Population pharmacokinetic investigation of digoxin in Japanese neonates.
Objective: To establish the role of patient characteristics in estimating doses of digoxin for neonates using routine therapeutic drug monitoring data. Method: The steady-state blood level data (n = 129) after repetitive oral administration in 71 hospitalized neonates were analysed using Nonlinear M...
| Publicado en: | Journal of Clinical Pharmacy & Therapeutics Vol. 32; no. 4; pp. 381 - 387 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Aug2007
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105980745&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105980745 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02694727 EV4 jtl: Journal of Clinical Pharmacy & Therapeutics issn: 02694727 maglogo: Y pubinfo: dt: Aug2007 vid: 32 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105980745 2009640729 10.1111/j.1365-2710.2007.00833.x NLM17635340 105980745 ppf: 381 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Population pharmacokinetic investigation of digoxin in Japanese neonates. aug: au: Yukawa E Akiyama K Suematsu F Yukawa M Minemoto M affil: Laboratory of Evidence-based Pharmacotherapy, College of Pharmaceutical Sciences, Daiichi University, Minami-Ku, Fukuoka, Japan. sug: subj: Cardiotonic Agents Pharmacokinetics Digoxin Pharmacokinetics Drug Monitoring Models, Biological Body Weight Cardiotonic Agents Administration and Dosage Chaos Theory Digoxin Administration and Dosage Dose-Response Relationship, Drug Female Gestational Age Infant, Newborn Japan Male Retrospective Design Software Human Infant, Newborn: birth-1 month Female Male ab: Objective: To establish the role of patient characteristics in estimating doses of digoxin for neonates using routine therapeutic drug monitoring data. Method: The steady-state blood level data (n = 129) after repetitive oral administration in 71 hospitalized neonates were analysed using Nonlinear Mixed Effects Modelling (nonmem), a computer program designed for analysing drug pharmacokinetics in study populations through pooling of data. Analysis of the pharmacokinetics of digoxin was accomplished using a one-compartment open pharmacokinetic model. The effect of a variety of developmental and demographic factors on digoxin disposition was investigated. Results: Estimates generated by nonmem indicated that the clearance of digoxin (CL/F; L/h) was influenced by the demographic variables: total body weight (TBW), gestational age (GA) and neonate clearance factor (trough serum concentration of digoxin; Conc). These influences could be modelled by the equation CL/F = 0.0261 x TBW (kg)(0.645) x Conc (ng/mL)(-0.724) x GA (weeks)(0.8). The interindividual variability in digoxin clearance was modelled with proportional errors. The estimated coefficient of variation was 7.0%, and the residual variability was 13.1%. Conclusion: Clinical application of the model to patient care may permit selection of an appropriate initial maintenance dose, thus enabling the clinician to achieve the desired therapeutic effect. However, the digoxin dosage regimen for the individual patient should be based on a careful appraisal of their clinical need for the drug. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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