence: 99%

Evaluation of Predictability for Vancomycin Dosage Regimens by the Bayesian Method with Japanese Population Pharmacokinetic Parameters.

Teramachi¹,

Hatakeyama²,

Matsushita

et al. 2002

Biological & Pharmaceutical Bulletin

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Vancomycin (VCM) is a glycopeptide antibiotic, isolated from Streptomyces orientalis, that is active against methicillin-resistant Staphylococcus aureus (MRSA). However, VCM has severe side effects, such as auditorotoxicity and nephrotoxicity, 1) at dose levels only slightly higher than the effective treatment concentration. Therefore, therapeutic drug monitoring (TDM) is important to administer VCM effectively and safely.

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Prescription Optimization through Pharmacokinetic Analyses of Patients with Side Effects

Maeda¹

2014

Jpn. J. Pharm. Health Care Sci.

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Since clinical pharmacists provide support for pharmacotherapy, pharmacists sometimes encounter unknown side effects and drug interactions. However, by involving pharmacological concepts to establish rules from patients experiencing side effects, adverse effects can be reduced or avoided. In this paper, ways to optimize prescriptions using pharmacokinetic analyses of absorption, distribution, metabolism and excretion in patients who had experienced side effects will be introduced. First, in the absorption phase, the effects of gastrectomy on pharmacokinetic profiles and side effects of oral etoposide were found. Second, in order to prevent diarrhea, which is a major side effect of irinotecan, orally administering Kremezin ® to adsorb SN-38, was found effective. In addition, in the distribution phase, the mechanism of interaction between lidocaine and mexiletine during tissue distribution was found. In the metabolism phase, a drug interaction mechanism between theophylline and acyclovir was found. By comparing the ratio between the serum concentration of SN-38G and SN-38, evaluating metabolic capacity rather than UDP-glucuronosyltransferase (UGT) 1A1 polymorphism was found more useful for patients treated with irinotecan. In the excretion phase, a method of drug administration based on creatinine clearance was established, since if treatment with renally excreted medications such as cibenzoline, ribavirin, and vancomycin is performed in accordance with the dosage regimen in the package insert of these drugs, cibenzoline causes hypoglycemia, ribavirin causes anemia, and vancomycin causes renal failure. By clarifying the mechanism of side effects using pharmacokinetics, improving the therapeutic effect by reducing or preventing side effects in the clinical setting is possible.

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Predicted Plasma Vancomycin Concentration on Intermittent Intravenous Drip Infusion of Vancomycin Hydrochloride by Baysian Method: Effect of Population Based Initial Estimates on Predictive Performance.

Cited by 3 publications

References 0 publications

Evaluation of Clinical Efficacy of Maeda’s Nomogram for Vancomycin Dosage Adjustment in Adult Japanese MRSA Pneumonia Patients

Evaluation of Clinical Efficacy of Maeda’s Nomogram for Vancomycin Dosage Adjustment in Adult Japanese MRSA Pneumonia Patients

Evaluation of Predictability for Vancomycin Dosage Regimens by the Bayesian Method with Japanese Population Pharmacokinetic Parameters.

Prescription Optimization through Pharmacokinetic Analyses of Patients with Side Effects

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