Interaction of azithromycin and methylprednisolone with ex-vivo extracorporeal membrane oxygenation circuits (ECMO).

Autor:	Chevalier A; Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA., McKnite A; Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA., Whelan A; Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA., Imburgia C; Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA., Rower JE; Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA.; Center for Human Toxicology, University of Utah, Salt Lake City, UT, USA., Watt KM; Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.; Division of Clinical Pharmacology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA., Green DJ; Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.; Division of Clinical Pharmacology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Jazyk:	angličtina
Zdroj:	Perfusion [Perfusion] 2024 Nov 05, pp. 2676591241297401. Date of Electronic Publication: 2024 Nov 05.
DOI:	10.1177/02676591241297401
Abstrakt:	Background: Azithromycin and methylprednisolone are two medications that are commonly used in patients who require ECMO support. Unfortunately, ECMO support can decrease drug concentrations through adsorption to circuit components. Such interactions have not been well described for either azithromycin or methylprednisolone. This study determined the extraction of these medications by ECMO circuits in an ex-vivo system. Methods: Medications were administered to closed-loop, blood-primed ECMO circuits to attain target therapeutic concentrations. Drug concentration remaining in the circuit was measured over 6 h. The difference in medication recovery was compared between the ECMO circuits and controls using two-sample t-tests. Results: Concentrations of azithromycin and methylprednisolone remained constant in control experiments over time, indicating medication stability in blood. There was no statistical difference in percent recovery after 6 h between control experiments and the ECMO circuits for either azithromycin ( p = .32) or methylprednisolone ( p = .17). Discussion: Azithromycin and methylprednisolone did not significantly interact with ex-vivo ECMO circuits. While these studies do not account for all in-vivo pharmacokinetic changes that may occur as a result of ECMO and critical illness, they suggest that standard dosing may be adequate to achieve therapeutic concentrations of azithromycin and methylprednisolone. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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