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肾病患者连续腹膜透析头孢唑林的药物动力学及给药方案

Drug administration schedule of cefazolin regarding to its pharmacokinetics in ambulatory peritoneal dialysis

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【作者】 凌骝徐铭甫倪岚樊丽蓉张楠森王承钰唐令铨唐建华周旭美董南方

【Author】 LING Liu, XU Ming-Fu, NI Lan, FAN Li-Rong, ZHANG Nan-Sen, WANG Cheng -Yu, TANG Ling-Quan, TANG Jian-Hua, ZHOU Xu-Mei, DONG Nan-Fang (Shanghai Sixth People’s Hospital, Shanghai 200040)

【机构】 上海第六人民医院药剂科内科上海医科大学临床药学进修班上海医科大学临床药学进修班 上海200040上海200040实习生实习生

【摘要】 本文报告5例肾病患者连续腹膜透析应用头孢唑林的药物动力学及给药方案。1g/2L头孢唑林灌入腹腔,留置4h后,流出液内药浓度为187±53μg/ml,吸收量为57±13%;同时测得血清内药峰浓度为76±8μg/ml。停药后20h,用不含头孢唑林的透析液交换3次后,血清内药浓度为50±9μg/ml,经腹膜累积排出率为体内药量的16±3%。建议给药方案为头孢唑林0.5-1.0g/d,分2次分别加于第二、四次交换的透析液中较为合适。

【Abstract】 A design was made to dialyse the peritoneal cavity continuously with 2 L of fluid, retaining there, and then to drain it out at the end of 4 hrs. Each dialysis was considered as a course of treatment. Within 24 hrs 5 to 6 courses should be given. 1 gm of cefazolin dissolved in 2L fluid was given in one course. After that, the drug conicentration in serum was found to be 76+8ug/ml, while the drug concentration in dialysate was 187+53ug/ml. By calculation 57+ 13% of the drug given was retained. In the 2nd,3rd and 4th courses of dialysis no drug was given. Afterwards, the drug concentration in serum was found to be 50+9 /ug/ml, while the drug concentration in dialysate was 12 to 17 ug/ml, therefore even after 20 hrs 16 + 3% of the drug given was excreted.The proper dosage suggested is as follows.The total daily dose is 0.25-0.5 gm,equally divided into 2 portions and given at the 2nd and 4th dialysis every day.

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