Pharmacokinetics of Midazolam in Critically Ill Patients Receiving Continuous Hemodiafiltration using a Polymethyl Methacrylate and/or Polysulfone Membrane
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概要
- 論文の詳細を見る
The objectives of this study were to evaluate the risk of the accumulation of midazolam and its active metabolites in critically ill patients in an intensive care unit (ICU) being treated by continuous hemodiafiltration (CHDF) using a polymethyl methacrylate (PMMA) and/or a polysulfone (PS) membrane and the influence of CHDF on the pharmacokinetics of midazolam in these patients. The serum and ultrafiltration liquid concentrations of midazolam and its active metabolites were measured by high-performance liquid chromatography to study the pharmacokinetics of midazolam and its active metabolites in seven patients with renal failure who were being treated by CHDF using a PMMA and/or a PS membrane. There was no progressive accumulation of midazolam or 1-hydroxymidazolam, though high levels of 1-hydroxymidazolam glucuronide were noted. The extraction rates for these 3 substances by CHDF using a PMMA and a PS membrane were 1.3%, 3.0% and 13.4%, and 5.0%, 4.8% and 74.4%, respectively. A positive correlation was observed between the 1-hydroxymidazolam glucuronide concentration and serum creatinine concentration for CHDF using the PMMA membrane (r^2=0.8223), while there was no correlation between these concentrations when the PS membrane was used (r^2=0.0361). These results show that CHDF using a PMMA membrane did not affect the elimination of 1-hydroxymidazolam glucuronide and the need for prolonged sedation should be therefore be taken into account in drug dose adjustment for patients undergoing CHDF.
- 日本医療薬学会の論文
- 2005-02-10
著者
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YAMAMOTO Yasuhiro
Department of Chemistry, Faculty of Science, Toho University
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MATSUMOTO Yoshiaki
Department of Clinical Pharmacology and Toxicology, Showa College of Pharmaceutical Sciences
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HIRANO Masaaki
Department of Pharmacy, Nippon Medical School Hospital
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Hirano Masaaki
Department Of Materials Science Kumamoto University
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Hirano Masaaki
Department Of Pharmacy Nippon Medical School Hospital
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Matsumoto Yoshiaki
Department Of Clinical Pharmacology And Toxicology Showa Pharmaceutical University
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HIRATA KIYOTAKA
Department of Pharmacy Services, Tama Nagayama Hospital, Nippon Medical School
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Ohno Kanae
Department of Clinical Pharmacology and Toxicology, Showa Pharmaceutical University
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Ohno Kanae
Department Of Clinical Pharmacology And Toxicology Showa Pharmaceutical University
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Hirata K
日本医科大学附属病院 薬剤部
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Matsumoto Yoshiaki
Department Of Clinical Pharmacokinetics College Of Pharmacy Nihon University
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Yamamoto Yasuhiro
Department Of Emergency And Critical Care Medicine Nippon Medical School Hospital
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