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头孢地嗪的药代动力学:现有数据综述

Pharmacokinetics of cefodizime: a review of the data on file.

作者信息

Barré J

机构信息

Laboratoire Hospitalo-Universitaire de Pharmacologie, Centre Hospitalier Intercommunal de Créteil, France.

出版信息

J Antimicrob Chemother. 1990 Nov;26 Suppl C:95-101. doi: 10.1093/jac/26.suppl_c.95.

DOI:10.1093/jac/26.suppl_c.95
PMID:2074258
Abstract

Cefodizime is a new aminothiazolyl cephalosporin which may be administered iv or im. The absolute bioavailability im is almost 100%. The mean volume of distribution is approximately 6.2-8.51. Protein binding of cefodizime is 73-89% over the plasma concentration range. Cefodizime penetrates into several tissues and body fluids such as lung, sputum, pleural and ascitic fluids, prostate, kidney, and urine to give concentrations often exceeding the MICs of susceptible pathogens. Total body clearance is low (35-52 ml/min) and clearance is predominantly renal with up to 80% of an iv dose recovered unchanged in the urine. The pharmacokinetics are linear within the range of doses studied (0.5-2 g). The plasma concentration profile is best described by a triple exponential function. The ranges of half-lives reported are as follows: the distribution half-life is 0.2-0.5 h (accounting for 6-15% of the AUC), the beta half-life is 1.5-2.1 h (accounting for 56-76% of the AUC), and the terminal (gamma) half-life is 3.9-7.9 h (accounting for 18-43% of the AUC) After 2 g bd for five days in healthy volunteers, steady state was reached on the second administration, and no accumulation of the drug was noted. The total clearance is about 20% less in elderly subjects than in young adults, but no dosing adjustment is needed in the elderly. The pharmacokinetic profile is significantly altered in patients with a creatinine clearance less than 30 ml/min (three- to five-fold increase in half-life). Accordingly, the dose should be reduced to 50% of normal, at the same dosing interval.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

头孢地嗪是一种新型氨基噻唑基头孢菌素,可静脉注射或肌肉注射。肌肉注射的绝对生物利用度几乎为100%。平均分布容积约为6.2 - 8.5升。在血浆浓度范围内,头孢地嗪的蛋白结合率为73% - 89%。头孢地嗪可渗透到多种组织和体液中,如肺、痰液、胸腔和腹水、前列腺、肾脏及尿液,其浓度常超过敏感病原体的最低抑菌浓度。总体清除率较低(35 - 52毫升/分钟),清除主要通过肾脏,静脉注射剂量的80%以原形在尿液中回收。在所研究的剂量范围(0.5 - 2克)内,药代动力学呈线性。血浆浓度曲线最好用三重指数函数描述。报道的半衰期范围如下:分布半衰期为0.2 - 0.5小时(占曲线下面积的6% - 15%),β半衰期为1.5 - 2.1小时(占曲线下面积的56% - 76%),终末(γ)半衰期为3.9 - 7.9小时(占曲线下面积的18% - 43%)。健康志愿者连续5天每日两次给予2克后,第二次给药时达到稳态,未观察到药物蓄积。老年受试者的总清除率比年轻成年人低约20%,但老年人无需调整剂量。肌酐清除率低于30毫升/分钟的患者药代动力学特征显著改变(半衰期增加三至五倍)。因此,剂量应减至正常剂量的50%,给药间隔不变。(摘要截选至250字)

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