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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Evaluation of Oseltamivir Dosing Recommendations for Elderly Patients
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Evaluation of Oseltamivir Dosing Recommendations for Elderly Patients

机译：评估老年患者的奥特拉米维尔给药推荐

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Background: The oseltamivir product monograph recommends dose adjustments based on changes in renal function. For treatment of influenza, the monograph recommends 75mg BID for patients with creatinine clearance (CrCl)>60mL/min, 30mg BID for patients with CrCl 30-60mL/min and 30mg daily for patients with CrCl 10-30mL/min. A 2013 population based pharmacokinetic analysis of oseltamivir and its active carboxylate metabolite (OC) reported that CrCl, age and weight were significant determinants of the OC concentration. Objective: To evaluate OC concentrations using product monograph recommended doses based on the 2013 population based pharmacokinetic analysis and an elderly population of 114 patients with known age, weight and CrCl. Methods: OC concentrations were simulated for 114 elderly patients (age range: 83-101) using product monograph recommended doses. Concentrations were compared to those simulated in a normal patient (55yr; 70kg, CrCl=100mL/min). The peak OC concentration at steady state (Cmaxss) and area under the curve at steady state (AUCss) was calculated for each elderly patient and grouped according to renal function. Differences were tested using analysis of variance. Results: In a normal patient the AUCss was 3.53mg*hr/L. The average AUCss for elderly patients with CrCl>60mL/min (n= 18), 30-60mL/min (n=70) and 10-30mL/min (n=26) were 3.78mg*hr/L, 2.16mg*hr/L, and 3.l4mg*hr/L, respectively, with all groups significantly different from each other (P<0.001). The concentration-time profiles also demonstrated elderly patients with CrCl 30-60mL/min and 10-30mL/min achieved lower concentrations compared to the normal patients. In order to achieve similar concentrations, elderly patients with CrCl 30-60mL/min should receive 45mg BID and patients with CrCl 10-30mL/min should receive 30mg BID. Conclusion: The current oseltamivir monograph dosing recommendations for the treatment of influenza in patients with renal impairment under doses patients.
机译：背景：Oseltamivir产品专着基于肾功能的变化建议进行剂量调整。对于甲型流感的处理，专着为肌酐清除（CRCL）> 60ml / min的患者推荐75mg培训，用于CRCL 30-60ml / min，每天30毫克30毫克，每天为CRCL 10-30ml / min。基于2013年的奥司他韦的群体药代动力学分析及其活性羧酸盐代谢物（OC）报​​道了CRCL，年龄和重量是OC浓度的重要决定因素。目的：根据基于2013人口的药代动力学分析和114名已知年龄，重量和CRCL的老年人，使用产品专着推荐剂量评估OC浓度推荐剂量。方法：使用产品专着推荐剂量模拟114名老年患者（年龄范围：83-101）模拟OC浓度。将浓度与模拟在正常患者（55yr; 70kg，CrCl = 100ml / min）进行比较。针对每个老年患者计算稳态（Cmaxs）和恒定状态下的曲线（AUCS）下的峰值OC浓度，并根据肾功能进行分组。使用方差分析测试差异。结果：在正常患者中，AUCS为3.53mg * HR / L.老年人CRCL> 60ml / min（n = 18），30-60ml / min（n = 70）和10-30ml / min（n = 26）的平均AUC为3.78mg * hr / l，2.16mg * HR / L和3.L4MG * HR / L分别，所有组均有显着差异（P <0.001）。浓缩时间型材还表现出CRCL 30-60ml / min和10-30ml / min的老年患者，与正常患者相比较低浓度。为了达到类似的浓度，老年CRCL 30-60ml / min患者应接受45mg出价和CRCL患者10-30ml / min应获得30mg出价。结论：目前奥特拉米维尔专着剂量的推荐，用于治疗剂量患者肾损伤患者患者的患者。

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