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2 型糖尿病合并高血压患者比索洛尔的群体药代动力学分析。

Population pharmacokinetic analysis of bisoprolol in type 2 diabetic patients with hypertension.

机构信息

Faculty of Medicine, University of Niš, Blvd Zorana Djindjića 81, Niš, 18000, Serbia.

Department of Endocrinology, Faculty of Medicine, University of Niš, Niš, Serbia.

出版信息

Eur J Clin Pharmacol. 2020 Nov;76(11):1539-1546. doi: 10.1007/s00228-020-02937-6. Epub 2020 Jun 25.

Abstract

PURPOSE

Given that it has been reported that type 2 diabetes mellitus may affect the pharmacokinetics of a large number of drugs and that there are still no published population pharmacokinetic (PopPK) analyses in routinely treated patients with hypertension and type 2 diabetes mellitus as comorbid condition, the aim of this study was to determine PK variability of bisoprolol in 70 Serbian patients using the PopPK approach.

METHODS

PopPK analysis was conducted using a nonlinear mixed effects model (NONMEM), version 7.3.0 (Icon Development Solutions). In our patients, a total daily dose of bisoprolol ranged from 1.25 to 10 mg. The drug was administrated orally as a single daily dose or in two divided doses per day.

RESULTS

A wide range of the drug concentrations were noted (1-103 ng/mL) in the population consisted of the adult patients with type 2 diabetes mellitus. From a total of 21 separately assessed covariates, our results indicated that only creatinine clearance could have a potential impact on the variability of the clearance of bisoprolol.

CONCLUSION

Routine assessment of renal function should be carried out before the initiation of treatment with bisoprolol in order to individualize the dose and to prevent possible accumulation and adverse drug reactions.

摘要

目的

据报道,2 型糖尿病可能会影响大量药物的药代动力学,而对于伴有 2 型糖尿病的高血压常规治疗患者,目前仍没有发表的群体药代动力学(PopPK)分析。因此,本研究旨在采用 PopPK 方法确定 70 例塞尔维亚患者中比索洛尔的 PK 变异性。

方法

采用 NONMEM 版本 7.3.0(Icon Development Solutions)进行 PopPK 分析。在我们的患者中,比索洛尔的总日剂量范围为 1.25 至 10 毫克。药物口服,每日一次或每日两次分服。

结果

在由成年 2 型糖尿病患者组成的人群中,观察到药物浓度范围很广(1-103ng/mL)。在总共 21 个单独评估的协变量中,我们的结果表明只有肌酐清除率可能对比索洛尔清除率的变异性有潜在影响。

结论

在开始比索洛尔治疗之前,应常规评估肾功能,以便个体化剂量,预防可能的蓄积和药物不良反应。

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