scholarly journals Population Pharmacokinetics of Abacavir in Pregnant Women

2014 ◽  
Vol 58 (10) ◽  
pp. 6287-6289 ◽  
Author(s):  
Floris Fauchet ◽  
Jean-Marc Treluyer ◽  
Laure-Helene Préta ◽  
Elodie Valade ◽  
Emmanuelle Pannier ◽  
...  
Keyword(s):  
Body Weight ◽  
Pregnant Women ◽  
Population Pharmacokinetics ◽  
Gestational Age ◽  
Population Approach ◽  
Covariate Effect ◽  
Dosing Regimen ◽  
First Time

ABSTRACTFor the first time, a population approach was used to describe abacavir (ABC) pharmacokinetics in HIV-infected pregnant and nonpregnant women. A total of 266 samples from 150 women were obtained. No covariate effect (from age, body weight, pregnancy, or gestational age) on ABC pharmacokinetics was found. Thus, it seems unnecessary to adapt the ABC dosing regimen during pregnancy.

scholarly journals Population Pharmacokinetics and Dosing Optimization of Azithromycin in Children with Community-Acquired Pneumonia

2018 ◽  
Vol 62 (9) ◽  
Author(s):  
Yi Zheng ◽  
Shu-Ping Liu ◽  
Bao-Ping Xu ◽  
Zhong-Ren Shi ◽  
Kai Wang ◽  
...  
Keyword(s):  
Body Weight ◽  
Population Pharmacokinetics ◽  
Pediatric Patients ◽  
Community Acquired Pneumonia ◽  
Pharmacodynamic Modeling ◽  
Pharmacokinetic Data ◽  
Loading Dose ◽  
Dosing Regimen ◽  
Time Curve ◽  
Dose Strategy

ABSTRACT Azithromycin is extensively used in children with community-acquired pneumonia (CAP). Currently, the intravenous azithromycin is used off-label in children partly due to lacking of pharmacokinetic data. Our objective was to evaluate the population pharmacokinetics (PPK) and optimize dose strategy in order to improve treatment in this distinctive population. This was a prospective, multicenter, open-labeled pharmacokinetic study. Blood samples were collected from hospitalized pediatric patients and concentrations were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS). PPK analysis was conducted using NONMEM software. The pharmacokinetic data from 95 pediatric patients (age range, 2.1 to 11.7 years) were available for analysis. The PPK was best fitted by a two-compartment model with linear elimination. Covariate analysis verified that body weight and alanine aminotransferase (ALT) had significant effects on azithromycin pharmacokinetics, yielding a 24% decrease of clearance in patients with ALT of >40. Monte Carlo simulation showed that for children with normal liver function, a loading-dose strategy (a loading dose of 15 mg/kg of body weight followed by maintenance doses of 10 mg/kg) would achieve the ratio of the area under free drug plasma concentration-time curve over 24 h (fAUC) to MIC90 (fAUC/MIC) target of 3 h in 53.2% of hypothetical patients, using a normative MIC susceptibility breakpoint of 2 mg/liter. For children with ALT of >40, the proposed dose needed to decrease by 15% to achieve comparable exposure. The corresponding risk of overdose for the recommended dosing regimen was less than 5.8%. In conclusion, the PPK of azithromycin was evaluated in children with CAP and an optimal dosing regimen was constructed based on developmental pharmacokinetic-pharmacodynamic modeling and simulation.

Assessment of risk factors for fetal growth retardation

2020 ◽  
pp. 50-53
Author(s):  
Kh. Alirzayeva ◽  
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Arterial Hypertension ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Deficiency Anemia ◽  
Fetal Growth Retardation ◽  
History Of

The objective: to determine the risk factors for the development of ESRD in pregnant women with preeclampsia and anemia. Materials and methods. 97 pregnant women with preeclampsia with iron-deficiency anemia were monitored. The first group included 46 pregnant women with diagnosed ZRD, the second group-51 pregnant women who gave birth to children with normal body weight. Criteria of FGR is to reduce body weight and length of newborn at birth (less than 10 percentile of assessment tables in comparison with due to gestational age), morphological maturity index (a lag of 2 weeks or more from the true gestational age), disproportionate body, the signs of malnutrition and trophic disorders of the skin and mucous membranes. Results. A step-by-step elimination of the factors that contributed the least to the development of ARI in a combination of preeclampsia and anemia was performed. The results of multivariate analysis showed that in General, the following factors had the strongest influence on the development of RR in preeclampsia and anemia: arterial hypertension (RR= 2.055 [95% CI 1.31-3.20]), overweight/obesity (RR=1.646 [95% CI 1.03-2.62]), anemia in the anamnesis (RR=2.591[95% CI 1.56-4.28]),complicated labor in the anamnesis (RR=1.886 [95% CI 1.29-2.74]), habitual miscarriage (RR=1.850 [95% CI 1.21-2.82]), a history of preeclampsia (RR= 1.922 [95% CI 1.31-2.80]), a history of RR (RR=3.502 [CI 2.37-5.16]). Conclusions. The most significant clinical and anamnestic risk factors for the development of RRT are: arterial hypertension, overweight/obesity, anemia in the anamnesis, pre-eclampsia in the anamnesis, complicated labor in the anamnesis, habitual miscarriage, RRT in the anamnesis. Keywords: pregnancy, preeclampsia, anemia, fetal growth retardation, risk factors.

Increased Knowledge of Pregnant Women about the Importance of Micro Minerals (Fe) During Pregnancy

2021 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Nico Syahputra Sebayang ◽  
Iin Nopitasari ◽  
Pestaria Saragih ◽  
Alhanannasir Alhanannasir
Keyword(s):  
Body Weight ◽  
Infant Mortality ◽  
Pregnant Women ◽  
Community Service ◽  
Gestational Age ◽  
Premature Birth ◽  
Normal Weight ◽  
Service Program ◽  
Government Programs ◽  
Short Children

Micro minerals (Fe) are indispensable for every woman, especially during pregnancy. The need for micro minerals (Fe) increases with increasing gestational age. Micro minerals (Fe) are not only important for pregnant women, they are also important for babies in the womb. Deficiency of micro minerals (Fe) can increase the risk of giving birth to babies with low body weight or premature birth and even maternal and infant mortality. If the baby is born with a normal weight, but there is still the possibility of stunting (short children). The purpose of this community service is to increase the knowledge of pregnant women about the importance of consuming micro minerals (Fe) during pregnancy. Knowledge of pregnant women in Sungai Rengit Murni village about the consumption of micro minerals (Fe) can be said to be quite good, reaching 70% of the total number of pregnant women (statement of regional midwives). We hope that as a servant, with this community service program, it is hoped that the knowledge of pregnant women about the importance of consuming micro minerals (Fe) during pregnancy will increase. So that the risk that will occur to the mother and baby is reduced. In addition, the service also supports government programs in reducing maternal problems during pregnancy until delivery.

scholarly journals HEMODYNAMIC STATUS OF PREGNANT WOMEN WITH OBESITY

2015 ◽  
Vol 7 (2) ◽  
pp. 86-90
Author(s):  
M M Matlubov ◽  
A A Semenixin ◽  
S A Ruzibaev ◽  
N I Zakirova ◽  
O V Kim
Keyword(s):  
Adverse Effect ◽  
Body Mass Index ◽  
Body Weight ◽  
Pregnant Women ◽  
Cardiovascular System ◽  
Body Mass ◽  
Functional State ◽  
Gestational Age ◽  
Control Group ◽  
Normal Body Weight

In order to study the state of hemodynamics in pregnant women with obesity of varying severity were examined 84 pregnant women aged between 23 and 28 years at 36-38 weeks gestation. The control group included 21 pregnant women of similar age and gestational age with normal body weight. All observed patients, pregnancy according obstetrical consultation was recognized uncomplicated. The degree of obesity was assessed by body mass index. Researches conducted showed that overweight as its progression has a very adverse effect on hemodynamics and functional state of the cardiovascular system as a whole, reduces coronary reserve. The most pronounced violation of the functional state of the cardiovascular system occur in obesity 2nd and 3rd degree.

scholarly journals A Practical Tranexamic Acid Dosing Scheme Based on Population Pharmacokinetics in Children Undergoing Cardiac Surgery

2013 ◽  
Vol 118 (4) ◽  
pp. 853-862 ◽  
Author(s):  
Stanislas Grassin-Delyle ◽  
Roland Couturier ◽  
Emuri Abe ◽  
Jean Claude Alvarez ◽  
Philippe Devillier ◽  
...  
Keyword(s):  
Body Weight ◽  
Cardiac Surgery ◽  
Tranexamic Acid ◽  
Population Pharmacokinetics ◽  
Central Compartment ◽  
Volume Of Distribution ◽  
Pediatric Cardiac Surgery ◽  
Pharmacokinetic Parameters ◽  
Risk For Bleeding ◽  
First Time

Abstract Background: Pediatric cardiac surgery patients are at high risk for bleeding, and the antifibrinolytic drug tranexamic acid (TA) is often used to reduce blood loss. However, dosing schemes remain empirical as a consequence of the absence of pharmacokinetic study in this population. The authors’ objectives were thus to investigate the population pharmacokinetics of TA in pediatric cardiac surgery patients during cardiopulmonary bypass (CPB). Methods: Twenty-one patients were randomized to receive TA either continuously (10 mg/kg followed by an infusion of 1 mg·kg−1·h−1 throughout the operation, and 10 mg/kg into the CPB) or discontinuously (10 mg/kg, then 10 mg/kg into the CPB and 10 mg·kg−1·h−1 at the end of CPB). Serum concentrations were measured at eight time points with chromatography–mass spectrometry and the data were modeled using Monolix (Lixoft, Orsay, France). Results: Tranexamic acid pharmacokinetics was ascribed to a two-compartment open model. The main covariate effects were body weight and CPB. Representative pharmacokinetic parameters adjusted to a 70-kg body weight were as follows: systemic clearance, 2.45 l/h; volume of distribution in the central compartment, 14.1 l; intercompartmental clearance, 5.74 l/h; and peripheral volume, 32.8 l. In accordance with this model, the authors proposed a weight-adjusted dosing scheme to maintain effective TA concentrations in children during surgery, consisting of one loading dose followed by a continuous infusion. Conclusions: The authors report for the first time the pharmacokinetics of TA in children undergoing cardiac surgery with CPB, and propose a dosing scheme for optimized TA administration in those children.

Population pharmacokinetics and dosing optimization of vancomycin in infants, children and adolescents with augmented renal clearance

2021 ◽  
Author(s):  
Cui-Yao He ◽  
Pan-Pan Ye ◽  
Bin Liu ◽  
Lin Song ◽  
John van den Anker ◽  
...  
Keyword(s):  
Body Weight ◽  
Population Pharmacokinetics ◽  
Renal Clearance ◽  
Pharmacokinetic Model ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Dosing Regimen ◽  
Augmented Renal Clearance ◽  
Vancomycin Dose ◽  
First Order

Augmented renal clearance (ARC) can cause underexposure to vancomycin, thereby increasing the risk of treatment failure. Our objective was to evaluate population pharmacokinetics and optimize the dosing regimen of vancomycin in the pediatric population with ARC. Sparse pharmacokinetic sampling and therapeutic drug monitoring (TDM) data were collected from pediatric patients with ARC treated with vancomycin. A pharmacokinetic model was developed using NONMEM 7.2. The dosing regimen was optimized using Monte Carlo dose simulations. A total of 242 vancomycin serum concentrations from 113 patients (age range 0.4 to 14.9 years, 49 females and 64 males) were available. Mean vancomycin dose was 58.8 mg/kg/day (13.6 mg/kg/dose), and mean vancomycin serum trough concentration was 6.5 mg/L. A one-compartment pharmacokinetic model with first order elimination was developed. Body weight and age were the most significant and positive covariates for clearance and volume of distribution. To the pediatric population with ARC, the current recommended vancomycin dose of 60 mg/kg/day was associated with a high risk of underdosing. To reach the target AUC/MIC of 400-700 in these pediatric patients, the vancomycin dose should be increased to 75 mg/kg/day for infants and children between 1 month and 12 years of age, and 70 mg/kg/day for adolescents between 12 and 18 years of age. In conclusion, a one-compartment pharmacokinetic model with first-order elimination was established with body weight and age as significant covariates. An optimal dosing regimen was developed in pediatric patients with ARC aged 1 month -18 years.

scholarly journals Initial dose recommendation for sirolimus in paediatric kaposiform haemangioendothelioma patients based on population pharmacokinetics and pharmacogenomics

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094762
Author(s):  
Xiao Chen ◽  
Dong-Dong Wang ◽  
Hong Xu ◽  
Zhi-Ping Li
Keyword(s):  
Body Weight ◽  
Population Pharmacokinetics ◽  
Initial Dose ◽  
Initial Dosage ◽  
Population Characteristics ◽  
Test Results ◽  
Dosing Regimen ◽  
The Monte Carlo Method ◽  
Laboratory Test Results ◽  
Retrospective Clinical Study

Objective Sirolimus has been used to treat paediatric kaposiform haemangioendothelioma patients. However, there is considerable pharmacokinetic variability among individuals, and it is difficult to develop an initial dosing regimen. The goal of the present study is to recommend an initial sirolimus dose in paediatric kaposiform haemangioendothelioma patients based on population pharmacokinetics and pharmacogenomics. Methods This was a retrospective clinical study. A population pharmacokinetics model was established and population characteristics, laboratory test results, drug combinations, and pharmacogenomics were considered as potential covariates. The Monte Carlo method was used to simulate the optimal initial dosage. Results The final covariates that affect sirolimus clearance include weight and the CYP3A5 genotype. The initial dosage of sirolimus for individuals with CYP3A5*3/*3 was 0.20 mg/kg split into two doses for 5 to 60 kg body weight. For individuals with CYP3A5*1, the initial dose was 0.23 mg/kg split into two doses for 5 to 30 kg body weight and 0.20 mg/kg split into two doses for 30 to 60 kg body weight. Conclusion The recommendation for the initial sirolimus dose in paediatric kaposiform haemangioendothelioma patients was based on population pharmacokinetics and pharmacogenomics. This study may provide practical value for sirolimus clinical use in paediatric kaposiform haemangioendothelioma patients.

scholarly journals The factors affecting the physical development of neonates in pregnant women with or without gestational diabetes mellitus

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0251024
Author(s):  
Xiaodi Zhao ◽  
Nana Li ◽  
Runping Jia ◽  
Shumin Chen ◽  
Ling Wang
Keyword(s):  
Diabetes Mellitus ◽  
Body Weight ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Gestational Age ◽  
Body Height ◽  
Physical Development ◽  
Factors Affecting

Objectives To explore the factors affecting neonatal physical development in pregnant women with or without gestational diabetes mellitus (GDM). Methods The subjects were selected from the pregnant woman giving birth in 2nd Affiliated Hospital of Zhengzhou University, from November 2015 to May 2016. The age, occupation, education level, gestational age, body weight before pregnancy, body weight at delivery, body height, delivery pattern, GDM status of pregnant women and neonatal gender, birth weight (BW), chest circumference (CC), head circumference (HC) and birth length (BL) were collected through medical records and questionnaires. The clinical data were retrospectively analyzed and studied. Results The significant differences were found between women with GDM and without GDM in following neonatal variables (P<0.05): BW, CC, and HC. GDM status increased the incidence of macrosomia (OR = 2.241, 95% CI: 1.406–3.573), large CC (OR = 2.470, 95% CI: 1.687–3.6153). Gestational weight gain (GWG) above IOM guideline was risk factor for macrosomia (OR = 1.763, 95% CI:1.098–2.833), large HC (OR = 1,584, 95% CI: 1.093–2.296) and large CC (OR = 1.707, 95% CI:1.163–2.506). Underweight was risk factor for short BL (OR = 2.543, 95% CI:1.161–5.571) and small CC (OR = 1.901, 95% CI:1.064–3.394). Female neonate was prone to appear short BL(OR = 2.831, 95% CI: 1.478–5.422) and small HC (OR = 2.750, 95% CI: 1.413–5.350), and not likely to macrosomia (OR = 0.538, 95% CI: 0.343–0.843), longer BL (OR = 0.584, 95% CI: 0.401–0.850), large HC (OR = 0.501, 95% CI: 0.352–0.713), and (OR = 0.640, 95% CI: 0.446–0.917). For women with GDM, gestational age was an risk factor of neonatal BW (low BW: OR = 0.207, 95% CI: 0.085–0.503; macrosomia: OR = 1.637, 95% CI: 1.177–2.276), BL (short BL: OR = 0.376, 95% CI: 0.241–0.585; long BL: OR = 1.422, 95% CI: 1.054–1.919), HC (small HC: OR = 0.343, 95% CI: 0.202–0.583; large HC: OR = 1.399, 95% CI: 1.063–1.842) and CC (small CC: OR = 0.524, 95% CI: 0.374–0.733; large CC: OR = 1.485, 95% CI: 1.138–1.936). Conclusions In our study, gestational age, GDM status, neonatal gender, GWG and pre-pregnancy body mass index (BMI) are associated the abnormal physical development of neonates. In women with GDM, gestational age was correlate with neonatal abnormal physical developments.

Association between gestational glycemic profile and delivery with a large for gestational age baby in pregnant women with type 1 diabetes

2020 ◽  
Author(s):  
Ekaterine Inashvili ◽  
Natalia Asatiani ◽  
Ramaz Kurashvili ◽  
Elena Shelestova ◽  
Mzia Dundua ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Pregnant Women ◽  
Gestational Age ◽  
Large For Gestational Age ◽  
Glycemic Profile
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