摘要：

Professorof ClinicalPharmacy Departmentof ClinicalPharmacy ClinicalPharmacist Departmentof ClinicalPharmacy where t1/20 0 is the serum half-life of isepamicin during HO, ko is the overall elimination rate constant of isepamicin during HO, and Clo is the total clearance of iseparnicin during HO. The Vd for iseparnicin can be treated as a constant, because the intradialysis period is considerably shorter than the interdialysis period.'·7 The observed serum concentrations of isepamicin during non-HO were as follows: Co 3.0 ug/ml.; and C 8.3 ug/ml., In addition, that observed at 19 h after the administration of replacement dose was 8.1 ug/rnl., On the other hand, those observed during HO were 16.0 ug/ml, at beginning and 7.3 ug/ml, at I h after dialysis. The pharmacokinetic parameters of isepamicin during non-HO and HO were as follows: k, 0.0013 h': t 1/2 533.1 h; Vd 18.9 L; CI 0.41 mL!min; ko 0.1967 h"; t / 200 3.5 h; and Clo 61.96 mL/min. Halstenson et al. determined that in patients with endstage renal failure, the mean total body clearance of isepamicin is only 2.24 mUmin/1.73 m'.' On the other hand, our result of 0.41 mL/min is very much lower than that of Halstenson et al.' This suggests that in this patient, there is very little intrinsic clearance of isepamicin during non-HD. The total clearance of isepamicin during HD is high and close to the HD clearance ranging from 33.4 to 98.5 mlzmin determined by Halstenson et al.,' although the composition and surface area of a dialysis membrane used in our study are different from those of Halstenson et al.' This indicates that isepamicin, like other aminoglycosides, is significantly removed by HD and that dosage adjustment is essential in patients who have renal failure and/or are undergoing HD. This is a case study of only one patient. Because the serum samples were obtained during routine therapeutic monitoring, the sample collection was limited to a minimal number of samples needed for pharmacokinetic analysis. Therefore, the pharmacokinetic parameters determined in this study may be subject to error. We consider, however, that the method used in this study is useful in predicting the effect of HD on serum concentration of isepamicin because the total clearance of iseparnicin during HD is close to the HD clearance determined by Halstenson et al. with their specified dialysis procedure.'

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