[Dosage adjustment of drugs during continuous hemofiltration. Results and practical consequences of a prospective clinical study].
In 43 ICU patients undergoing continuous volume constant hemofiltration (CVHF), the pharmacokinetics of 12 drugs were investigated to ensure correct dosage adjustments. Under conditions of CVHF, maximum doses were defined for cefotaxime, ceftazidime, digoxin, digitoxin, imipenem, metronidazole++, netilmicin, phenobarbital, phenytoin, theophylline, tobramycin, and vancomycin. For the estimation of sufficient doses without blood level measurements, sieving coefficients (S) were calculated by a new method. In addition, S was integrated as a CVHF-specific factor into a common equation for drug dose adjustment in patients with renal insufficiency. The regression of dosage received from kinetics on blood-level-independent equation adjustment was r = 0.9923. Since the volumes of distribution in ICU patients are variable, it is suggested that further drug monitoring is necessary for toxic drugs.
Kroh
U
U
Abteilung für Anaesthesie und Intensivtherapie im Interdisziplinären Medizinischen Zentrum, Philipps-Universität Marburg.
Hofmann
W
W
Dehne
M
M
el Abed
K
K
Lennartz
H
H
D000328:Adult; D000368:Aged; D002439:Cefotaxime / Q000008:administration & dosage; D002442:Ceftazidime / Q000008:administration & dosage; D004074:Digitoxin / Q000008:administration & dosage; D004077:Digoxin / Q000008:administration & dosage; D006440:Hemofiltration; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D009428:Netilmicin / Q000008:administration & dosage; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D010634:Phenobarbital / Q000008:administration & dosage; D010672:Phenytoin / Q000008:administration & dosage; D013806:Theophylline / Q000008:administration & dosage; D014031:Tobramycin / Q000008:administration & dosage; D014640:Vancomycin / Q000008:administration & dosage
D004364:Pharmaceutical Preparations; D008795:Metronidazole; D009428:Netilmicin; D010672:Phenytoin; D014640:Vancomycin; D015378:Imipenem; D004077:Digoxin; D002442:Ceftazidime; D013806:Theophylline; D004074:Digitoxin; D002439:Cefotaxime; D014031:Tobramycin; D010634:Phenobarbital
Dosisanpassung von Pharmaka während kontinuierlicher Hämofiltration. Ergebnisse und praktische Konsequenzen einer prospektiven klinischen Studie.