title: In vitro removal of therapeutic drugs with a novel adsorbent system.
abstract: OBJECTIVE
  Substances in the middle molecular weight range have been shown to play a significant pathogenetic role in as diverse disorders as end-stage renal disease and multiple organ failure. To overcome the limitations in the amount removed by hemofilters, new sorbents with a high biocompatibility are actively being developed. Furthermore, biocompatible sorbents by their nonspecific adsorptive behavior could have great impact on detoxification treatment in exogenous intoxications. We performed an in vitro evaluation of a newly developed highly biocompatible sorbent cartridge (Betasorb((R))), examining its adsorptive capacity concerning therapeutic drugs.
  
  
  METHODS
  Uremic blood spiked with a range of therapeutic drugs was recirculated for 2 h in an in vitro hemoperfusion circuit containing a Betasorb device for hemoperfusion. The drug concentrations before and after the passage of the cartridge were measured, and the total amount removed was calculated.
  
  
  RESULTS
  The sorbent showed effective removal of glycopeptide antibiotics, digoxin, theophylline, phenobarbital, phenytoin, carbamazepine, and valproic acid. Moderate removal could be demonstrated for tacrolimus and cyclosporine A; aminoglycosides were removed to a small extent only.
  
  
  CONCLUSIONS
  Betasorb hemoperfusion shows a potent adsorptive capacity concerning therapeutic drugs (except aminoglycosides) and could be of major value in the treatment of intoxications. On the other hand, drug monitoring and possible adjustments are necessary during Betasorb hemoperfusion to maintain the therapeutic ranges of the drugs in blood.
authors.affiliation: University Children's Hospital, Kinderklinik und Kinderpoliklinik am Dr. von Haunerschen Kinderspital, Munich, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Reiter
authors.forename: Valeria
authors.initials: V
authors.lastname: Bordoni
authors.forename: Giuliano
authors.initials: G
authors.lastname: Dall'Olio
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Ricatti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Soli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Ruperti
authors.forename: Giuliano
authors.initials: G
authors.lastname: Soffiati
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Galloni
authors.forename: Vincenzo
authors.initials: V
authors.lastname: D'Intini
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D000327:Adsorption; D000900:Anti-Bacterial Agents / Q000097:blood / Q000493:pharmacokinetics; D001672:Biocompatible Materials; D002220:Carbamazepine / Q000097:blood / Q000493:pharmacokinetics; D004077:Digoxin / Q000493:pharmacokinetics; D006020:Glycopeptides; D006464:Hemoperfusion / Q000295:instrumentation*; D006801:Humans; D008954:Models, Biological; D010634:Phenobarbital / Q000097:blood / Q000493:pharmacokinetics; D010672:Phenytoin / Q000097:blood / Q000493:pharmacokinetics; D016060:Sorption Detoxification / Q000295:instrumentation*; D013806:Theophylline / Q000097:blood / Q000493:pharmacokinetics; D014511:Uremia; D014635:Valproic Acid / Q000097:blood / Q000493:pharmacokinetics
chemical_list: D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D006020:Glycopeptides; D002220:Carbamazepine; D014635:Valproic Acid; D010672:Phenytoin; D004077:Digoxin; D013806:Theophylline; D010634:Phenobarbital