1 / 16

Dosage Regimen Design for Patients with Renal Insufficiency

Dosage Regimen Design for Patients with Renal Insufficiency. Pharmacy 732 Winter, 2001. Parameter Adjustment or “Q” Factor: Concept. How much?. Q Factor: Where’s It Come From?. Assuming nonrenal Cl is not changed by RF:. Eq. 1. Q Factor: Where...?. But. Eq. 2. Q Factor: Where…?.

wauna
Download Presentation

Dosage Regimen Design for Patients with Renal Insufficiency

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Dosage Regimen Designfor Patients with Renal Insufficiency Pharmacy 732 Winter, 2001

  2. Parameter Adjustment or “Q” Factor: Concept How much?

  3. Q Factor: Where’s It Come From? Assuming nonrenal Cl is not changed by RF: Eq. 1

  4. Q Factor: Where...? But Eq. 2

  5. Q Factor: Where…? Since ClR-N=feClT-N Eq. 3

  6. Q Factor: Where…? Eq. 1 Eq. 2 Eq. 3

  7. Q Factor: Where…?

  8. Q Factor: Where…?

  9. Q Factor: Assumptions • Know fe (normal renal function) •  ClR  GFR (i.e. CrCl) • No change in ClNR • First-order kinetics • One compartment model • Metabolites not active/toxic

  10. Q Factor: What Do You Do With It? • Adjust dosage regimen (D, , or both) • Adjusting D alone • DRF = DN Q • Css similar, peak lower, trough higher • Adjusting  alone • RF = N / Q • Css similar, peak similar, trough similar

  11. Q Factor: What Do You…? • Adjust both D and  • DRF = DN Q  RF/ N • Css similar, peak and trough in-between

  12. An Example: Ganciclovir Antiviral, normal dose = 5 mg/kg, dose interval = 12 hrs. Need to dose drug in patient with CrCl = 10 mL/min. What is Q factor?

  13. or

  14. What is the appropriate dosage regimen given this Q?

  15. WARNING! • Other kinetic parameters may also be altered by RF • Absorption • Distribution (, , ) • Metabolism (, , ) • Always best to have literature for specific drug in renal failure patients • Chapter 47 of DiPiro

  16. Other Sources of Information • Package insert • Drug Information Handbook • AHFS Drug Information • Bennett

More Related