Pharmacokinetics of zanamivir in critically ill patients undergoing continuous venovenous hemofiltration.

IF 1.3 4区医学 Q4 INFECTIOUS DISEASES

Antiviral Therapy Pub Date : 2023-02-01 DOI:10.1177/13596535221150746

André Wieringa, Peter Gj Ter Horst, GertJan Hj Wagenvoort, Birgit Cp Koch, Jasper J Haringman

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引用次数: 1

Abstract

Background: Limited data exist for dosing of zanamivir in the setting of CVVH in the intensive care unit (ICU). Our objective is to report the pharmacokinetics and sieving coefficient (S_v) of zanamivir in patients receiving continuous venovenous hemofiltration (CVVH).

Methods: In this prospective observational study, patients of ≥18 years admitted to the ICU with a life-threatening Influenza A or B infection, treated with zanamivir i.v. undergoing CVVH were included. Patients received a zanamivir loading dose of 600 mg i.v., 12 h later followed by maintenance dosages two times daily according to the treating physician. Per patient, nine CFT plasma and nine ultrafiltrate samples were drawn on day 2 of treatment and analysed with a validated HPLC-MS/MS method.

Results: Four patients were included in the study. The zanamivir elimination half-life was prolonged with 5.6-9.9 h, compared to patients with normal renal function. A S_v of approximately 1.0 was identified, with unrestricted transport of zanamivir to the ultrafiltrate.

Conclusions: Zanamivir is well cleared by CVVH. In absence of the possibility for therapeutic drug monitoring, the ultrafiltration rate seems as a good surrogate parameter to estimate the CL_CVVH and may help guide the dosing of zanamivir.

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扎那米韦在持续静脉-静脉血液滤过危重患者中的药代动力学。

背景:在重症监护病房(ICU) CVVH的情况下，扎那米韦的剂量数据有限。我们的目的是报道扎那米韦在接受连续静脉静脉血液滤过(CVVH)患者中的药代动力学和筛分系数(Sv)。方法:在这项前瞻性观察性研究中，纳入了ICU收治的≥18岁的危及生命的甲型或乙型流感感染患者，这些患者接受扎那米韦静脉注射治疗并接受CVVH。根据主治医生的指示，患者接受600毫克静脉注射扎那米韦，12小时后给予维持剂量，每日两次。每位患者在治疗的第2天抽取9份CFT血浆和9份超滤液样品，并使用经过验证的HPLC-MS/MS方法进行分析。结果:4例患者纳入研究。与肾功能正常的患者相比，扎那米韦消除半衰期延长了5.6-9.9 h。Sv约为1.0，扎那米韦不受限制地转运到超滤液中。结论:扎那米韦被CVVH清除良好。在缺乏治疗药物监测的可能性的情况下，超滤率似乎是估计CLCVVH的一个很好的替代参数，并可能有助于指导扎那米韦的剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Antiviral Therapy 医学-病毒学

CiteScore

2.60

自引率

8.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.