基于子宫收缩频率的群体动力学-药效学模型的静脉催产素引产最佳起始剂量方案。

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Pharmacotherapy Pub Date : 2024-04-01 Epub Date: 2024-02-29 DOI:10.1002/phar.2911
Zhiheng Yu, Rong Chen, Cheng Zhao, Renwei Zhang, Tianyan Zhou, Yangyu Zhao
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引用次数: 0

摘要

背景:静脉注射催产素常用于引产。然而,由于研究结果相互矛盾,指导原则也不尽相同,因此人们对初始剂量方案缺乏共识。本研究旨在建立催产素诱导子宫收缩的群体动力学-药效学(K-PD)模型,考虑真实世界的数据和相关影响因素,以确定静脉注射催产素的最佳起始剂量方案:这项回顾性研究纳入了2020年在北京大学第三医院接受静脉催产素引产的孕妇。建立了一个群体 K-PD 模型来描述子宫收缩频率(UCF)的时间过程,并通过协变量筛选确定了影响催产素药代动力学和药效学的重要因素。根据具体指南,利用基于模型的模拟优化了当前的起始方案:结果:K-PD 模型很好地描述了 77 名孕妇的数据和 1095 次 UCF 观察。胎次、宫颈扩张和胎膜完整性是影响催产素效果的重要因素。根据基于模型的模拟,目前的方案显示起效时间长、输注率高。本研究提出了一种新的方法,即先快速输注,然后降低输注率,使大多数产妇能在约 30 分钟内以尽可能低的输注率达到目标 UCF:结论:催产素的 K-PD 模型有效地描述了引产过程中 UCF 的变化。结论:K-PD 模型有效地描述了引产过程中 UCF 的变化,并揭示了胎次、宫颈扩张和胎膜完整性是影响催产素效果的关键因素。通过模型模拟得到的最佳起始剂量方案为催产素治疗提供了有价值的临床参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimal starting dosing regimen of intravenous oxytocin for labor induction based on the population kinetic-pharmacodynamic model of uterine contraction frequency.

Background: Intravenous oxytocin is commonly used for labor induction. However, a consensus on the initial dosing regimen is lac with conflicting research findings and varying guidelines. This study aimed to develop a population kinetic-pharmacodynamic (K-PD) model for oxytocin-induced uterine contractions considering real-world data and relevant influencing factors to establish an optimal starting dosing regimen for intravenous oxytocin.

Methods: This retrospective study included pregnant women who underwent labor induction with intravenous oxytocin at Peking University Third Hospital in 2020. A  population K-PD model was developed to depict the time course of uterine contraction frequency (UCF), and covariate screening identified significant factors affecting the pharmacokinetics and pharmacodynamics of oxytocin. Model-based simulations were used to optimize the current starting regimen based on specific guidelines.

Results: Data from 77 pregnant women with 1095 UCF observations were described well by the K-PD model. Parity, cervical dilation, and membrane integrity are significant factors influencing the effectiveness of oxytocin. Based on the model-based simulations, the current regimens showed prolonged onset times and high infusion rates. This study proposed a revised approach, beginning with a rapid infusion followed by a reduced infusion rate, enabling most women to achieve the target UCF within approximately 30 min with the lowest possible infusion rate.

Conclusion: The K-PD model of oxytocin effectively described the changes in UCF during labor induction. Furthermore, it revealed that parity, cervical dilation, and membrane integrity are key factors that influence the effectiveness of oxytocin. The optimal starting dosing regimens obtained through model simulations provide valuable clinical references for oxytocin treatment.

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来源期刊
Pharmacotherapy
Pharmacotherapy 医学-药学
CiteScore
7.80
自引率
2.40%
发文量
93
审稿时长
4-8 weeks
期刊介绍: Pharmacotherapy is devoted to publication of original research articles on all aspects of human pharmacology and review articles on drugs and drug therapy. The Editors and Editorial Board invite original research reports on pharmacokinetic, bioavailability, and drug interaction studies, clinical trials, investigations of specific pharmacological properties of drugs, and related topics.
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