uu.seUppsala universitets publikasjoner
Endre søk
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
MODEL-BASED EVALUATION OF DOSE REGIMENS IN PRETERM AND TERM NEONATES FOR DEXMEDETOMIDINE AND VANCOMYCIN
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
2017 (engelsk)Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
Abstract [en]

Background: Dexmedetomidine (Dexdor) is a sedative and an analgesic compound approved for intravenous use in adults, but it is also used off-label in neonates. There are no pharmacokinetic (PK) data to support buccal administration of Dexdor in neonates. Vancomycin is an antibiotic commonly used to treat methicillin-resistant Staphylococcus aureus (MRSA), and the best predictor of successful outcome is the 24-h area under the concentration-time curve (AUC24) to MIC ratio of > 400. Specific dosing guidelines to ensure efficacy and safety in preterm neonates are currently lacking. Objective: To find an appropriate dose range for Dexdor for single buccal administration to neonates with a postmenstrual age (PMA) of 32 – 44 weeks. To find a vancomycin dose regimen predicting the best efficacy/toxicity ratio for newborns at 32 – 40 gestation weeks. Methods: Published PK-models where used to simulate expected PK profiles for different dosing regimens of Dexdor and vancomycin in preterm and term neonates using Berkeley Madonna, Insight-Rx and Excel. Results: The most appropriate dose of Dexdor for buccal administration is 1 ± 0.25 μg/kg, given 0.5 - 1 hour before a minor procedure. Currently used vancomycin regimen for neonates (15 mg/kg twice daily) is most likely insufficient in treating MRSA. PMA is a significant covariate, and it is suggested that dosing in preterm neonates should be adjusted according to PMA. Conclusions: Dosing 1 ± 0.25 μg/kg of Dexdor should be a safe and adequate starting dose for buccal administration to neonates, but clinical studies are required to confirm this. For vancomycin, a revised dose regimen is suggested for preterm neonates that take into account both weight and PMA.

sted, utgiver, år, opplag, sider
2017.
Emneord [en]
DEXMEDETOMIDINE, VANCOMYCIN, NEONATE, MODEL, DOSE, regimen, preterm, term, buccal, intravenous, pkpd, Berkley-Madonna, Insight-RX
HSV kategori
Identifikatorer
URN: urn:nbn:se:uu:diva-329312OAI: oai:DiVA.org:uu-329312DiVA, id: diva2:1140628
Eksternt samarbeid
Insight RX; Akademiska Sjukhuset
Veileder
Examiner
Tilgjengelig fra: 2017-09-13 Laget: 2017-09-12 Sist oppdatert: 2018-01-13bibliografisk kontrollert

Open Access i DiVA

Fulltekst mangler i DiVA

Av organisasjonen

Søk utenfor DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric

urn-nbn
Totalt: 98 treff
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf