肾衰竭时氨基糖苷类药物的使用。
Aminoglycoside use in renal failure.
作者信息
Nayak-Rao S
机构信息
Department of Nephrology, Bahrain Specialist Hospital, PO Box 10588, Manama, Bahrain.
出版信息
Indian J Nephrol. 2010 Jul;20(3):121-4. doi: 10.4103/0971-4065.70839.
Aminoglycosides are the mainstay in the treatment of serious gram negative infections including catheter-associated infections. They are not metabolized and are rapidly excreted as such by glomerular filtration resulting in a plasma t(½) of approximately two hours in those with normal renal function. The t(½), however, can extend to 30-60 hours in patients who are functionally anephric; therefore, dosage reduction or modification is necessary in renal failure patients. In patients on hemodialysis the clearance of aminoglycosides is significant and variable. The concept of conventional postdialysis dosing in patients on hemodialysis needs to be revised in favor of higher predialysis doses to maintain effective bactericidal activity. This article is a brief review of the use of aminoglycosides in renal failure patients.
氨基糖苷类药物是治疗包括导管相关感染在内的严重革兰氏阴性菌感染的主要药物。它们不被代谢，经肾小球滤过迅速原样排泄，肾功能正常者的血浆半衰期约为两小时。然而，对于无功能性肾的患者，半衰期可延长至30 - 60小时；因此，肾衰竭患者需要减少剂量或调整用药方案。接受血液透析的患者，氨基糖苷类药物的清除率显著且变化不定。血液透析患者传统的透析后给药观念需要修正，应采用更高的透析前剂量以维持有效的杀菌活性。本文简要综述了氨基糖苷类药物在肾衰竭患者中的应用。
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