评估血液透析清除依替巴肽的体外系统。
Assessment of eptifibatide clearance by hemodialysis using an in vitro system.
机构信息
Department of Clinical Pharmacy, The University of Tennessee Health Science Center, 910 Madison, Memphis, TN 38163-0001, USA.
出版信息
Blood Purif. 2010;30(4):266-71. doi: 10.1159/000320766. Epub 2010 Nov 11.
BACKGROUND/AIMS: Eptifibatide is a parenteral glycoprotein IIb-IIIa inhibitor that prevents platelet aggregation. Although contraindicated in dialysis patients due to limited safety and dialysis data, eptifibatide is prescribed in this population and is associated with bleeding complications. This study was done to determine dialysis clearance (CL(D)) of eptifibatide using an in vitro system.
METHODS
Three common dialyzers were tested. In vitro dialysis was performed at a dialysate flow rate of 500 ml/min, 'blood' flow rate (Q(B)) of 200 and 400 ml/min, and the minimal ultrafiltration rate. Eptifibatide CL(D) and fraction removed were calculated for each condition.
RESULTS
CL(D) ranged from 122 to 225 ml/min and was not significantly different among the dialyzers tested. CL(D) was flow dependent with higher clearances observed at higher Q(B). The estimated fraction of eptifibatide removed was 73-83%.
CONCLUSIONS
These data suggest that hemodialysis is an effective method to decrease the effects of eptifibatide in patients with impaired kidney function.
背景/目的：依替巴肽是一种注射用糖蛋白 IIb-IIIa 抑制剂，可防止血小板聚集。尽管由于安全性和透析数据有限而被禁忌用于透析患者，但依替巴肽仍在该人群中使用，并与出血并发症相关。本研究旨在使用体外系统确定依替巴肽的透析清除率（CL(D)）。
方法
测试了三种常见的透析器。在透析液流速为 500 ml/min、“血液”流速（Q(B)）为 200 和 400 ml/min 以及最小超滤率的条件下进行体外透析。计算了每种条件下的依替巴肽 CL(D)和去除分数。
结果
CL(D)范围为 122 至 225 ml/min，在测试的透析器之间无显著差异。CL(D)与流速相关，较高的 Q(B)观察到更高的清除率。依替巴肽去除的估计分数为 73-83%。
结论
这些数据表明，血液透析是一种有效降低肾功能受损患者依替巴肽作用的方法。
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