A genetic-based population PK/PD modeling of methadone in Chinese opiate dependence patients

2022 ◽  
Author(s):  
Dong Guo ◽  
Zhirong Tan ◽  
Xiaoya Lou ◽  
Shan Shi ◽  
Yan Shu ◽  
...  
Keyword(s):  
Opiate Dependence ◽  
Population Pk

Classical conditioning in opiate dependence.

1984 ◽  
Author(s):  
Charles P. O'Brien ◽  
Ronald N. Ehrman ◽  
Joseph W. Ternes
Keyword(s):  
Classical Conditioning ◽  
Opiate Dependence

Clinical Pharmacokinetic Studies in Pregnant Women and the Relevance of Pharmacometric Tools

2019 ◽  
Vol 25 (5) ◽  
pp. 483-495 ◽  
Author(s):  
André Dallmann ◽  
Paola Mian ◽  
Johannes Van den Anker ◽  
Karel Allegaert
Keyword(s):  
Pregnant Women ◽  
Clinical Pharmacokinetic ◽  
Individual Variability ◽  
Current Status ◽  
Pharmacokinetic Studies ◽  
Full Potential ◽  
Pbpk Models ◽  
Pregnancy And Postpartum ◽  
Population Pk ◽  
The Impact

Background: In clinical pharmacokinetic (PK) studies, pregnant women are significantly underrepresented because of ethical and legal reasons which lead to a paucity of information on potential PK changes in this population. As a consequence, pharmacometric tools became instrumental to explore and quantify the impact of PK changes during pregnancy. Methods: We explore and discuss the typical characteristics of population PK and physiologically based pharmacokinetic (PBPK) models with a specific focus on pregnancy and postpartum. Results: Population PK models enable the analysis of dense, sparse or unbalanced data to explore covariates in order to (partly) explain inter-individual variability (including pregnancy) and to individualize dosing. For population PK models, we subsequently used an illustrative approach with ketorolac data to highlight the relevance of enantiomer specific modeling for racemic drugs during pregnancy, while data on antibiotic prophylaxis (cefazolin) during surgery illustrate the specific characteristics of the fetal compartments in the presence of timeconcentration profiles. For PBPK models, an overview on the current status of reports and papers during pregnancy is followed by a PBPK cefuroxime model to illustrate the added benefit of PBPK in evaluating dosing regimens in pregnant women. Conclusions: Pharmacometric tools became very instrumental to improve perinatal pharmacology. However, to reach their full potential, multidisciplinary collaboration and structured efforts are needed to generate more information from already available datasets, to share data and models, and to stimulate cross talk between clinicians and pharmacometricians to generate specific observations (pathophysiology during pregnancy, breastfeeding) needed to further develop the field.

Interaction between methadone and clarithromycin as the suspected cause of an opioid toxidrome

2021 ◽  
Vol 14 (5) ◽  
pp. e240647
Author(s):  
Blair Wallace ◽  
Daniel Edwardes ◽  
Christian Subbe ◽  
Muhammed Murtaza
Keyword(s):  
Respiratory Failure ◽  
Community Acquired Pneumonia ◽  
Opiate Dependence ◽  
Pleuritic Chest Pain ◽  
Once Daily ◽  
High Importance ◽  
Level Of Consciousness ◽  
The World ◽  
History Of

A 40-year-old patient was admitted through the acute medical take with pleuritic chest pain and rigours. He had a medical history of opiate dependence and was receiving 60 mg of methadone once daily. He was diagnosed with a community-acquired pneumonia and treated with amoxicillin and clarithromycin. After administration of only two concomitant doses of methadone and oral clarithromycin, he developed an opioid toxidrome with type-2 respiratory failure, a decreased level of consciousness and pinpoint pupils. The patient was treated with naloxone and his symptoms improved. Retrospectively, it was suspected that an interaction between clarithromycin and methadone might have contributed to the toxidrome. Respiratory failure has not been previously prescribed for this combination of medication and is of high importance for physicians and pharmacists around the world.

Effect of craving induction on inhibitory control in opiate dependence

2011 ◽  
Vol 219 (2) ◽  
pp. 519-526 ◽  
Author(s):  
Antonio Verdejo-García ◽  
Dan I. Lubman ◽  
Anne Schwerk ◽  
Kim Roffel ◽  
Raquel Vilar-López ◽  
...  
Keyword(s):  
Inhibitory Control ◽  
Opiate Dependence

Levomethadyl in Maintenance Treatment of Opiate Dependence

JAMA ◽  
1972 ◽  
Vol 220 (6) ◽  
pp. 811 ◽  
Author(s):  
Arthur Zaks
Keyword(s):  
Maintenance Treatment ◽  
Opiate Dependence

Three new residual error models for population PK/PD analyses

1995 ◽  
Vol 23 (6) ◽  
pp. 651-672 ◽  
Author(s):  
Mats O. Karlsson ◽  
Stuart L. Beal ◽  
Lewis B. Sheiner
Keyword(s):  
Residual Error ◽  
Error Models ◽  
Population Pk

Methods to detect non-compliance and reduce its impact on population PK parameter estimates

2014 ◽  
Vol 41 (3) ◽  
pp. 279-289 ◽  
Author(s):  
Leonid Gibiansky ◽  
Ekaterina Gibiansky ◽  
Valerie Cosson ◽  
Nicolas Frey ◽  
Franziska Schaedeli Stark
Keyword(s):  
Parameter Estimates ◽  
Population Pk

scholarly journals Population Pharmacokinetics and Probability of Target Attainment of Different Dosing Regimens of Ceftazidime in Critically Ill Patients with a Proven or Suspected Pseudomonas aeruginosa Infection

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 612
Author(s):  
Annabel Werumeus Buning ◽  
Caspar J. Hodiamont ◽  
Natalia M. Lechner ◽  
Margriet Schokkin ◽  
Paul W. G. Elbers ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Hematologic Malignancy ◽  
Compartment Model ◽  
Target Attainment ◽  
Worst Case ◽  
Optimal Dosing ◽  
Population Pk ◽  
Pseudomonas Aeruginosa Infection

Altered pharmacokinetics (PK) of hydrophilic antibiotics in critically ill patients is common, with possible consequences for efficacy and resistance. We aimed to describe ceftazidime population PK in critically ill patients with a proven or suspected Pseudomonas aeruginosa infection and to establish optimal dosing. Blood samples were collected for ceftazidime concentration measurement. A population PK model was constructed, and probability of target attainment (PTA) was assessed for targets 100% T > MIC and 100% T > 4 × MIC in the first 24 h. Ninety-six patients yielded 368 ceftazidime concentrations. In a one-compartment model, variability in ceftazidime clearance (CL) showed association with CVVH. For patients not receiving CVVH, variability in ceftazidime CL was 103.4% and showed positive associations with creatinine clearance and with the comorbidities hematologic malignancy, trauma or head injury, explaining 65.2% of variability. For patients treated for at least 24 h and assuming a worst-case MIC of 8 mg/L, PTA was 77% for 100% T > MIC and 14% for 100% T > 4 × MIC. Patients receiving loading doses before continuous infusion demonstrated higher PTA than patients who did not (100% T > MIC: 95% (n = 65) vs. 13% (n = 15); p < 0.001 and 100% T > 4 × MIC: 20% vs. 0%; p = 0.058). The considerable IIV in ceftazidime PK in ICU patients could largely be explained by renal function, CVVH use and several comorbidities. Critically ill patients are at risk for underexposure to ceftazidime when empirically aiming for the breakpoint MIC for P. aeruginosa. A loading dose is recommended.

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