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Initial dosage optimization of valproic acid in patients with bipolar disorder based on gender difference and combined used clozapine

Initial dosage optimization of valproic acid in patients wit...

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2023年度全国临床药理学学术论坛

作者： Xiao Chen Dong-Dong Wang School of Nursing Xuzhou Medical University Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy & School of Pharmacy Xuzhou Medical University

Background:The present study aims to optimize the initial dosage of VPA in patients with bipolar *** Design and Methods:A total of 126 patients with bipolar disorder treated by VPA were used to construct VPA population pharmacokinetic ***:The CL/F and V/F of VPA in patients with bipolar disorder were 11.3 L/h and 36.4 L,*** difference and combined used clozapine were significantly affecting VPA clearance in patients with bipolar *** the same weight,the VPA clearance rates were 1.134 :1 :1.276884 :1.126 in male patients without combined used clozapine,female patients without combined used clozapine,male patients with combined used clozapine,female patients with combined used clozapine,*** study furtherly optimized the initial dosage of VPA in male patients without combined used clozapine,female patients without combined used clozapine,male patients with combined used clozapine,female patients with combined used clozapine,respectively(Refer to Table 1).Conclusions:It was the first time to investigate the initial dosage optimization of VPA in patients with bipolar disorder based on gender difference and combined used clozapine,providing reference for the precision drug use of VPA in clinical patients with bipolar disorder.

关键词： dosage optimization valproic acid bipolar disorder gender difference combined used clozapine

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Population Pharmacokinetic Model-guided optimization of Intravenous Voriconazole Dosing Regimens in Critically Ill Patients with Liver Dysfunction

Population Pharmacokinetic Model-guided Optimization of Intr...

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2022第27届广东省药师周大会

作者： Xiao-bin Lin Ka Yin Lui Peng-hao Guo Xiao-man Liu Tao Liang Xiao-guang Hu Li Tong Jing-jing Wu Yan-zhe Xia Pan Chen Guo-ping Zhong Xiao Chen Chang-jie Cai Department of Pharmacy The First Affiliated HospitalSun Yat-sen University Department of Critical Care Medicine The First Affiliated HospitalSun Yat-sen University Department of Clinical Laboratory The First Affiliated HospitalSun Yat-sen University Institute of Clinical Pharmacology School of Pharmaceutical SciencesSun Yat-sen University

Objectives:This prospective study aimed toestablish a population pharmacokinetic(PPK) model ofintravenous voriconazole(VRC)incritically ill patients with liver dysfunction,andto explore the optimal dosing strategies in specific clinical scenariosfor invasive fungal infections(IFIs)caused by common Aspergillus and Candida ***:The PPK analysis was conducted on 297 plasma VRC concentrations from 26 critically ill patientswith liver ***-based simulations with therapeutic range of 2-6 mg/L as the plasma trough concentration(Cmin) target and the free area under the concentration-time curve from 0 h to 24 h(?AUC24) divided by the minimum inhibitory concentration(MIC)(i.e.?AUC24/MIC) ≥ 25 as the effective target were performed to optimize VRC dosing regimensfor Child-Pugh class AandB(CP-A/B) and Child-Pugh class C(CP-C) ***:A two-compartment model with first-order elimination adequately described the *** covariates in the final model werebody weight onboth central and peripheraldistributionvolumeand Child-Pugh class on *** VRC loading dose of 5 mg/kg every 12 h(q12 h) for the first day was adequate for CP-A/B and CP-C patients to attainthe Cmin target at 24 *** doseregimens of 100 mgq12 h or 200 mgq24 h for CP-A/B patients and 50 mgq12 h or 100 mgq24 h for CP-C patientscould obtain the probability of effective target attainmentof > 90% at an MIC≤ 0.5 mg/L and achieve the cumulative fraction of response of> 90% against ***,***,***,***,***,and ***,the daily VRC dosescould be increased by 50 mg for CP-A/B and CP-C patients at an MIC of 1 mg/L,with plasma Cminmonitoredclosely to avoid serious adverse *** is recommendedthat an appropriate alternative antifungal agent or a combination therapycould be adopted when an MIC ≥ 2 mg/Lis reported,or whenthe infection iscaused by *** the MIC valueisnot ***:For criti

关键词： voriconazole population pharmacokinetics dosage optimization liver dysfunction critically ill patients

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