目的:基于药动学(pharmacokinetics,PK)/药效学(pharmacodynamics,PD)模型和蒙特卡洛模拟(Mote Carlo simulation,MCS),分析大肠埃希菌所致脓毒症休克患者抗感染治疗方案的优化过程,为临床感染患者构建合理有效的治疗方案提供参考。方法...目的:基于药动学(pharmacokinetics,PK)/药效学(pharmacodynamics,PD)模型和蒙特卡洛模拟(Mote Carlo simulation,MCS),分析大肠埃希菌所致脓毒症休克患者抗感染治疗方案的优化过程,为临床感染患者构建合理有效的治疗方案提供参考。方法:一患者因不明原因发热入院,初步诊断为尿路感染和脓毒症休克。入院后第一时间完善了相关实验室检查,随后采用PK/PD模型和MCS依据微生物培养结果及其药敏试验确定最优的抗感染治疗方案。结果:入院第3天,微生物培养检出大肠埃希菌,随后的药敏试验提示其对美罗培南、亚胺培南敏感,而对头孢哌酮-舒巴坦钠中介;采用PK/PD模型和MCS对拟定的几个抗感染治疗方案进行分析,结果发现美罗培南(1 g,q8h)和亚胺培南(0.5 g,q6h)的达标概率(probability of target attainment,PTA)均为100.00%,而头孢哌酮-舒巴坦钠(3 g,q12h)的PTA为1.14%,头孢哌酮-舒巴坦钠(3 g,q8h)的PTA为7.65%;最终,临床选择了美罗培南(1 g,q8h)治疗,1周后患者的感染指征基本消失。结论:PK/PD模型和MCS两个工具可以较好地帮助临床药师预测抗感染治疗方案的可能效果,从而更好地协助医生制定和优化治疗方案,进而最大程度保证患者的治疗效果。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
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
Neutropenia with fever is a special group of patients. Due to low immune function, inflammation-related clinical symptoms and signs are often not obvious, and pathogenic bacteria and infection focus are not clear. Fev...Neutropenia with fever is a special group of patients. Due to low immune function, inflammation-related clinical symptoms and signs are often not obvious, and pathogenic bacteria and infection focus are not clear. Fever may be the only sign of infection. If appropriate antimicrobial treatment is not given in time, infection-related mortality is high. In our study, we aimed to optimize the dosage regimen of Micafungin in children with febrile neutropenic against Candida spp. by Mote Carlo Simulation (MCS). Pharmacokinetic parameters and microbiological data of Micafungin were collected. Then we used MCS to calculate Probability of Target Attainment (PTA) and Cumulative Fraction of Response (CFR). With dosages of 0.5 mg/kg, 1 mg/kg, 1.5 mg/kg, 2 mg/kg, 3 mg/kg, and 4 mg/kg in oral group and dosages of 100 mg, and 200 mg in intravenous administration, all have different degree of antifungal effect. But when the dosage regimen was 50 mg IV, the therapeutic effect of Micafungin against Candida spp. was not good.展开更多
With the development of the PK-PD model,its application in veterinary antimicrobials has also received great attention.This paper expounded the theory of PK-PD model,and made a brief analysis of the dosing regimens of...With the development of the PK-PD model,its application in veterinary antimicrobials has also received great attention.This paper expounded the theory of PK-PD model,and made a brief analysis of the dosing regimens of various antibiotics according to the parameters of antimicrobial drugs,in order to optimize the clinical drug delivery plan and promote the rational use of clinical antibiotics.展开更多
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
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。
文摘Neutropenia with fever is a special group of patients. Due to low immune function, inflammation-related clinical symptoms and signs are often not obvious, and pathogenic bacteria and infection focus are not clear. Fever may be the only sign of infection. If appropriate antimicrobial treatment is not given in time, infection-related mortality is high. In our study, we aimed to optimize the dosage regimen of Micafungin in children with febrile neutropenic against Candida spp. by Mote Carlo Simulation (MCS). Pharmacokinetic parameters and microbiological data of Micafungin were collected. Then we used MCS to calculate Probability of Target Attainment (PTA) and Cumulative Fraction of Response (CFR). With dosages of 0.5 mg/kg, 1 mg/kg, 1.5 mg/kg, 2 mg/kg, 3 mg/kg, and 4 mg/kg in oral group and dosages of 100 mg, and 200 mg in intravenous administration, all have different degree of antifungal effect. But when the dosage regimen was 50 mg IV, the therapeutic effect of Micafungin against Candida spp. was not good.
基金Supported by China UK Technology and Innovation Project ICUK
文摘With the development of the PK-PD model,its application in veterinary antimicrobials has also received great attention.This paper expounded the theory of PK-PD model,and made a brief analysis of the dosing regimens of various antibiotics according to the parameters of antimicrobial drugs,in order to optimize the clinical drug delivery plan and promote the rational use of clinical antibiotics.
文摘目的:探讨“冬病夏治”全方配伍和无白芥子配伍延胡索乙素在模型家兔“肺俞”穴皮下药代动力学特征及药代动力学-药效动力学(PK-PD)模型的相关性。方法:支气管哮喘模型家兔随机分成延胡索单方组、缺白芥子组、全方组,微透析技术收集14 h穴位皮下透析液,液相色谱-质谱法(Liquid Chromatography Mass Spectrometry,LCMS)法检测方中君药延胡索主要成分延胡索乙素浓度,获得药代动力学参数;酶联免疫吸附试验(ELISA)法检测对应时间点模型动物血清中IgE水平,获得药效学参数;对药动学、药效学参数进行PK-PD模型拟合。结果:白芥子配伍后的药峰浓度(C_(max))、药时曲线下面积(AUC_(0-t))、平均滞留时间(MRT_(0-t))均显著增加(P<0.01,P<0.01,P<0.05),达峰时间(T_(max))提前(P<0.01);“浓度-时间-效应”三维曲线表明,方中有白芥子配伍时,药效出现更快、消退更慢,起效时间晚于峰浓度,具有一定滞后性。结论:动力学参数、PK-PD模型结果表明,白芥子配伍能够改变“方中君药”——延胡索的主要成分延胡索乙素穴位局部的皮下分布,促进方中君药有效成分快速吸收,延长滞留时间,在方剂中起到主药、改善其他药物分布的“双重”作用。
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.
