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頁籤選單縮合
題名 | 癌症病人的Vancomycin藥物動力學=Pharmacokinetics of Vancomycin in Cancer Patients |
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作者 | 葉春蘭; 蘇慧真; 王慧瑜; | 書刊名 | 藥學雜誌 |
卷期 | 28:3=112 2012.09[民101.09] |
頁次 | 頁61-65 |
分類號 | 418.281 |
關鍵詞 | 藥物動力學參數; 分佈體積; 清除率; Vancomycin; Steady-state; |
語文 | 中文(Chinese) |
中文摘要 | 本文以 vancomycin 為例,目前文獻顯示癌症病人使用 vancomycin 因分佈體積和清除率的增加,因此應使用較高劑量以達臨床上治療效果,而我國癌症病人是否也有相同結果很值得探討,因此本文藉由某醫學中心回溯性蒐集95年1月至99年3月使用 vancomycin 之癌症和非癌症的成人病人,在第一次達 steady-state 監測其藥物血中濃度,並依據監測結果使用一室分佈模式分別算出分佈體積、清除率和半衰期等藥物動力學參數,比較兩者之間的差異性。 初步結果癌症病人共蒐集50位,非癌症病人64位,兩者在平均每日 vancomycin 劑量和給藥間隔並無統計上差異,然而癌症病人平均 vancomycin 波峰濃度和波谷濃度均較非癌症病人為低,並具有統計上意義 (p<0.05),進一步分析藥物動力學參數,發現癌症病人平均分佈體積為51.22±13.11 L,高於非癌症病人42.66±11.32 L (P<0.05);清除率方面同樣癌症病人平均清除率為3.76±1.41 L/h,高於非癌症病人3.08±0.89 L/h (P<0.05),然而平均半衰期兩者並無統計上差異,此初步結果顯示著癌症病人如欲達到和非癌症病人相同治療效果,應使用較高劑量。 |
英文摘要 | Several pharmacokinetic studies in cancer patients documented the necessity of dose adjustment for vancomycin user because of the increased clearance and volume distribution. It is valuable to discuss this issue in Taiwanese population. A retrospective study was used from January 2006 to March 2010 in a medical center and data were collected among vancomycin user with or without cancer. Vancomycin serum concentrations were determined after the fourth dose or at steady state. The individual pharmacokinetic parameters (volume of distribution, clearance and half-life) were calculated using a one-compartment model and compared between cancer and non-cancer patients. A total of 114 patients were recruited in this study and classified into cancer (n=50) and non-cancer (n=64) groups. There were no significant differences between two groups in the interval and daily dosage of vancomycin, but the peak and trough concentration were significantly lower in the cancer group than those in the non-cancer group. Further analysis of pharmacokinetic parameters, the mean volume of distribution (Vd) and clearance (CL) in the cancer group were higher significantly than those in non-cancer group (Means of Vd were respectively 51.22±13.11 L in the cancer group and 42.66±11.32 L in the noncancer group, p<0.05; means of CL were respectively 3.76±1.41 L/h in the cancer group and 3.08±0.89 L/h in the non-cancer group, p<0.05), but the average of half-life was no statistical difference between the two groups. These results implied that higher doses for cancer patients were needed to achieve the same therapeutic effect. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。