Nahata M C
College of Pharmacy, Ohio State University, Columbus.
Clin Pharmacokinet. 1993 Mar;24(3):221-9. doi: 10.2165/00003088-199324030-00004.
Drugs are often given intravenously with an expectation that the predicted serum concentrations will be achieved rapidly. Routine pharmacokinetic monitoring of some drugs may be of limited value, unless the effect of intravenous drug delivery systems on serum concentrations is known. In vitro studies have demonstrated that the actual time for complete drug delivery can be markedly longer than predicted and is dependent inter alia on factors including the delivery device, flow rate, injection site, drug volume and tubing diameter. Studies in paediatric patients have shown that the serum concentrations of drugs, including aminoglycosides and chloramphenicol, are strongly influenced by intravenous drug delivery systems. Similarly, data from adult patients have indicated that a drug delivery system can affect serum concentrations of aminoglycosides. Some data are available about the pharmacokinetics of drugs delivered by newer devices, e.g. controlled release infusion systems, membrane devices and implanted pumps, but additional research is needed to determine their predictability of delivery and pharmacokinetics of commonly used drugs. To achieve optimal therapeutic outcomes in patients, it is crucial to understand the impact of an intravenous drug delivery system on serum concentrations and to develop guidelines for pharmacokinetic monitoring.
药物通常通过静脉注射给药，期望能迅速达到预测的血清浓度。某些药物的常规药代动力学监测价值可能有限，除非了解静脉给药系统对血清浓度的影响。体外研究表明，药物完全输送的实际时间可能明显长于预测时间，且尤其取决于多种因素，包括输送装置、流速、注射部位、药物体积和 tubing 直径（此处“tubing”可能是“导管”之意，结合语境推测）。儿科患者的研究表明，包括氨基糖苷类和氯霉素在内的药物血清浓度受静脉给药系统的强烈影响。同样，成年患者的数据表明，给药系统可影响氨基糖苷类药物的血清浓度。关于新型装置（如控释输注系统、膜装置和植入式泵）给药的药物药代动力学已有一些数据，但还需要更多研究来确定它们对常用药物输送的可预测性及其药代动力学。为使患者获得最佳治疗效果，了解静脉给药系统对血清浓度的影响并制定药代动力学监测指南至关重要。
