내과계 중환자에서 THEOPHYLLINE clearance에 영향을 미치는 인자
Factors for affecting a theophylline clearance in medically ill patients
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
To investigate the factors for affecting a theophylline clearance, we conducted the study on the MICU patients who were hospitalized from June 2006 to April 2008 in tertiary hospital, who took theophylline and evaluated serum drug concentration at steady state by using CAPCIL program. The data was collected retrospectively by medical chart review. In pharmacokinetics of theophylline, average peak concentration was 8.4 mg/L and trough was 6.0 mg/L. The volume of distribution ranged from 0.33 to 0.75 L/kg. Half-life was 10.7 hours and average clearance was 0.04 L/kg/hr in ICU patients. Theophylline clearance was highly correlated with age, body weight, and APHACH Ⅱ score. Clearance was high who using low molecular weight heparin. Clearance of Patients who showed hypokalemia and atrial fibrillation, were low. In multivariate analysis, using LMWH and underweight are statistically significant factors for theophylline clearance. In conclusion, many factors influenced theophylline clearance in ICU patients and it would be harder to set a dosage of theophylline than general patients because of these complicated factors. Therefore, to desing an appropriate dosage shoud be needed for drug efficacy and safety in ICU patients.
Abstract
To investigate the factors for affecting a theophylline clearance, we conducted the study on the MICU patients who were hospitalized from June 2006 to April 2008 in tertiary hospital, who took theophylline and evaluated serum drug concentration at steady state by using CAPCIL program. The data was collected retrospectively by medical chart review. In pharmacokinetics of theophylline, average peak concentration was 8.4 mg/L and trough was 6.0 mg/L. The volume of distribution ranged from 0.33 to 0.75 L/kg. Half-life was 10.7 hours and average clearance was 0.04 L/kg/hr in ICU patients. Theophylline clearance was highly correlated with age, body weight, and APHACH Ⅱ score. Clearance was high who using low molecular weight heparin. Clearance of Patients who showed hypokalemia and atrial fibrillation, were low. In multivariate analysis, using LMWH and underweight are statistically significant factors for theophylline clearance. In conclusion, many factors influenced theophylline clearance in ICU patients and it would be harder to set a dosage of theophylline than general patients because of these complicated factors. Therefore, to desing an appropriate dosage shoud be needed for drug efficacy and safety in ICU patients.
참고문헌 (11)
- John moxham, "morris and Malcolm Green : Effect of aminophylline on the human diaphragm", Thorax, 40, pp.288~292 (1985)
- Richard L.ZuWallack, "Salmeterol plus theophylline combination therapy in the treatment of COPD", Chest, 119, pp.1661~1670 (2001)
- Pretzlaff, R.K., "Aminophylline in the treatment of fluid overload", Critical care med, 27(12), pp.2782~2785 (1999)
- Michael E. Winter, "Basic clinical pharmacokinetics", pp.39~53 (2004), Lippincott Williams & Wilkins
- Akihiro Ohnishi, "Differential Pharmacokinetics of Theophylline in Elderly Patiens", Drugs Aging, 20(1), pp.71~84 (2003)
- Effect of Acute Aminophylline administration on Diaphragm Function in High Cervical Tetraplegia-a case report, "Amy T. Bascom", Chest, 658~661 (2005)
- D.B., Chang, "Clearance of theophylline by hemodialysis in one patient with chronic renal failure", Chest, 102, pp.1621~1623 (1992)
- Wolfgang Huber, "Reduced incidence of radiocontrast induced nephropathy in ICU patients under theophylline prophylxis: a prospective comparison to series of patients at similar risk", Intensive care med, 27, pp.1200~1209 (2001)
- Leslie Hendeles, "Update on the Pharmacodynamics and Pharmacokinetics of Theophylline", Chest, 88, pp.103~111 (1985)
- J. Gregory gillum, "Induction of theophylline clearance by rifampin and rifabutin in healthy male volunteers", Antimicrobial Agents And Chemotherapy, 40(8), pp.1866~1869 (1996)
- Loi C-M, "Aging and drug interactions. Ⅲ . Individual and combined effects of cimetidine and ciprofloxacin on theophylline metabolism in healthy male and female nonsmokers", J Pharmacol Exp Ther, 280, pp.627~637 (1997)