• 제목/요약/키워드: constant rate infusion

검색결과 39건 처리시간 0.027초

모집단 약물동태학 방법에 의한 겐타마이신 약물동태에 미치는 환경의 영향 (Enviromental Influences on Gentamicin Pharmacokinetics by Using Population Pharmacokinetic Methods)

  • 범진필
    • 약학회지
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    • 제56권1호
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    • pp.48-54
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    • 2012
  • Enviromental differences in gentamicin pharmacokinetics by using population pharmacokinetic methods were compared with 20 Korean patients and 24 Korean-American appendicitis patients. Two to six blood specimens were collected from all patients at the following times : just before a regularly scheduled infusion and at 0.5 hour after the end of a 0.5 hour infusion. Nonparametric expected maximum (NPEM) algorithm for population modeling was used. The estimated parameters were the elimination rate constant (K), the slope (KS) of the relationship between K versus creatinine clearance ($C_{cr}$), the apparent volume of distribution (V), the slope (VS) of the relationship between V versus weight, gentamicin clearance (CL) and the slope (CS) of the relationship between CL versus $C_{cr}$ and the V. The output includes two marginal probability density function (PDF), means, medians, modes, variance and CV%. The mean K (KS) were $0.402{\pm}0.129\;h^{-1}(0.00486{\pm}0.00197\;[h{\cdot}ml/min/1.73\;m^2]^{-1})$ and $0.411{\pm}0.135\;h^{-1}(0.00475{\pm}0.00180\;[h{\cdot}ml/min/1.73\;m^2]^{-1})$ for Korean and Korean-American populations, respectively. The mean V (VS) were not different at $14.3{\pm}3.6l(0.241{\pm}0.0511l/kg)$ and $15.1{\pm}3.84l(0.239{\pm}0.0492l/kg)$ for Korean and Korean-American populations, respectively (p>0.2). The mean CL (CS) were $5.68{\pm}1.69l/h(0.0714{\pm}0.0222l/kg[h{\cdot}ml/min/1.73\;m^2])$ and $5.70{\pm}1.77l/h(0.0701{\pm}0.0215l/kg[h{\cdot}ml/min/1.73\;m^2])$ for Korean and Korean-American populations, respectively. There were no enviromental differences in gentamicin pharmacokinetics between Korean and Korean-American appendicitis patients.

비모수적 기대최대치(NPEM)연산방법에 의한 미국인과 재미동포 충수돌기염 환자에게 겐타마이신의 모집단 약물동태학 (Population Pharmacokinetics for Gentamicin in American and Korean-American Appendicitis Patients Using Nonparametric Expected Maximum(NPEM) Algorithm)

  • 범진필;최준식
    • 약학회지
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    • 제39권2호
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    • pp.103-112
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    • 1995
  • Population pharmacokinetics for gentamicin were compared with 24 American patients (16 male and 8 female) and 16 Korean-American appendicitis patients(12 male and 4 female). Two to six blood specimens were collected from all patients at the following times: just before a regularly scheduled infusion and at 1/2 hour after the end of a 1/2 hour infusion. Nonparametric expected maximum(NPEM) algorithm for population modeling was used. The estimated parameters were the elimination rate constant(K), the slope of the relationship between K versus creatinine clearance(KS), the apparent volume of distribution(V), the slope of the relationship between V versus weight(VS), gentamicin clearance(CL) and the slope of the relationship between CL versus creatinine clearance and the VS(CS). The output includes a 3-dimensional plot of the joint probability density function(PDF), two marginal PDF, means, medians, modes, variance, skewness, kurtosis, and CV%. The mean K(KS) were 0.424$\pm$0.139(0.00429$\pm$0.00164) and 0.411$\pm$0.135 hr$^{-1}$ (0.00475$\pm$0.00180[hr.mL/min/1.73m$^{2}]^{-1}$) for American and Korean-American populations, respectively. The mean V(VS) were not different at 15.6$\pm$4.77(0.233$\pm$0.0526) and 15.1$\pm$3.84L(0.239$\pm$0.0492 L/kg) for American and Korean-American populations, respectively (P>0.2). The mean CL (CS) were 6.28$\pm$1.85(0.0634$\pm$0.0191) and 5.70$\pm$1.77 L/hr(0.0701$\pm$0.0215 L/kg[hr.mL/min/1.73m$^{2}$)] for American and Korean-American populations, respectively. There are no differences in gentamicin pharmacokinetics between American and Korean-American Appendicitis patients.

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Hepatobiliary Excretion of Tributylmethylamonium in Rats with Lipopolysaccharide-Induced Acute Inflammation

  • Lee, In-Kyung;Lee, Young-Mi;Song, Im-Sook;Chung, Suk-Jae;Kim, Sang-Geon;Lee, Myung-Gull;Shim, Chang-Koo
    • Archives of Pharmacal Research
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    • 제25권6호
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    • pp.969-972
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    • 2002
  • The alteration in the pharmacokinetic behaviors of organic cations (OCs) in rats during acute inflammation (AI) was investigated. AI was induced by an intraperitoneal injection of lipopolysaccharide (LPS, 5 mg/kg) 24 hr prior to the start of pharmacokinetic studies. Tributylmethylammonium (TBuMA) was selected as a model OC since it is largely excreted into bile, and is neither metabolized nor binds to proteins in the body. When TBuMA was administered intravenously to AI rats at a dose of 6.6 $\mu$mole/kg, the AUC was increased, while biliary excretion (i.e., cumulative amount and apparent clearance) was decreased compared to normal rats. When TBuMA was administered intravenously to AI rats at a constant rate (i.e., a bolus injection at a dose of 1.5 $\mu$mole/kg followed by a constant infusion at a rate of 1.5 $\mu$mole/kg/hr for 165 min), steady-state concentrations of plasma and liver concentrations of TBuMA were increased significantly, while in vivo hepatic uptake (amount) and canalicular excretion (clearance) were decreased. These results are consistent with a hypothesis in which both the sinusoidal uptake of TBuMA into hepatocytes via the OCT1 and the canalicular excretion of the compound from hepatocytes via the P-gp are decreased by LPS-induced AI.

잡견을 이용한 실험적 뇌사모델에서 뇌사가 혈역학적 변화와 심근손상에 미치는 영향 -제2보 : 뇌압을 점진적으로 증가시켜 유발한 뇌사모델의 심전도 및 혈역학적 변화- (Effect of the Brain Death on Hemodynamic Changes and Myocardial Damages in Canine Brain Death Model -Electrocard iographic and Hemodynamic Changes in the Brain Death Model Induced by Gradual Increase of Intracranial Pressure-)

  • 조명찬;이동운
    • Journal of Chest Surgery
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    • 제29권1호
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    • pp.1-6
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    • 1996
  • 5마리의 잡견(18~22kg)을 이용하여, 경막외강에 생리식염수를 연속 점적하여 뇌사를 유발시킨다. 뇌사발생시 점의 뇌압은 122.0$\pm$6.25mmHg이며 뇌사후 30분 최고치에 도달하였다. 뇌사를 유발시키는데 필요한 생리식염수의 양은 4.8$\pm$1.0ml이었고, 143.0$\pm$30.9분이 필요하였다. 뇌사가 올때까지 동맥압은 변하지 않지만 그후 점차 떨어지고, 맥박수는 뇌사 30분 후 안정시 보다 50% 정도 증가한 최고치에 달한다. 체온, 심박출량, 폐동맥압, 좌심실 이완말기압등의 혈역학적 지표는 뇌사진행 중에는큰 변화가 없었고, 심실 기외수축이 일시적으로 나타난 이외에는 부정맥도 관찰되지 않았다. 급작스러운 뇌압 상승 모델에서 보였던 혈역학적 변화는 관찰되지 않았다.

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충수돌기염 환자에서 겐타마이신의 임상약물동태 (Clinical Pharmacokinetics of Gentamicin in Appendicitis Patients)

  • 최준식;정해광;범진필;이진환;김성환
    • 한국임상약학회지
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    • 제5권2호
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    • pp.1-12
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    • 1995
  • The purpose of this investigation was to determine pharmacokinetic parameters of gentamicin using linear least square regression(LLSR) and Bayesian analysis in Korean normal volunteers and appendicitis patients. Nonparametric expected maximum(NPEM) algorithm for population pharmacokinetic parameters was used. Gentamicin was administered every 8 hours for 3 days by infusion over 30 minutes. The volume of distribution(V) and elimination rate constant(K) of gentamicin were $0.215\pm0.0562,\;0.226\pm0.0325L/kg\;and\;0.339\pm0.0443,\;0.357\pm0.0243hr^{-1}$ for normal volunteers and appendicitis patients using LLSR analysis. Population pharmacokinetic parameters, VS and KS were $0.228\pm0.0614L/kg\;and\;0.00356\pm0.00041(hr{\cdot}mL/min/1.73m^2)^{-1}$ for appendicitis patients using NPEM algorithm. The V and K were $0.232\pm0.0568L/kg\;and\;0.337\pm0.0385hr^{-1}$ for appendicitis patients using Bayesian analysis. There were no differences in gentamicin pharmacokinetics between LLSR and Bayesian analysis.

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위장관 수술환자에서 겐타마이신의 임상약물동태 (Clinical Pharmacokinetics of Gentamicin in Gastrointestinal Surgical Patients)

  • 최준식;문홍섭;최인;범진필
    • 약학회지
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    • 제40권1호
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    • pp.1-9
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    • 1996
  • The purpose of this investigation was to determine pharmacokinetic parameters of gentamicin using nonlinear least square regression(NLSR) and Bayesian analysis in Korean normal volunteers and gastrointestinal surgical patients. Nonparametric expected maximum(NPEM) method for population pharmacokinetic parameters was used. Gentamicin was administered every 8 hours for 3 days by infusion over 30 minutes. The volume of distribution(V) and elimination rate constant(K) of gentamicin were $0.226{\pm}0.032,\;0.231{\pm}0.063L/Kg\;and\;0.357{\pm}0.024,\;0.337{\pm}0.041hr^{-1}$ for normal volunteers and gastrointestinal surgical patients using NLSR analysis. Population pharmacokinetic parameters, KS and VS were $0.00344{\pm}0.00049(hr{\cdot}ml/min/1.73m^2)^{-1}\;and\;0.214{\pm}0.0502L/Kg$ for gastrointestinal surgical patients using NPEM method. The V and K were $0.216{\pm}0.048L/Kg\;and\;0.336{\pm}0.043hr^{-1}$ for gastrointestinal surgical patients using Bayesian analysis. There were no differences in gentamicin pharmacokinetics between NLSR and Bayesian analysis in gastrointestinal surgical patient.

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임파종환자에서 반코마이신의 임상약물동태 (Clinical Pharmacokinetics of Vancomycin in Lymphoma Patients and Normal Volunteers)

  • 김재호;최준식;이진환
    • 한국임상약학회지
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    • 제9권2호
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    • pp.88-91
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    • 1999
  • The purpose of this study was to compare the pkarmacokinetic parameters of vancomycin using a 2-compartment model in 8 Korean healthy volunteers and 8 lymphoma patients. Vancomycin (1.0 g) was administered by IV infusion over 60 minutes. The $\beta-phase$ rate constant $(\beta)$, apparent volume of distribution at steady srate $(V_{ss})$, total body clearance (CL) and area under the plasma level-time curve (AUC) of vancomycin in healthy volunteers were $0.15\pm0.02\;hr^{-1},\;33.8\pm4.12\;L/kg,\;5.36\pm0.61\;L/hr\;and\;185.8\pm20.5\;{\mu}g/ml{\cdot}hr$, respectively. The corresponding values in lymphoma patients ere $0.09\pm0.02\;hr^{-1},\;38.2\pm5.11\;L/kg,\;4.58\pm0.52\;L/hr\;and\;218.3\pm22.9\;{\mu}g/ml{\cdot}hr$. There were significant differences (p<0.05) in ${\beta}$ and CL between healthy volunteers and lymphoma patients.

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Dobutamine 투여 후 발생한 개의 서맥 1례 (Bradycardia after Dobutamine Administration in a Dog)

  • 장민;손원균;황혜신;조상민;이강재;윤정희;이인형
    • 한국임상수의학회지
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    • 제31권4호
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    • pp.350-353
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    • 2014
  • A 13-year-old, castrated male, Shih Tzu dog with a history of acute ataxia was referred to veterinary medical teaching hospital and anesthetized for diagnostic magnetic resonance imaging of cervical intervertebral disk disease. After preanesthetic evaluation including physical examination, blood chemistry, radiography and ultrasound, the patient was premedicated with intravenous butorphanol (0.2 mg/kg). Anesthesia was induced by intravenous propofol (6 mg/kg) and maintained with isoflurane at 1.2 minimal alveolar concentrations. Because the mean arterial pressure (MAP) decreased from 70 to 58 mmHg at 70 minutes after induction, dobutamine was administered by constant rate infusion ($5{\mu}g/kg/min$) to treat hypotension. However MAP did not increase, and heart rate rapidly decreased from 100 to 55 beats per minute (bpm). To treat bradycardia, intravenous glycopyrrolate ($5{\mu}g/kg$) was administered, and heart rate increased to 165 bpm. After extubation of endotracheal tube, the patient showed normal recovery without any problems related to cardiovascular system. Unexpected dobutamine-induced bradycardia was considered as Bezold-Jarisch reflex. It is recommended that clinicians know and prepare the possibility of bradycardia during dobutamine therapy under general anesthesia.

상온하 혈액희석 체외순환에 있어서 혈액 GAS 동태에 관한 실험적 연구 (Experimental Studies of the Blood Gas Transport during Normothermic Hemodilution Perfusion)

  • 박희철
    • Journal of Chest Surgery
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    • 제13권2호
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    • pp.85-91
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    • 1980
  • Extracorporeal circulation by hemodilution technique has been currently used with its clinical safety and good peripheral tissue perfusion in open heart surgery. There is no doubt that $O_{2}$ carrying capacity of the blood is disturbed by decreased hemoglobin level resulting from hemodilution of the circulating blood. From the view point of the blood gas exchange, these experimental studies were undertaken to determined the sate limit of hemodilution in the condition of cardiopulmonary bypass with a constant perfusion flow rate. Twelve adult mongrel dogs weighing 10 to 13 Kg. were anesthetized with pentobarbital and then respiration was controlled with Harvard volume respirator using room air. The cardiopulmonary by pass was performed by use of Sarns heart lung machine (console 5000, 5 head and 2 roller pumps) and Travenol pediatric bubble oxygenator. The perfusion rate during bypass was maintained at a constant rate of 80 ml/min/Kg of body weight. The ratio of oxygen gas flow to blood flow was kept in 3 to 1 constantly. International hemodilution was attained by serial blood withdrawals and immediate infusion of equal volumes of diluants composed of Ringer's lactate, 5% dextrose in water and 25% mannitol solution, proportionally 60%, 30%, and 10%. Arterial and venous blood samples were obtained between 15 and 20 minutes following each hemodilution. Hematocrits and hemoglobin values, $PO_{2}$, $PCO_{2}$ and pH were measured. Oxygen and carbon dioxide contents oxygen consumption and carbon dioxide elimination were calculated groups according to different hematocrit values and the correlations were evaluated. Result were as follows. 1. the arterial $O_{2}$ tension and $O_{2}$ saturation were maintained at the physiological level irrespective of the hematocrit value. 2. The venous $O_{2}$ tension and $O_{2}$ saturation showed a tendency to decline with the decrease in hematocrit value and positive correlation between them (r = +0.49, r = +0.76), The mean values of venous $O_{2}$ tension and $O_{2}$ saturation, however, were not decreased when the hematocrit levels were lower than 20%. 3. The arterial $O_{2}$ content declined lineally in proportion to the fall of hematocrit level with a positive correlation between them (r = +0.95). 4. The venous $O_{2}$ contents were decreased gradually as the hematocrit value decreased with positive correlation between them ( r =+0.89). The trend of diminution of venous $O_{2}$ content, however, was became low according to progressive decrease of hematocrit level. 5. Systemic oxygen consumption was in higher range than $O_{2}$ requirement of basal metabolism when the hematocrit value was above 20%, but abruptly decreased when the hematocrit value became to below 20%. 6. The arterial $CO_{2}$ tension and $CO_{2}$ content showed trend of increasing with progressive decrease of hematocrit value but exhibited a rather broad range and there was no relationship between those value and the hematocrit value. 7. The venous $CO_{2}$ tension and $CO_{2}$ content have also no correlation with change of Ht. value but related directly to those value of arterial blood with positive correlation between them (r = +0.78, r = +0.95_. 8. A-V difference of $CO_{2}$ content and $CO_{2}$ elimination wasnot significantly influenced by Ht. value. From the results, we obtained that feasible limit in inteneional hemodilution is above the hematocrit value of 20% under the given experimental condition.

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난소암 환자에서 반코마이신의 임상약물동태 (Clinical Pharmacokinetics of Vancomycin in Ovarian Cancer Patients)

  • 김양우;최준식;이진환;박재영;최병철;범진필
    • 한국임상약학회지
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    • 제8권1호
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    • pp.13-18
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    • 1998
  • The purpose of this study was to determine pharmacokinetic parameters of vancomycin using the compartment model dependent and compartment model independent analysis in 6 Korean normal volunteers and 8 ovarian cancer patients. Vancomycin was administered 1.0 g bolus by IV infusion over 60 minutes. The elimination rate constant ($\beta$), volume of distribution (Vd), total body clearance (CLt), and area under the plasma level-time curve (AUC) of vancomycin in normal volunteers using the compartment model dependent analysis were $0.150\pm0.030\;hr^{-1},\;32.9\pm2.81\;L/kg,\;5.36\pm0.63\;L/hr,\;and\;186.5\pm20.5\;{\mu}g/ml{\cdot}hr$, respectively. The $\beta$, Vd, CLt, and AUC of vancomycin in ovarian cancer patients using the compartment model dependent analysis were $0.109\;0.008\;hr^{-1},\;41.5\pm3.01\;L/kg,\;4.58\pm0.57\;L/hr\;and\;218.3\pm22.9\;{\mu}g/ml{\cdot}hr$, respectively. There were significant differences (p<0.05,\;p<0.01) in $\beta$, Vd, CLt, and AUC between normal volunteers and ovarian cancer patients. The elimination rate constant (Kel), CLt, and AUC of vancomycin in normal volunteers using the compartment model independent analysis were $0.152\pm0.022\;hr^{-1},\;5.77\pm0.75\;L/hr,\;and\;173.2\pm22.5;{\mu}g/ml{\cdot}hr$, respectively. The Kel, CLt, and AUC of vancomycin in ovarian cancer patients using the compartment model independent analysis were $0.126\pm0.012\;hr^{-1},\;4.96\pm0.55\;L/hr,\;and\;201.7\pm25.6;{\mu}g/ml{\cdot}hr$, respectively. There were significant differences (p<0.05, p<0.01) in Kel, CLt, and AUC between normal volunteers and ovarian cancer patients. And also, there was significant difference (p<0.05) in Kel of vancomycin in ovarian cancer patients between the compartment model dependent and independen analysis. It is necessary for effective dosage regimen of vancomycin in ovarian cancer patient to use these population parameters.

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