Trimethoprim-Sulfamethoxazole Pharmacokinetics during Continuous Ambulatory Peritoneal Dialysis (CAPD)

1989 ◽  
Vol 9 (1) ◽  
pp. 51-55 ◽  
Author(s):  
S.E. Walker ◽  
T.W. Paton ◽  
D.N. Churchill ◽  
B. Ojo ◽  
M.A. Manuel ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Oral Administration ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Half Life ◽  
Total Body Clearance ◽  
Route Of Administration ◽  
Adult Patients ◽  
The Mean ◽  
Total Body ◽  
Body Clearance

Ten adult patients on continuous ambulatory peritoneal dialysis (CAPO) received one dose of trimethoprim320 mg (TMP) and sulfamethoxazole 1600 mg (SMX) orally (p.o.), intravenously (i.v.), and intraperitoneally (i.p.) on three separate occasions to characterize the pharmacokinetics of both drugs. Concentrations of both TMP and SMX were measured in serum and dialysate by HPLC to 48 h. Half-life, total body clearance (TBC), and peritoneal clearance (PCI) were determined. The mean half-life of TMP was 28 h, while for SMX it was 12.5 h. Relative to the i.v. dose, the bioavailability following oral administration for TMP was 98% and 87% for SMX. Intraperitoneal bioavailability was 73% for TMP and 65% for SMX after a 4-h dwell. After 24 h, regardless of the route of administration, less than 3% of TMP and less than 6% of SMX appeared in dialysate. We conclude that peritoneal losses contribute insignificantly to TMPISMX elimination during CAPO.

Single -Dose Pefloxacin Pharmacokinetics and Metabolism in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD)

1991 ◽  
Vol 11 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Paul Nikolaidis ◽  
Scott E. Walker ◽  
Nicholas Dombros ◽  
Achilleas Tourkantonis ◽  
Tom W. Paton ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Half Life ◽  
Total Body Clearance ◽  
Serum Concentrations ◽  
Drug Concentrations ◽  
Elimination Half ◽  
The Mean ◽  
Total Body ◽  
Body Clearance

Seven adult patients on continuous ambulatory peritoneal dialysis (CAPD) received one dose of pefloxacin, a novel quinolone antibiotic, orally and intravenously on two separate occasions to characterize the pharmacokinetics and metabolism of the drug. Concentrations of both pefloxacin and its active metabolite N-desmethylpefloxacin (norfloxacin) were measured in serum and dialysate by HPLC. Half-life, total body clearance and peritoneal clearance were determined. The overall elimination half-life was 19.9h. Relative to the IV dose the bioavailability following oral administration of pefloxacin was 76%. The mean serum and dialysate concentrations were similar up to 24 h after the oral or IV dose. After a 6 h dwell time the dialysate concentration of pefloxacin was 2.24 mg/L which is above the MICgo for most bacteria responsible for peritonitis in CAPD patients. The peritoneal clearance of pefloxacin averaged 2.5 mL/min. Serum concentrations of the metabolite norfloxacin were less than 0.5 mg/L during the 24 h study period. We conclude that pefloxacin might be equally effective in the treatment of peritonitis of CAPD after oral or IV administration. Since the peritoneal clearance contributes insignificantly to the elimination of pefloxacin during CAPD, the proposed maintenance regimen of an oral or IV 400 mg dose/day seems to be a reasonable therapy for infections in CAPD patients.

Pharmacokinetics of Cefamandole in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

1983 ◽  
Vol 3 (3) ◽  
pp. 135-137 ◽  
Author(s):  
Salvador Pancorbo ◽  
Christina Comty
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Body Clearance ◽  
Volume Of Distribution ◽  
Serum Concentrations ◽  
Alternate Route ◽  
The Mean ◽  
Total Body ◽  
Body Clearance

The pharmacokinetics of cefamandole have been evaluated in five patients undergoing continuous ambulatory peritoneal dialysis (CAPD). The drug was absorbed rapidly from the peritoneum reaching peak serum concentrations averaging 31.3 mcg/ml. Approximately 72% of the dose instilled into the peritoneum was absorbed over a six hour period. Subsequently cefamandole disappeared from the serum slowly with a mean half-life of 10.4 hours. The volume of distribution was 0.25 I/kg. The calculated total body clearance averaged 20.0 ml/min and the mean dialysis clearance was 3.2 ml/min. The authors postulate that in renal failure patients cefamandole may be eliminated by an alternate route.

Disposition of Foscarnet during Peritoneal Dialysis

1996 ◽  
Vol 30 (10) ◽  
pp. 1106-1109 ◽  
Author(s):  
Alicia CM Alexander ◽  
Adam Akers ◽  
Gary R. Matzke ◽  
Francesca T. Aweeka ◽  
Donald S. Fraley
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Serum Concentration ◽  
Normal Renal Function ◽  
Half Life ◽  
Total Body Clearance ◽  
Case Summary ◽  
Clinically Significant ◽  
Total Body ◽  
Body Clearance

OBJECTIVE: To report the disposition of foscarnet in a patient undergoing peritoneal dialysis. CASE SUMMARY: A 34-year-old man with AIDS received foscarnet for the treatment of esophageal cytomegalovirus. We characterized the clearance of foscarnet in this patient during continuous cyclic peritoneal dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD). DISCUSSION: The foscarnet half-lives during CCPD and CAPD were 41.4 and 45.8 hours, respectively. These values are significantly greater than the half-life of 4.5 hours observed in patients with normal renal function and about half that reported in anuric patients undergoing hemodialysis during the interdialytic period. The CCPD and CAPD clearances of foscarnet were 5.8 and 4.5 mL/min, respectively; the CAPD clearances of creatinine and urea nitrogen were 4.1 and 6.0 mL/min, respectively. The patient's estimated total body clearance values of foscarnet during CCPD and CAPD were 9.8 and 8.8 mL/min, respectively. Thus, CCPD and CAPD augmented the patient's residual clearance of foscarnet by 145% and 105%, respectively. CONCLUSIONS: Since incremental increases in residual clearance of 30% or more generally will result in clinically significant changes in a drug's serum concentration, foscarnet dosage needs to be individualized for patients receiving peritoneal dialysis.

Dose-Ranging Pharmacokinetic Study of Ciprofloxacin after 200-, 300-, and 400-mg Intravenous Doses

1992 ◽  
Vol 26 (1) ◽  
pp. 8-10 ◽  
Author(s):  
David E. Nix ◽  
J. Michael Spivey ◽  
Allyn Norman ◽  
Jerome J. Schentag
Keyword(s):  
Steady State ◽  
Half Life ◽  
Total Body Clearance ◽  
Volume Of Distribution ◽  
Elimination Half Life ◽  
Elimination Half ◽  
The Mean ◽  
Total Body ◽  
Venous Irritation ◽  
Body Clearance

OBJECTIVE: To assess the pharmacokinetics and tolerance of ciprofloxacin after the administration of single intravenous doses of 200, 300, and 400 mg. DESIGN: Double-blind, three-period, randomized, crossover trial. SETTING: Private, university-affiliated, hospital-based, clinical research center. PATIENTS: Normal healthy male volunteers, 18–40 years of age. INTERVENTIONS: Subjects received 200-, 300-, and 400-mg single intravenous doses of ciprofloxacin via 30-minute infusions in random sequence. MAIN OUTCOME MEASURES: Serum ciprofloxacin concentrations were determined by HPLC after each dose and the results were used to derive pharmacokinetic parameters. Tolerance was assessed by reported and observed adverse events, urine microscopic examinations for crystals, and examination of intravenous infusion sites. RESULTS: The mean area under the time curve (AUC) values displayed linearity with respect to the administered dose. No statistical differences were observed in total body clearance, steady-state volume of distribution, or elimination half-life with respect to dose administered. The mean total body clearance, steady-state volume of distribution, or elimination half-life ranged from 36 to 41 L/h, 146 to 169 L, and 3.5 to 3.7 h for the 200-, 300-, and 400-mg doses, respectively. Adverse effects, including venous irritation (four subjects) and crystalluria (two subjects), were mild and did not require withdrawal of any subject from the study. CONCLUSIONS: Intravenous ciprofloxacin in doses ranging from 200 to 400 mg demonstrated linear pharmacokinetics. These single doses were well tolerated, although cases of transient venous irritation and crystalluria were observed.

scholarly journals The pharmacokinetics and bioavailability of rabeprazole following single intravenous infusion and oral administration in healthy Chinese volunteers

2011 ◽  
Vol 1 (1) ◽  
pp. 4
Author(s):  
Yongqing Wang ◽  
Hongwen Zhang ◽  
Ling Meng ◽  
Nana Tang ◽  
Hongyu Yuan ◽  
...  
Keyword(s):  
Oral Administration ◽  
Intravenous Administration ◽  
Intravenous Infusion ◽  
Half Life ◽  
Total Body Clearance ◽  
Constant Infusion ◽  
Healthy Chinese ◽  
Total Body ◽  
To Receive ◽  
Body Clearance

To investigate the pharmacokinetics and bioavailability of rabeprazole administrated by intravenous infusion and oral administration in healthy Chinese volunteers. A total of 20 male subjects were recruited and randomly assigned at the beginning of the study to receive a single dose of rabeprazole (20 mg) administrated either intravenously or orally. Following a 7-day washout period, all subjects received another 20mg dose via the alternate route. Intravenous dose was given in constant infusion over 30 min, and the oral dose was given in two 10mg tablets. Intravenous administration yielded the following measurements: the terminal half-life was (62.4±10.7) min; the Cmax was (1308.6±266.4) ng·ml-1; the total body clearance was (0.21±0.05) L·min-1; the AUC0-τ and AUC0-∞ were (99.6±21.9) mg∙min∙L-1 and (102. 4±23.3) mg∙min∙L-1, respectively. Oral administration yielded the following measurements: the half-life was (64.2±15.5) min; the Cmax was (508.3±180.2) ng·ml-1; Tmax was attained at about 229.5 min; the total body clearance was (0.31±0.10) L·min-1; the AUC0-τ and AUC0-∞ were (69.5±20.0) mg∙min∙L-1 and (70.6±20.2) mg∙min∙L-1, respectively. The bioavailability of rabeprazole was estimated to be 70.1% in healthy Chinese volunteers. The total body clearance after oral administration was significantly higher than that measured following intravenous administration (P <0.01).

Cimetidine Disposition in Patients on Continuous Ambulatory Peritoneal Dialysis

1981 ◽  
Vol 2 (2) ◽  
pp. 73-76 ◽  
Author(s):  
Thomas W. Paton ◽  
M. Arifie Manuel ◽  
Scott E. Walker
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Total Body Clearance ◽  
Beta Phase ◽  
Male Patients ◽  
Total Body ◽  
Stage Renal Disease ◽  
End Stage ◽  
Body Clearance

The disposition of cimetidine was studied following a single intrave nous dose of 300 mg over 10 minutes in six male patients with end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD). The infusion of cimetidine and CAPD were initiated simultaneously. Cimetidine disappearance from plasma was biphasic with beta-phase ti varying from 6.1 to 7.4 hours. The total body clearance varied from 138 to 195 ml/min with a peritoneal clearance ranging from 1.9 to 4.0 ml/min. The total amount of cimetidine removed in the dialysate varied from 3.1 to 8.3 mg (1.2 to 2.7% of the dose administered) over 24 hours. This study demonstrates that very little cimetidine is removed by CAPD. We recommend that, to avoid toxicity, patients on CAPD should be given 200 mg cimetidine every 12 hours.

scholarly journals Pharmacokinetics of Intravenous Piperacillin Administration in Patients Undergoing On-Line Hemodiafiltration

2009 ◽  
Vol 53 (8) ◽  
pp. 3266-3268 ◽  
Author(s):  
Kook-Hwan Oh ◽  
Chiweon Kim ◽  
Hankyu Lee ◽  
Hajeong Lee ◽  
Ji Yong Jung ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Total Body Clearance ◽  
Volume Of Distribution ◽  
Pharmacokinetic Parameters ◽  
Recovery Method ◽  
Elimination Half ◽  
On Line ◽  
The Mean ◽  
Total Body ◽  
Body Clearance

ABSTRACT The pharmacokinetic characteristics of piperacillin sodium were studied in five volunteers undergoing on-line hemodiafiltration (HDF). The subjects were given 2 g of piperacillin sodium intravenously over 1 min and placed on on-line HDF for 4 h starting at 60 min after the piperacillin infusion. Noncompartmental models were employed for estimation of the pharmacokinetic parameters, and intradialytic piperacillin clearance was calculated by the recovery method. The mean volume of distribution and the elimination half-life were 0.27 ± 0.13 liter/kg (mean ± standard deviation) and 1.1 ± 0.6 h, respectively. The total body clearance of piperacillin was 0.19 ± 0.08 liter/h/kg. Piperacillin clearance through on-line HDF was 0.11 ± 0.06 liter/h/kg. The mean serum piperacillin concentration was 4.0 ± 1.9 μg/ml at the end of the 4-h on-line HDF session. The concentration of infused piperacillin recovered in the dialysate was 527 ± 236 mg (26.3% ± 11.8%). We suggest the replacement of 500 mg of piperacillin after each on-line HDF session.

Pharmacokinetics of Intermittent Intraperitoneal Cefazolin in Continuous Ambulatory Peritoneal Dialysis Patients

1999 ◽  
Vol 19 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Harold J. Manley ◽  
George R. Bailie ◽  
Rupesh D. Asher ◽  
George Eisele ◽  
Reginald F. Frye
Keyword(s):  
Body Weight ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Rate Constant ◽  
Half Life ◽  
Elimination Rate ◽  
Pharmacokinetic Parameters ◽  
Number Of Patients ◽  
The Mean ◽  
Concentration Levels

Objective To investigate the pharmacokinetic parameters of intermittent intraperitoneal (IP) cefazolin, and recommend a cefazolin dosing regimen in continuous ambulatory peritoneal dialysis (CAPD) patients. Design Prospective nonrandomized open study. Setting CAPD outpatient clinic in Albany, New York. Patients Seven volunteer CAPD patients without peritonitis. Three of the patients were nonanuric while 4 were anuric. Interventions Cefazolin (15 mg/kg total body weight) was given to each patient during the first peritoneal exchange. Blood and dialysate samples were collected at times 0, 0.5, 1, 2, 3, 6 (end of the first antibiotic-containing dwell), 24, and 48 hours after the administration of IP cefazolin. Urine samples were collected in nonanuric patients over the study period. Results The mean ± SD amount of cefazolin dose absorbed from the dialysate after the 6-hour dwell was 69.7% ± 8.0% of the administered dose. The cefazolin absorption rate constant from dialysate to serum was 0.21 ± 0.1 /hr (absorption half-life 3.5 ± 0.8 hr). The mean serum concentrations reached at 24 and 48 hours were 52.4 ± 3.7 mg/L and 30.3 ± 5.9 mg/L, respectively. The mean dialysate cefazolin concentrations reached at 24 and 48 hours were 15.1 ± 3.4 mg/L and 7.9 ± 1.4 mg/L, respectively. The cefazolin serum elimination rate constant was 0.02 ± 0.01 /hr (elimination half-life 31.5 ± 8.8 hr). The total cefazolin body clearance was 3.4 ± 0.6 mL/min. In the 3 nonanuric patients the mean renal clearance of cefazolin was 0.6 ± 0.4 mL/min. The peritoneal clearance of cefazolin was 1.0 ± 0.3 mL/min. The systemic volume of distribution of cefazolin was 0.2 ± 0.05 L/kg. No statistical difference was detected in pharmacokinetic parameters between anuric and nonanuric patients, although this may be due to the small number of patients in each group. Conclusion A single daily dose of cefazolin dosed at 15 mg/kg actual body weight in CAPD patients is effective in achieving serum concentration levels greater than the minimum inhibitory concentration for sensitive organisms over 48 hours, and dialysate concentration levels over 24 hours. Caution is warranted in extrapolation of dosing recommendations to patients who maintain a significant degree of residual renal function.

Combined Boric Acid and Cinchocaine Chloride Poisoning in a 12-month-old Infant: Evaluation of Haemodialysis

1988 ◽  
Vol 7 (2) ◽  
pp. 175-178 ◽  
Author(s):  
M. Egfjord ◽  
J.A. Jansen ◽  
H. Flachs ◽  
J.S. Schou
Keyword(s):  
Renal Function ◽  
Boric Acid ◽  
Half Life ◽  
Total Body Clearance ◽  
Renal Toxicity ◽  
Chloride Poisoning ◽  
Total Body ◽  
Plasma Half Life ◽  
Body Clearance

A mixture containing 3 g of boric acid and 300 mg of cinchocaine chloride prescribed due to painful dental protrusion was accidentally ingested by a 12-month-old girl. She developed violent vomiting and coughing. Irritability, tremor, seizures and a delirious reaction. She was treated with diazepam, intubated, sedated and ventilated. Her diuresis was stimulated with furosemide and fluid. Within the first 24 h she was treated with haemodialysis twice on femoral catheters. Her renal function was unaffected. In two days she fully recovered. The maximum measured levels of boric acid and cinchocaine chloride approximately 6 h after ingestion were 26 μg/ml and 71 ng/ml respectively. The plasma half-life of boric acid was 7.0 h and decreased to 3.6 and 4.4 h during the two haemodialyses. The total body clearance of boric acid increased correspondingly from 21 ml/min to 41 and 34 ml/min. The in vitro clearance of boric acid of the dialyser was later determined to be 18 ml/min. It is concluded that haemodialysis is valuable in the treatment of boric acid intoxication because it increases the elimination of the drug even in patients without any sign of renal toxicity.

Pharmacokinetics in the human of a new synthetic vasopressin and oxytocin uterine antagonist

1986 ◽  
Vol 112 (4) ◽  
pp. 465-472 ◽  
Author(s):  
Stefan Lundin ◽  
Mats Åkerlund ◽  
Per-Olof Fagerström ◽  
Arnar Hauksson ◽  
Per Melin
Keyword(s):  
Body Weight ◽  
Half Life ◽  
Intranasal Administration ◽  
Bolus Injection ◽  
Total Body Clearance ◽  
Late Pregnancy ◽  
Primary Dysmenorrhoea ◽  
Total Body ◽  
Observation Period ◽  
Body Clearance

Abstract. The pharmacokinetics in the human of 1-deamino-2-D-Tyr(OEt)-4-Thr-8-Orn-vasotocin (dE-TVT), was studied after iv and intranasal administration in 11 subjects at 12 experiments each route. The plasma concentration of the analogue was analysed by means of an arginine vasopressin antibody, which cross-reacted with dE-TVT to 4.7%. When given intravenously as bolus injection (10 nmol/kg/body weight), the total body clearance amounted to 0.623 ± 0.099 (sem) 1/h kg and the half-life to 16.2 ± 2.4 min. After intranasal administration (100 nmol/kg/body weight), the bioavailability was 10.5 ± 2.9%. Peak concentrations in plasma appeared 2–8 min after iv and 10–45 min after intranasal administration. At the end of an observation period of 2 h measurable amounts in plasma were still found in one of the iv and seven of the intranasal experiments. It is concluded that the moderately long half-life is suitable for the treatment of hospitalized patients in premature labour where promising results with intravenous infusion (50 μg/min) of dE-TVT have been obtained. It is still uncertain whether or not the absorption of dE-TVT is sufficient for intranasal administration to out-patients with uterine hyperactivity in late pregnancy and to patients with primary dysmenorrhoea, where significant relief of symptoms were seen after iv administration (10 μg/kg body weight).

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