Dosage of phenytoin in neurocritical patients using Bayesian algorithms: a pilot study
| Autor: | Juan Grandjean, Salvador Cabrera, Daniel Muñoz-Pichuante, Ximena Lagos, Lorenzo Villa Zapata |
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| Rok vydání: | 2019 |
| Předmět: |
Phenytoin
Adult Male Pilot Projects 030226 pharmacology & pharmacy Bayesian Prediction 03 medical and health sciences Young Adult 0302 clinical medicine Therapeutic index Pharmacokinetics medicine Humans Pharmacology (medical) 030212 general & internal medicine Dosing General Pharmacology Toxicology and Pharmaceutics Lead (electronics) Aged Aged 80 and over Dose-Response Relationship Drug business.industry Retrospective cohort study Bayes Theorem Plasma levels Middle Aged Anesthesia Female business Algorithms Software medicine.drug |
| Zdroj: | Drug metabolism and personalized therapy. 34(4) |
| ISSN: | 2363-8915 |
| Popis: | Phenytoin is widely used in neurocritical patients. Owing to its high pharmacokinetic variability and narrow therapeutic range, plasma level-guided dosing has become the standard. Bayesian prediction (BP) is considered the most flexible and precise pharmacokinetic strategy among several options. A retrospective study of BP dosage adjustment in 20 patients (35 plasma measures) was developed. Results indicated that 70% of phenytoin plasma levels of first plasma samples were beyond the therapeutic range. Phenytoin doses were also estimated according to BP for all patients. The measurements confirmed the ability of the strategy to lead to optimal dosage in 80% of patients, thus indicating a three-fold improvement over the basing dosage adjustment recommended in the literature. |
| Databáze: | OpenAIRE |
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