title: Pharmacokinetics of liposomal amphotericin B during extracorporeal albumin dialysis.
abstract: Extracorporeal blood purification techniques such as hemofiltration or albumin dialysis can exert a significant, but not easily predictable influence on plasma pharmacokinetics of antimicrobial agents. The effect of albumin dialysis on the pharmacokinetics of liposomal amphotericin B (AMB) and other lipid-formulated drugs has not been investigated so far. Therefore, plasma concentrations of liberated and liposomal AMB were measured in a patient, who obtained liposomal AMB for suspected invasive mycosis and required albumin dialysis because of cholestatic liver failure caused by graft versus host disease after bone marrow transplantation. Liberated and liposomal AMB were separated by solid phase extraction and measured by high performance liquid chromatography. No excessive AMB elimination took place during albumin dialysis. Plasma levels of liposomal AMB exceeded those of liberated AMB. Pharmacokinetic data were comparable to those obtained previously in patients on hemofiltration and in critically ill patients without extracorporeal blood purification.
authors.affiliation: Clinical Pharmacokinetics Unit, Innsbruck Medical School, Innsbruck, Austria.
authors.forename: Helene
authors.initials: H
authors.lastname: Vogelsinger
authors.forename: Michael
authors.initials: M
authors.lastname: Joannidis
authors.forename: Jordan
authors.initials: J
authors.lastname: Kountchev
authors.forename: Rosa
authors.initials: R
authors.lastname: Bellmann-Weiler
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Wiedermann
authors.forename: Romuald
authors.initials: R
authors.lastname: Bellmann
mesh_terms: D000328:Adult; D000418:Albumins; D000666:Amphotericin B / Q000493:pharmacokinetics*; D000935:Antifungal Agents / Q000493:pharmacokinetics*; D006086:Graft vs Host Disease / Q000150:complications; D006801:Humans; D017093:Liver Failure / Q000209:etiology / Q000378:metabolism* / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis
chemical_list: D000418:Albumins; D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B