万古霉素的临床药物动力学。

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董事长Matzke GR、Zhanel GG Guay博士

万古霉素的临床药物动力学。

Jul-Aug Pharmacokinet。1986; 11 (4): 257 - 82。doi: 10.2165 / 00003088-198611040-00001。

PubMed ID

3530582 (在PubMed

]

文摘

万古霉素利用率大幅增加在过去的10年中由于增加耐甲氧西林葡萄球菌感染的临床意义。最近的研究集中在描述性格的万古霉素和评估患者血清浓度和治疗之间的关系以及负面影响。虽然万古霉素不明显从完整的胃肠道吸收,几个最近的案例报告记录达到治疗和潜在有毒万古霉素口服后血清浓度pseudomembranous结肠炎患者。非肠道管理万古霉素的性格已经被triexponential最好的特征模型。初始阶段的半衰期(t1/2π)是大约7分钟,第二阶段的(t1/2α)大约是0.5到1小时,而终端消除半衰期(t1/2β)在学科范围从3到9个小时正常肾功能。中央室的体积(Vc)成年人大约是0.15 L /公斤而分布的稳态量(vds)范围从0.39到0.97 L /公斤。超过80%的万古霉素剂量不变排出的尿液后24小时内政府和万古霉素的浓度在肝组织和胆汁被报道在或低于检测极限。万古霉素肾清除率接近0.5到0.8的同时测定肌酐或125 i-iothalamate许可,表明肾排泄的主要路线是肾小球滤过。最近,non-renal肝结合等因素提出了消除万古霉素的一个重要途径。然而,这些数据很难与其他研究表明最小non-renal间隙的万古霉素与终末期肾病学科。 As yet, the disposition of vancomycin in patients with hepatic disease has not been adequately defined. Only limited data are available regarding the concentrations of vancomycin in biological fluids other than plasma. The penetration of vancomycin into cerebrospinal fluid (CSF) in patients with and without meningitis has been quite variable. Although early studies suggested that adequate CSF concentrations may not be achieved in subjects with uninflamed meninges, more recent investigations have reported contradictory results. Therapeutic concentrations of vancomycin, i.e. greater than 2.5 mg/L, have, however, been reported in ascitic, pericardial, pleural and synovial fluids. Tissue concentrations of vancomycin have exceeded simultaneous serum concentrations in heart, kidney, liver and lung sp

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药物

万古霉素