Clozapine Once-Daily Versus Divided Dosing Regimen

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kohei Kitagawa ◽  
Ryuhei So ◽  
Nobuyuki Nomura ◽  
Masaru Tsukahara ◽  
Fuminari Misawa ◽  
...  
Keyword(s):  
Dosing Regimen ◽  
Once Daily

Evaluation of Low-Dose Gentamicin Once Daily Dosing Regimen at A General Hospital in Malaysia

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Ab Rahman A F ◽  
Md Sahak N. ◽  
Ali A. M.
Keyword(s):  
Medical Records ◽  
Public Hospital ◽  
Low Dose ◽  
Dosing Regimen ◽  
Once Daily ◽  
Neutropenic Sepsis ◽  
Wide Acceptance ◽  
The Mean ◽  
Initiation Of Therapy ◽  
Almost All

Objective: Once daily dosing (ODD) aminoglycoside is gaining wide acceptance as an alternative way of dosing. In our setting it is the regimen of choice whenever gentamicin is indicated. The objective of this study was to evaluate the practice of gentamicin ODD in a public hospital in Malaysia. Methods: We conducted a retrospective review of medical records of patients on gentamicin ODD who were admitted to Hospital Melaka during January 2002 until March 2010. All adult patients who were on ODD gentamicin with various level of renal function were included in the study. Patients on gentamicin less than 72 hours and pregnant women were excluded. Results: From 110 patients, 75 (68.2%) were male and 35 (31.8%) were female. Indications for ODD gentamicin included pneumonia, 34 (31.0%) neutropenic sepsis, 27 (24.5%) and sepsis, 11 (10.0%). The mean dose and duration of gentamicin was 3.2 mg/kg/day and 7 days, respectively. Almost all patients were on gentamicin combined with other antibiotics. Clinical cure based on fever resolution was found in 89.1% of patients treated with ODD. Resolution of fever took an average of 48 hours after initiation of therapy. The evaluation for bacteriologic cure could not be performed because of insufficient data on culture and sensitivity. Out of 38 patients with analyzable serum creatinine data, four patients might have developed nephrotoxicity. Conclusion: In our setting, lower dosages of ODD gentamicin when used in combination with other antibiotics seemed to be effective and safe in treating most gram negative infections.

Application of Exposure-Response Analyses to Establish the Pharmacodynamic Similarity of a Once-Daily Regimen to an Approved Twice-Daily Dosing Regimen for the Treatment of HCV Infection

2017 ◽  
Vol 19 (5) ◽  
pp. 1523-1535
Author(s):  
Akshanth R. Polepally ◽  
Haoyu Wang ◽  
Patrick J. Marroum ◽  
Mukul Minocha ◽  
Balakrishna Hosmane ◽  
...  
Keyword(s):  
Hcv Infection ◽  
Daily Regimen ◽  
Dosing Regimen ◽  
Once Daily ◽  
Exposure Response

Compliance as a Factor in the Development of Nitrate Tolerance: A Patient Investigation

1993 ◽  
Vol 21 (1) ◽  
pp. 51-57 ◽  
Author(s):  
P Löfdahl
Keyword(s):  
Angina Pectoris ◽  
Nitrate Concentration ◽  
Nitrate Tolerance ◽  
Isosorbide Mononitrate ◽  
Dosing Regimen ◽  
Once Daily ◽  
Telephone Interviews ◽  
The Times ◽  
Plasma Nitrate ◽  
Long Acting

Telephone interviews were conducted to establish the prescribing instructions given by experienced physicians to patients with angina pectoris treated with long-acting nitrates. In addition, the times of day when doses were taken were recorded. The aim of the study was to determine whether or not an asymmetric dosing regimen was being followed by the patients. The majority (62.7%) of patients were being treated with 5-isosorbide mononitrate taken orally twice daily. All but two took the correct number of tablets, but more than 50% of these patients were not taking the second tablet at the correct time to achieve the recommended 6 − 8-h period during which the plasma nitrate concentration was sufficiently low to avoid nitrate tolerance. Possible explanations for the incorrect use of the prescribed drug may be that the patients did not understand the physician's instructions and did not appreciate the importance of rigidly adhering to these instructions. A more satisfactory approach, with improved patient compliance, may be a once-daily dosing regimen.

scholarly journals Comparison of Once-Daily versus Twice-Daily Administration of Cefdinir against Typical Bacterial Respiratory Tract Pathogens

2001 ◽  
Vol 45 (10) ◽  
pp. 2936-2938 ◽  
Author(s):  
Gigi H. Ross ◽  
Laurie Baeker Hovde ◽  
Khalid H. Ibrahim ◽  
Yasir H. Ibrahim ◽  
John C. Rotschafer
Keyword(s):  
Respiratory Tract ◽  
Community Acquired Pneumonia ◽  
Pharmacodynamic Model ◽  
Daily Administration ◽  
Respiratory Pathogens ◽  
Daily Regimen ◽  
Dosing Regimen ◽  
Once Daily ◽  
Dosing Strategy

ABSTRACT In an in vitro pharmacodynamic model, a twice-daily cefdinir dosing regimen was more effective than a once-daily regimen against common bacterial respiratory pathogens in producing 3-log10killing and preventing the occurrence of regrowth at 24 h. Twice-daily administration is likely the more appropriate cefdinir dosing strategy for the treatment of community-acquired pneumonia.

scholarly journals A simple, once-daily dosing regimen for treating HIV-1 infection in intravenous drug users

HIV Medicine ◽  
2000 ◽  
Vol 1 (3) ◽  
pp. 162-163 ◽  
Author(s):  
S Staszewski ◽  
A Haberl ◽  
A Carlebach ◽  
C Rottmann ◽  
V Miller ◽  
...  
Keyword(s):  
Drug Users ◽  
Intravenous Drug ◽  
Intravenous Drug Users ◽  
Dosing Regimen ◽  
Once Daily ◽  
Hiv 1

scholarly journals MK-5172, a Selective Inhibitor of Hepatitis C Virus NS3/4a Protease with Broad Activity across Genotypes and Resistant Variants

2012 ◽  
Vol 56 (8) ◽  
pp. 4161-4167 ◽  
Author(s):  
Vincenzo Summa ◽  
Steven W. Ludmerer ◽  
John A. McCauley ◽  
Christine Fandozzi ◽  
Christine Burlein ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Protease Inhibitors ◽  
Selective Pressure ◽  
Pegylated Interferon ◽  
Therapeutic Agents ◽  
Hepatitis C Virus Infection ◽  
Dosing Regimen ◽  
Once Daily ◽  
Hcv Genotypes

ABSTRACTHCV NS3/4a protease inhibitors are proven therapeutic agents against chronic hepatitis C virus infection, with boceprevir and telaprevir having recently received regulatory approval as add-on therapy to pegylated interferon/ribavirin for patients harboring genotype 1 infections. Overcoming antiviral resistance, broad genotype coverage, and a convenient dosing regimen are important attributes for future agents to be used in combinations without interferon. In this communication, we report the preclinical profile of MK-5172, a novel P2-P4 quinoxaline macrocyclic NS3/4a protease inhibitor currently in clinical development. The compound demonstrates subnanomolar activity against a broad enzyme panel encompassing major hepatitis C virus (HCV) genotypes as well as variants resistant to earlier protease inhibitors. In replicon selections, MK-5172 exerted high selective pressure, which yielded few resistant colonies. In both rat and dog, MK-5172 demonstrates good plasma and liver exposures, with 24-h liver levels suggestive of once-daily dosing. When administered to HCV-infected chimpanzees harboring chronic gt1a or gt1b infections, MK-5172 suppressed viral load between 4 to 5 logs at a dose of 1 mg/kg of body weight twice daily (b.i.d.) for 7 days. Based on its preclinical profile, MK-5172 is anticipated to be broadly active against multiple HCV genotypes and clinically important resistance variants and highly suited for incorporation into newer all-oral regimens.

scholarly journals Pharmacokinetics and Safety of Caspofungin in Older Infants and Toddlers

2008 ◽  
Vol 53 (4) ◽  
pp. 1450-1456 ◽  
Author(s):  
Michael Neely ◽  
Hasan S. Jafri ◽  
Nita Seibel ◽  
Katherine Knapp ◽  
Peter C. Adamson ◽  
...  
Keyword(s):  
Adverse Events ◽  
Peak Concentration ◽  
High Performance ◽  
Geometric Mean ◽  
Area Under The Curve ◽  
Efficacy And Safety ◽  
Infants And Toddlers ◽  
Dosing Regimen ◽  
Elimination Phase ◽  
Once Daily

ABSTRACT Although information about the efficacy and safety experience with caspofungin at 50 mg/m2 daily is available for children and adolescents, the dosing regimen in infants and toddlers 3 to 24 months of age has yet to be established. We studied the pharmacokinetics and safety of caspofungin at 50 mg/m2 once daily in nine patients 10 to 22 months (median, 13 months) of age with fever and neutropenia who received caspofungin once daily for 2 to 21 (mean, 9.3) days. Plasma caspofungin concentrations were measured by high-performance liquid chromatography assay on days 1 and 4. On day 4, the area under the curve from 0 to 24 h (AUC0-24) was 130.3 μg-h/ml, the peak concentration (C 1) was 17.2 μg/ml, and the trough concentration (C 24) was 1.6 μg/ml. The day 4 geometric mean ratios (GMRs) and 90% confidence interval (CI) for these parameters in infants/toddlers relative to adults were 1.26 (1.06, 1.50), 1.83 (1.57, 2.14), and 0.81 (0.64, 1.04), respectively. Relative to children (2 to 11 years of age), the day 4 GMRs (and 90% CI) were 1.13 (0.89, 1.44), 1.10 (0.85, 1.42), and 1.12 (0.72, 1.76), respectively. The harmonic mean elimination phase t 1/2 in infants/toddlers (8.8 h) was reduced ∼33% relative to adults (13.0 h) but was similar to that in children (8.2 h). Clinical adverse events occurred in seven patients (78%); none were considered drug related. Laboratory adverse events occurred in five patients (56%) and were considered drug related in three (33%). There were no infusion-related events or discontinuations due to toxicity. Caspofungin at 50 mg/m2 daily was well tolerated in infants and toddlers; the AUC and caspofungin C 24 were generally comparable to those in adults receiving caspofungin at 50 mg daily.

scholarly journals Serum Bactericidal Activities of High-Dose Daptomycin with and without Coadministration of Gentamicin against Isolates of Staphylococcus aureus and Enterococcus species

2006 ◽  
Vol 50 (11) ◽  
pp. 3529-3534 ◽  
Author(s):  
C. Andrew DeRyke ◽  
Christina Sutherland ◽  
Bo Zhang ◽  
David P. Nicolau ◽  
Joseph L. Kuti
Keyword(s):  
Staphylococcus Aureus ◽  
Bactericidal Activity ◽  
Pharmacokinetic Profile ◽  
High Dose ◽  
Dosing Regimen ◽  
Time Curve ◽  
Once Daily ◽  
Vancomycin Resistant ◽  
Bactericidal Activities ◽  
Randomized Crossover Study

ABSTRACT The purpose of this experiment was to evaluate the pharmacokinetics and serum bactericidal titers (SBTs) of daptomycin alone and in combination with gentamicin against strains of Staphylococcus aureus and enterococci to determine if there might be any benefit to the addition of the aminoglycoside. A multiple-dose, randomized crossover study was performed in 11 healthy volunteers to evaluate the steady-state pharmacokinetic profile of 6 mg/kg of body weight daptomycin once daily with or without 1 mg/kg gentamicin every 8 h. SBTs were determined against clinical isolates of nosocomial (MRSA 494) and community-acquired (CA-MRSA 44) methicillin-resistant S. aureus, vancomycin-susceptible Enterococcus faecalis (VSEF 49452), vancomycin-resistant Enterococcus faecium (VREF 80), and quality control strains of methicillin-susceptible S. aureus (ATCC 29213) and vancomycin-susceptible E. faecalis (ATCC 29212). Enhancement of bactericidal activity was evaluated by calculating and comparing the areas under the bactericidal curve (AUBC) for each dosing regimen against each isolate. The area under the concentration-time curve from 0 to 24 h and clearance for daptomycin alone were 645 ± 91 μg · h/ml and 9.47 ± 1.4 mg/h/kg, respectively, compared with 642 ± 69 μg · h/ml and 9.45 ± 1.0 mg/h/kg for daptomycin plus gentamicin. Daptomycin alone displayed sustained bactericidal activity against five of the six isolates over the entire 24-h dosing interval; bactericidal activity was maintained for 8 h against VREF 80. Mean AUBCs for daptomycin alone ranged from 935 to 1,263 and 36 to 238 against staphylococcal and enterococcal isolates, respectively, compared with 902 to 972 and 34 to 213 against staphylococci and enterococci when coadministered with gentamicin. The results of this study suggest that the addition of gentamicin does not alter the pharmacokinetic profile or enhance the bactericidal activity of daptomycin against staphylococcal or enterococcal isolates.

scholarly journals Pharmacokinetics of Two Multiple-Dosing Regimens of D0870 in Human Immunodeficiency Virus-Positive Patients: a Phase I Study

1998 ◽  
Vol 42 (4) ◽  
pp. 903-906 ◽  
Author(s):  
S. De Wit ◽  
E. O’Doherty ◽  
J. Edwards ◽  
R. Yates ◽  
R. P. Smith ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Adverse Events ◽  
Hiv Positive ◽  
Loading Dose ◽  
Dosing Regimen ◽  
Accumulation Ratio ◽  
Once Daily ◽  
Immunodeficiency Virus ◽  
Dosing Regimens ◽  
Oral Doses

ABSTRACT D0870 is a triazole with a broad antifungal spectrum, and it has been shown to have both in vitro and in vivo activities against wild-type and fluconazole-resistant strains of Candida albicans. Twenty-two human immunodeficiency virus (HIV)-positive male subjects were enrolled in an open, nonrandomized trial investigating the pharmacokinetics of two different dosing regimens of D0870 and assessing the safety of multiple oral doses of D0870 in HIV-positive subjects and their ability to tolerate multiple oral doses. Nine subjects received an initial loading dose of 50 mg, followed by four once-daily maintenance doses of 10 mg. A further nine subjects received an initial 200-mg loading dose followed by four daily maintenance doses of 25 mg. All subjects were fasting. A single loading dose of 50 mg of D0870 resulted in a mean maximum concentration in serum (C max) of 107 ± 32 ng/ml. Concentrations in plasma were maintained by the 10-mg once-daily dosing regimen as seen by the similar values of the area under the concentration-time curve from 0 to 24 h following dosing on days 1 and 5 and a mean accumulation ratio close to unity (0.90). The terminal plasma half-life of D0870 in plasma following dosing on day 5 ranged from 23 to 85 h (mean, 49 h). A single loading dose of 200 mg of D0870 resulted in a C max of 431 ± 186 ng/ml. Concentrations in plasma were again maintained by the 25-mg daily dosing regimen, with the mean accumulation ratio being close to unity (1.17). The terminal half-life of D0870 in plasma following dosing on day 5 of phase II of the study ranged from 34 to 137 h (mean, 71 h). In addition, the concentrations achieved in the plasma of these HIV-positive subjects were similar to the values predicted from simulations based on data derived from normal, healthy subjects. D0870 was well tolerated. No serious adverse events were experienced during the course of the study, and all volunteers completed the trial. A total of 15 adverse events were reported, but none were considered to be related to the administration of D0870 and all had resolved by the end of the trial. No changes in the hematology, clinical chemistry, or urinalysis parameters were considered to be related to dosing with D0870. No clinically significant changes in the electrocardiogram parameters were noted during the trial. The data generated in this trial support further investigation of these regimens with HIV-positive subjects with fluconazole-susceptible or -resistant oropharyngeal candidosis.

Sign in / Sign up

Export Citation Format

Share Document