In this study,we aimed to develop and evaluate a whole-body physiologically based pharmacokinetic(WB-PBPK)/pharmacodynamic(PD)model for saxagliptin,simulate its pharmacokinetic and pharmacodynamic properties in health...In this study,we aimed to develop and evaluate a whole-body physiologically based pharmacokinetic(WB-PBPK)/pharmacodynamic(PD)model for saxagliptin,simulate its pharmacokinetic and pharmacodynamic properties in healthy adults and patients with hepatic function impairment,and provide a new method for the research to the clinical pharmacy of special patients.Based on the drug-specific properties,such as log D,plasma protein binding collected by the published literature,the WB-PBPK model and the PD model were established.After comparing the simulated concentration-time profiles and the pharmacokinetic parameters with data in healthy adults from oral and intravenous clinical investigation,the WB-PBPK model could be optimized.After comparing the simulated DPP-4 inhibition profile with the observed pharmacodynamic in healthy subjects,the PD model could be optimized.The PK/PD model was utilized to predict the mean and variability of the pharmacokinetic and pharmacodynamic profiles in subjects with different hepatic impairment.All of the predicted pharmacokinetic curves were comparable to the observed curves both in healthy subjects and hepatic impairment subjects(Cmax and AUC were less than 1.3-fold).The predicted pharmacodynamic curves were comparable to the observed ones in different oral dosage after optimization,and pharmacodynamics of saxagliptin in hepatic impairment subjects were predicted successfully.The WB-PBPK/PD model can accurately simulate the pharmacokinetics and pharmacodynamics of saxagliptin in normal adults and different hepatic impaired patients.展开更多
In the present study,we optimized the ceftriaxone dosing regimens based on pharmacokinetic/pharmacodynamic(PK/PD)principles using Monte Carlo simulation(MCS).Based on PK/PD theory,MCS was performed using Crystal Ball ...In the present study,we optimized the ceftriaxone dosing regimens based on pharmacokinetic/pharmacodynamic(PK/PD)principles using Monte Carlo simulation(MCS).Based on PK/PD theory,MCS was performed using Crystal Ball software combining PK and PD parameters with 10000 simulation runs to calculate the probability of target attainment(PTA)and cumulative fraction of response(CFR)for the seven clinically common dosing regimens of ceftriaxone(1 g qd,1.5 g qd,1 g bid,2 g qd,1 g tid,1.5 g bid,and 2 g bid).A%fT≥50 as the target value expected to achieve satisfactory clinical efficacy and a dosing regimen with an obtained CFR≥90%or the ability to achieve the highest PTA was used as a reasonable choice for empirical antimicrobial therapy,i.e.the clinically optimal regimen.All eight pathogenic bacteria had a CFR>90%when the dosing regimen was 2 g bid and 1 g tid,seven pathogenic bacteria had a CFR>90%when the dosing regimen was 1 g bid and 1.5 g bid,except for Pseudomonas aeruginosa,and all pathogenic bacteria had a CFR<90%when the dosing regimen was 1 g qd and 1.5 g qd.The dosing regimens of 2 g bid and 1 g tid were effective against all eight pathogenic bacteria infections,and 1 g bid and 1.5 g bid dosing regimens were effective against the other seven pathogenic bacteria except for Pseudomonas aeruginosa.展开更多
目的应用蒙特卡洛模拟评价奥马环素等6种给药方案对肺炎链球菌、金黄色葡萄球菌和大肠埃希菌感染的疗效。方法结合药动学参数和药效学参数,以AUC/MIC为PK/PD模型进行蒙特卡洛模拟,得到6种给药方案对上述3种病原菌的达标概率(PTA)及累积...目的应用蒙特卡洛模拟评价奥马环素等6种给药方案对肺炎链球菌、金黄色葡萄球菌和大肠埃希菌感染的疗效。方法结合药动学参数和药效学参数,以AUC/MIC为PK/PD模型进行蒙特卡洛模拟,得到6种给药方案对上述3种病原菌的达标概率(PTA)及累积反应分数(CFR)。结果奥马环素等6种给药方案对肺炎链球菌、金黄色葡萄球菌(抑菌靶值下模拟),都能达到CFR>90%;对于金黄色葡萄球菌(杀菌靶值下模拟),仅600 mg po q24h和多剂量C组(负荷剂量450 mg po q12h,维持剂量450 mg poq24h)达到CFR>90%;但对大肠埃希菌,所有给药方案的CFR均不达标。结论奥马环素的说明书推荐给药方案(负荷剂量200 mg iv,维持剂量300 mg po q24h)对肺炎链球菌、金黄色葡萄球菌有较好的治疗效果;但对大肠埃希菌,6种给药方案均达不到预期疗效。展开更多
[目的]建立芍药内酯苷的药动学-药效学(PK-PD)模型。[方法]首先采用液质联用法测定大鼠脑缺血再灌注损伤模型给予辛芍组方后的不同时间点所得血浆样本中芍药内酯苷的药物浓度,获得药时曲线;同时采用试剂盒测定不同时间点所得血浆样本中...[目的]建立芍药内酯苷的药动学-药效学(PK-PD)模型。[方法]首先采用液质联用法测定大鼠脑缺血再灌注损伤模型给予辛芍组方后的不同时间点所得血浆样本中芍药内酯苷的药物浓度,获得药时曲线;同时采用试剂盒测定不同时间点所得血浆样本中的超氧化物歧化酶(SOD)和乳酸脱氢酶(LDH)含量,获得时效曲线。然后用Win Non Lin软件采用房室模型的分析方法对芍药内酯苷的药代动力学参数进行拟合,获得PK参数。在此基础之上,固定相关的药代动力学参数,对时效关系进行拟合,得到相关的PD参数,根据PD参数,建立辛芍组方中芍药内酯苷的PK-PD模型。[结果]当以SOD为药效指标时,可得辛芍组方中芍药内酯苷的PK-PD模型为E=21.04+(7.16×Ce)/(Ce+372.4);当以LDH为药效指标时,可得辛芍组方中代表成分芍药内酯苷的PK-PD模型为E=216.83-(37.31×Ce)/(Ce+0.04)。[结论]SOD和LDH的浓度与芍药内酯苷的浓度存在一定的相关性。芍药内酯苷可通过提高SOD、降低LDH发挥抗氧化作用来实现保护脑缺血再灌注损伤。展开更多
目的介绍美罗培南在危重症、脓毒症及脓毒症休克、肾功能不全、病态肥胖、烧伤等特殊机体状态下的PK/PD及给药方案研究进展,为其临床合理应用提供参考。方法查阅国内外相关文献,进行系统的文献整理和综合分析。结果患者特殊的病理生理状...目的介绍美罗培南在危重症、脓毒症及脓毒症休克、肾功能不全、病态肥胖、烧伤等特殊机体状态下的PK/PD及给药方案研究进展,为其临床合理应用提供参考。方法查阅国内外相关文献,进行系统的文献整理和综合分析。结果患者特殊的病理生理状态,可使美罗培南的PK和PD发生重要改变,其中最重要的改变是Vd和CL。多个研究报道,增大美罗培南给药剂量,延长输注时间,可提高目标获得概率(Probability of target attainment,PTA)或累积反应分数(Cumulative fraction of response,CFR),但对于敏感的致病菌常规给药方案仍可得到良好的治疗效果。药物对治疗靶部位的组织穿透力也是影响PD的重要指标。研究发现,美罗培南可以很好的渗透到脑脊液、腹腔、肺部、软组织、前列腺、胰腺等。结论临床医生在使用美罗培南前,应了解患者的病理生理状态,明确病原菌、感染部位,根据PK/PD制定合理的给药方案。展开更多
本研究旨在建立辛芍组方中灯盏甲素的PK-PD结合模型。首先采用液质联用法测定大鼠脑缺血再灌注损伤模型给药后的不同时间点所得血浆样本中灯盏甲素的药物浓度,获得药时曲线;同时采用试剂盒测定不同时间点所得血浆样本中的两种药效指标(...本研究旨在建立辛芍组方中灯盏甲素的PK-PD结合模型。首先采用液质联用法测定大鼠脑缺血再灌注损伤模型给药后的不同时间点所得血浆样本中灯盏甲素的药物浓度,获得药时曲线;同时采用试剂盒测定不同时间点所得血浆样本中的两种药效指标(SOD和LDH),获得时效曲线。然后用Win Non Lin软件采用房室模型的分析方法对灯盏甲素的药代动力学参数进行拟合,获得PK参数。在此基础之上,固定相关的药代动力学参数,对时效关系进行拟合,得到相关的PD参数,根据PD参数,建立辛芍组方中灯盏甲素的PK-PD结合模型。当以SOD为药效指标时,可得辛芍组方中灯盏甲素的PK-PD模型为E=20.67+(1.22×Ce)/(Ce+5.58);当以LDH为药效指标时,可得辛芍组方中代表成分灯盏甲素的PK-PD模型为E=214.17-(32.72×Ce)/(Ce+0.08)。结果表明,SOD和LDH的浓度与灯盏甲素的浓度存在一定的相关性。辛芍组方及其主要活性成分灯盏甲素可通过提高SOD、降低LDH发挥抗氧化作用来实现保护脑缺血再灌注损伤。展开更多
文摘In this study,we aimed to develop and evaluate a whole-body physiologically based pharmacokinetic(WB-PBPK)/pharmacodynamic(PD)model for saxagliptin,simulate its pharmacokinetic and pharmacodynamic properties in healthy adults and patients with hepatic function impairment,and provide a new method for the research to the clinical pharmacy of special patients.Based on the drug-specific properties,such as log D,plasma protein binding collected by the published literature,the WB-PBPK model and the PD model were established.After comparing the simulated concentration-time profiles and the pharmacokinetic parameters with data in healthy adults from oral and intravenous clinical investigation,the WB-PBPK model could be optimized.After comparing the simulated DPP-4 inhibition profile with the observed pharmacodynamic in healthy subjects,the PD model could be optimized.The PK/PD model was utilized to predict the mean and variability of the pharmacokinetic and pharmacodynamic profiles in subjects with different hepatic impairment.All of the predicted pharmacokinetic curves were comparable to the observed curves both in healthy subjects and hepatic impairment subjects(Cmax and AUC were less than 1.3-fold).The predicted pharmacodynamic curves were comparable to the observed ones in different oral dosage after optimization,and pharmacodynamics of saxagliptin in hepatic impairment subjects were predicted successfully.The WB-PBPK/PD model can accurately simulate the pharmacokinetics and pharmacodynamics of saxagliptin in normal adults and different hepatic impaired patients.
基金2019 Second Hospital of Hebei Medical University Pro ject(Grant No.2h2019042)。
文摘In the present study,we optimized the ceftriaxone dosing regimens based on pharmacokinetic/pharmacodynamic(PK/PD)principles using Monte Carlo simulation(MCS).Based on PK/PD theory,MCS was performed using Crystal Ball software combining PK and PD parameters with 10000 simulation runs to calculate the probability of target attainment(PTA)and cumulative fraction of response(CFR)for the seven clinically common dosing regimens of ceftriaxone(1 g qd,1.5 g qd,1 g bid,2 g qd,1 g tid,1.5 g bid,and 2 g bid).A%fT≥50 as the target value expected to achieve satisfactory clinical efficacy and a dosing regimen with an obtained CFR≥90%or the ability to achieve the highest PTA was used as a reasonable choice for empirical antimicrobial therapy,i.e.the clinically optimal regimen.All eight pathogenic bacteria had a CFR>90%when the dosing regimen was 2 g bid and 1 g tid,seven pathogenic bacteria had a CFR>90%when the dosing regimen was 1 g bid and 1.5 g bid,except for Pseudomonas aeruginosa,and all pathogenic bacteria had a CFR<90%when the dosing regimen was 1 g qd and 1.5 g qd.The dosing regimens of 2 g bid and 1 g tid were effective against all eight pathogenic bacteria infections,and 1 g bid and 1.5 g bid dosing regimens were effective against the other seven pathogenic bacteria except for Pseudomonas aeruginosa.
文摘目的应用蒙特卡洛模拟评价奥马环素等6种给药方案对肺炎链球菌、金黄色葡萄球菌和大肠埃希菌感染的疗效。方法结合药动学参数和药效学参数,以AUC/MIC为PK/PD模型进行蒙特卡洛模拟,得到6种给药方案对上述3种病原菌的达标概率(PTA)及累积反应分数(CFR)。结果奥马环素等6种给药方案对肺炎链球菌、金黄色葡萄球菌(抑菌靶值下模拟),都能达到CFR>90%;对于金黄色葡萄球菌(杀菌靶值下模拟),仅600 mg po q24h和多剂量C组(负荷剂量450 mg po q12h,维持剂量450 mg poq24h)达到CFR>90%;但对大肠埃希菌,所有给药方案的CFR均不达标。结论奥马环素的说明书推荐给药方案(负荷剂量200 mg iv,维持剂量300 mg po q24h)对肺炎链球菌、金黄色葡萄球菌有较好的治疗效果;但对大肠埃希菌,6种给药方案均达不到预期疗效。
文摘[目的]建立芍药内酯苷的药动学-药效学(PK-PD)模型。[方法]首先采用液质联用法测定大鼠脑缺血再灌注损伤模型给予辛芍组方后的不同时间点所得血浆样本中芍药内酯苷的药物浓度,获得药时曲线;同时采用试剂盒测定不同时间点所得血浆样本中的超氧化物歧化酶(SOD)和乳酸脱氢酶(LDH)含量,获得时效曲线。然后用Win Non Lin软件采用房室模型的分析方法对芍药内酯苷的药代动力学参数进行拟合,获得PK参数。在此基础之上,固定相关的药代动力学参数,对时效关系进行拟合,得到相关的PD参数,根据PD参数,建立辛芍组方中芍药内酯苷的PK-PD模型。[结果]当以SOD为药效指标时,可得辛芍组方中芍药内酯苷的PK-PD模型为E=21.04+(7.16×Ce)/(Ce+372.4);当以LDH为药效指标时,可得辛芍组方中代表成分芍药内酯苷的PK-PD模型为E=216.83-(37.31×Ce)/(Ce+0.04)。[结论]SOD和LDH的浓度与芍药内酯苷的浓度存在一定的相关性。芍药内酯苷可通过提高SOD、降低LDH发挥抗氧化作用来实现保护脑缺血再灌注损伤。
文摘目的介绍美罗培南在危重症、脓毒症及脓毒症休克、肾功能不全、病态肥胖、烧伤等特殊机体状态下的PK/PD及给药方案研究进展,为其临床合理应用提供参考。方法查阅国内外相关文献,进行系统的文献整理和综合分析。结果患者特殊的病理生理状态,可使美罗培南的PK和PD发生重要改变,其中最重要的改变是Vd和CL。多个研究报道,增大美罗培南给药剂量,延长输注时间,可提高目标获得概率(Probability of target attainment,PTA)或累积反应分数(Cumulative fraction of response,CFR),但对于敏感的致病菌常规给药方案仍可得到良好的治疗效果。药物对治疗靶部位的组织穿透力也是影响PD的重要指标。研究发现,美罗培南可以很好的渗透到脑脊液、腹腔、肺部、软组织、前列腺、胰腺等。结论临床医生在使用美罗培南前,应了解患者的病理生理状态,明确病原菌、感染部位,根据PK/PD制定合理的给药方案。
文摘本研究旨在建立辛芍组方中灯盏甲素的PK-PD结合模型。首先采用液质联用法测定大鼠脑缺血再灌注损伤模型给药后的不同时间点所得血浆样本中灯盏甲素的药物浓度,获得药时曲线;同时采用试剂盒测定不同时间点所得血浆样本中的两种药效指标(SOD和LDH),获得时效曲线。然后用Win Non Lin软件采用房室模型的分析方法对灯盏甲素的药代动力学参数进行拟合,获得PK参数。在此基础之上,固定相关的药代动力学参数,对时效关系进行拟合,得到相关的PD参数,根据PD参数,建立辛芍组方中灯盏甲素的PK-PD结合模型。当以SOD为药效指标时,可得辛芍组方中灯盏甲素的PK-PD模型为E=20.67+(1.22×Ce)/(Ce+5.58);当以LDH为药效指标时,可得辛芍组方中代表成分灯盏甲素的PK-PD模型为E=214.17-(32.72×Ce)/(Ce+0.08)。结果表明,SOD和LDH的浓度与灯盏甲素的浓度存在一定的相关性。辛芍组方及其主要活性成分灯盏甲素可通过提高SOD、降低LDH发挥抗氧化作用来实现保护脑缺血再灌注损伤。
