• Title/Summary/Keyword: population pharmacokinetics

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Strategy for Bioequivalence of Doxifluridine (항암제 doxifluridine의 생물학적동등성 연구방안)

  • Jin, Qing Ri;Kwon, Kwang-Il;Kang, Wonku
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.1
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    • pp.61-67
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    • 2005
  • This study was designed to establish a strategy for the bioequivalence study of doxifluridine, an anticancer drug, in dogs instead of cancer patients. Although the results from animals may not occur in the same manner from human, those would be worth enough in terns of the bioequivalence. As for critically ill population such as cancer patients, bioequivalence studies in animals bring many advantages. Six healthy Beagle dogs were selected on the basis of hematology and blood chemistry test. After an over night fast, 200 mg of doxifluridine was orally administered, and blood was serially taken up to 12 hours. Plasma concentration of doxifluridine was measured using a newly validated bioanalytical method by a HPLC coupled tandem mass spectrometry. Time course of plasma doxifluridine concentration was analyzed with non-compartmental and compartmental approaches. Consequently, we represented hematology and blood chemistry database for the selection of healthy Beagle dogs, and suggested a sensitive and validated analytical method of doxifluridine, as well as a study design for the bioequivalence of doxifluridine in dogs.

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Chemotherapy in Cancer Patients with Comorbidity (공존이환(Comorbidity)이 있는 암환자에서의 항암약물치료)

  • Moon Yong-Wha;Jeung Hei-Cheul
    • Journal of Gastric Cancer
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    • v.4 no.2
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    • pp.59-74
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    • 2004
  • This report attempts to explain the (i) implications of comorbidity for research and practice in the fieldo of oncology, (ii) the approach for dosing of anti-cancer drugs in the presence of comorbidity, as an example of its clinical application, and finally (iii) the dosing guidelines for the anticancer drugs clinically active in gastric cancer in the presence of renal or liver dysfunction. This has resulted from the idea of approaching comorbidity in a systematic way and of integrating it with oncologic decisions. Various methods have been used to assess comorbidity. However, significant work remains to be done to analyze how various diseases combine to influence the oncologic outcome. The main end-point explored so far has been mortality, but a largely open challenge remains to correlate comorbidity with treatment tolerance and functional and quality of life, as well as to integrate it in clinical decision-making. Cancer chemotherapy in comorbidity should be considered as an example of the need for dose optimization in individual patients, and it should be determined by considering the basic principles of the pharmacokinetics and the pharmacodynamics of the agents. This review analyzes the available data on the pharmacokinetics and the toxicities of anti-cancer agents in the comorbidity population.

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Clinical Pharmacokinetics of Carbamazepine (Carbamazepine의 임상 약동학)

  • 김민정;류윤미;신완균
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.04a
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    • pp.280-280
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    • 1996
  • carbamazepine은 대표적인 항전간제로써, 약물의 유효 혈중 농도 범위가 좁아서 TDM(Theapeutic Drug Monitoring)을 시행하는 약물이다. 그리고 이 약물은 parent drug 뿐만 아니라 대사체의 하나인 carbamazepine-10,11-epoxide 역시 carbamazepine와 동일한 효과가 있는 것으로 알려져 있어, 임상적으로 TDM 시행시에는 carbamazepine의 carbamazepine-10,11-epoxide로의 대사에 소요되는 시간과 대사 정도에 대한 자료가 필요하다. 그러나 이제껏 제시되고 있는 population parameter들이 모두 서양인에 대한 자료이므로 국내에서 이 약물을 투여하는데 있어서 인종간의 차이를 확인하지 않고서 서양인의 자료에 준하여 적용하는 것은 상당한 위험성이 따를 수도 있으므로 한국인에 있어서의 carbamazepine 대사에 관한 연구가 필요하였다. 방법 7명의 건강한 성인을 대상으로 carbamazepine 제제 400mg을 1회 경구 투여한 다음, 0, 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48, 72 시간 경과시 채혈하여 정량하였다. 결과 carbamazepine의 AUC 881$\pm$233(minㆍ$\mu\textrm{g}$/$m\ell$), MRT 72.1$\pm$10.8(min), t$_{1}$2/ 40.1 $\pm$ 8.6(min), CL 6.75 $\pm$ 2.72($m\ell$/min/kg), Vdssn 484 $\pm$ 215($m\ell$/kg)의 값을 얻었다.

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In vivo Evaluation of a Novel ${\beta}-Lactam$ Antibiotics, YH-487 (새로운 ${\beta}-Lactam$계 항생물질 YH-487의 in vivo 항균활성)

  • Won, Yu-Jung;Kang, Heui-Il;Lee, Jong-Wook;Chung, Dong-Hyo
    • Applied Biological Chemistry
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    • v.40 no.2
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    • pp.157-162
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    • 1997
  • A novel compound, named YH-487, was synthesized by attaching the thiol and aminothiazole residue to $C_3$ and $C_7$ position of 7-aminocephalosporanic acid (7-ACA). The therapeutic efficacy on infected animals, pharmacokinetics in vivo and the effect on intestinal microflora of YH-487 were examined. The pharmacokinetics of YH-487 were similar to that of cefotaxime, a third generation ${\beta}-lactam$ antibiotics, in rat. Upon in vivo administration, YH-487 was predominantly delivered to kidney, and mostly excreted through kidney without making any metabolites. The therapeutic efficacy of YH-487 to animal infected with E. coli was three times and twenty times higher than that of cefotaxime and cefotiam, respectively, In vivo administration of YH-487 to Sprague-Dawley rats significantly decreased the population of intestinal gram negative species such as Enterobacteria and Barteroides. However, no significant changes were obseved in gram positive species such as Lactobacillus, Bifidobacteria and Staphylococcus. In addition, continuous administration of YH-487 did not increase the possibility to induce resistant strains in intestinal microflora.

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Effect of $SLCO1B1^*15$ on Pravastatin Pharmacokinetics: A Systematic Review and Meta-analysis (프라바스타틴에서 $SLCO1B1^*15$의 약동학적 영향: 체계적 고찰 및 메타분석)

  • Kim, Jong Yoon;Nakagawa, Naoto;Yoon, Hyonok;Chun, Pusoon;Rhew, Ki Yon
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.231-239
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    • 2014
  • Background and objective: Pravastatin has been shown to have favorable risk-benefit profile when it is administered to hypercholesterolemic subjects to prevent cardiovascular events. However, subjects with impaired OATP1B1 activity may be more susceptible to pravastatin-induced muscle toxicity than subjects with normal OATP1B1 activity. A systematic review was conducted to evaluate the effect of SLCO1B1 genetic polymorphism on pharmacokinetics of pravastatin. Method: Medline$^{(R)}$ and Embase$^{(R)}$ were searched for relevant studies until July 2013. The search terms used were pravastatin AND (SLCO1B1 OR OATP1B1 OR LST1 OR SLC21A6) AND (gene OR $genetic^*$ OR $genomic^*$ OR $pharmacogenet^*$ OR $pharmacogenom^*$ OR $polymorph^*$). Results: A meta-analysis of the area under the concentration-time curve (AUC) of pravastatin in $SLCO1B1^*15$ and $SLCO1B1^*1a/^*1a$ was conducted. Five studies met all the inclusion criteria and methodological requirements. There was no statistically significant difference in the AUC value between $SLCO1B1^*15$ and $SLCO1B1^*1a/^*1a$ (p=0.728). However, $SLCO1B1^*15$ participants exhibited significantly higher AUC values than $SLCO1B1^*1b/^*1b$ carriers (p<0.001). In case of $SLCO1B1^*15^*15$ carriers, they had significantly higher AUC value than $SLCO1B1^*1a/^*1a$ subjects (p=0.002). Lastly, compared with to the subjects of $SLCO1B1^*1a/^*1a$, the carriers of heterozygous $SLCO1B1^*15$ increased the AUC value of pravastatin statistically significantly in Asian population (p=0.014). Conclusion: The present meta-analysis suggests that subjects with $SLCO1B1^*15$ are associated with increased AUC of pravastatin.

Population Pharmacokinetics of Cyclosporine after Hematopoietic Stem Cell Transplantation in Leukemic Patients (조혈모세포이식을 받은 한국 성인 백혈병환자에서 cyclosporine의 집단약동학 분석)

  • Kim, Seung-Hee;Kim, Kyung-Im;Yun, Hwi-yeol;Kang, Won-Ku;Yoon, Sung-Soo;Shin, Wan-Gyoon;Lee, Hye-Suk;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.1
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    • pp.9-16
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    • 2010
  • Purpose: 본 연구는 한국인 성인 조혈모세포이식환자를 대상으로 경구용 사이클로스포린의 집단약동학 분석을 통하여 사이클로스포린의 약동학적 파라미터에 영향을 미치는 요인 분석을 실시하고자 하였다. Methods: 2000년 12월부터 2006년 8월까지 서울대학교병원에서 동종조혈모세포이식을 받고 면역억제제로 사이클로스포린을 복용한 성인 백혈병환자를 대상으로 후향적으로 자료를 수집하였다. 사이클로스포린의 약동학에 영향을 미치는 인자로는 연령, 성별, 이식 후 날짜, 신기능, 공여자와의 관계, 질병의 종류, 혈중 빌리루빈 농도, 사이클로스포린의 대사를 유도하는 프레드니솔론의 투여량, 헤마토크리트, 사이클로스포린의 대사를 저해하는 약물의 병용여부 등을 검토하였다. 분석은 NONMEM$^{(R)}$ VI 프로그램을 이용하였으며, 변수를 추가하지 않은 기본 모형을 만든 후에 단계적인 요인의 추가와 제거를 통해 최종모형을 제작하였다. Results: 최종 상관 모형은 다음과 같다; CL/F (L/h) = $85.6{\times}e^{(0.646\;{\times}\;HCT/28.9\;+\;0.0464\;{\times}\;Gender)}$. 사이클로스포린의 겉보기 클리어런스는 환자의 성별이 남자일 때 또는 헤마토크릿이 감소할수록 증가하였다. 그 외 파라미터는 다음과 같이 계산되었다; $K_{\alpha}=0.0787\;(h^{-1})$; Q=57.1(L/kg/h); $V_{d-central\;compartment}$=1,100 (L); $V_{d-peripheral\;compartment}$ = 213,000(L). 개체간 편차는 40% 미만이었으며, 개체내 편차를 포함하는 잔차는 24.02%였다. Conclusions: 사이클로스포린의 약동학적 특징과 그 클리어런스에 영향을 끼칠 수 있는 임상적 요인을 이해하는 것은 환자 개개인의 용량과 용법의 결정 및 이상반응 발생의 예방에 유용할 수 있다. 한국인 조혈모세포이식환자에서 사이클로스포린의 약동학에 영향을 미치는 최종 파라미터를 구한 본 연구의 결과는 조혈모세포이식을 받은 한국인 성인환자에서 사이클로스포린의 모니터링 및 용량조절에 유용할 것으로 전망된다.

Psychosomatic Management of Medically Ill Elderly : Focused on Consultation Psychiatry (신체질환이 있는 노인 환자의 정신신체 의학적 치료 : 자문정신의학을 중심으로)

  • Ryu, Seong-Gon;Kwon, Hee-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.1
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    • pp.25-30
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    • 2008
  • With the rapid growth of geriatric population, geriatric psychiatric consultation has come to play a more important role in recent years. It is necessary to find out characteristics of psychiatric consultation-liaison in elderly and applicate practical guideline of consultation in medical setting. Management of medically ill elderly in psychiatric consultation requires different guideline from that of other age group patient. Because aging and each organ-specific diseases change the pharmacokinetics of psychotropic drugs variably. These pharmacokinetic changes should be considered in psychosomatic treatment in medically ill elderly. The relatively low consultation rates for psychiatric disorders in the elderly indicate that research is needed into factors that both prevent and facilitate elderly patients with psychological symptoms from consulting their general practitioners.

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The Influence of Assay Error Weight on Gentamicin Pharmacokinetics Using the Bayesian and Nonlinear Least Square Regression Analysis in Appendicitis Patients

  • Jin, Pil-Burm
    • Archives of Pharmacal Research
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    • v.28 no.5
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    • pp.598-603
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    • 2005
  • The purpose of this study was to determine the influence of weight with gentamicin assay error on the Bayesian and nonlinear least squares regression analysis in 12 Korean appen dicitis patients. Gentamicin was administered intravenously over 0.5 h every 8 h. Three specimens were collected at 48 h after the first dose from all patients at the following times, just before regularly scheduled infusion, at 0.5 h and 2 h after the end of 0.5 h infusion. Serum gentamicin levels were analyzed by fluorescence polarization immunoassay technique with TDxFLx. The standard deviation (SD) of the assay over its working range had been determined at the serum gentamicin concentrations of 0, 2, 4, 8, 12, and 16 ${\mu}g$/mL in quadruplicate. The polynominal equation of gentamicin assay error was found to be SD (${\mu}g$/mL) = 0.0246-(0.0495C)+ (0.00203C$^2$). There were differences in the influence of weight with gentamicin assay error on pharmacokinetic parameters of gentamicin using the nonlinear least squares regression analysis but there were no differences on the Bayesian analysis. This polynominal equation can be used to improve the precision of fitting of pharmacokinetic models to optimize the process of model simulation both for population and for individualized pharmacokinetic models. The result would be improved dosage regimens and better, safer care of patients receiving gentamicin.

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

  • Kim, Yang Woo;Choi, Jun Shik;Lee, Jin Hwan;Park, Jae Young;Choi, Byong Chul;Burm, Jin Pil
    • Korean Journal of Clinical Pharmacy
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    • v.8 no.1
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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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