Kim S H, Shim H J, Kim W B, Lee M G
College of Pharmacy, Seoul National University, Korea.
Antimicrob Agents Chemother. 1998 May;42(5):1217-21. doi: 10.1128/AAC.42.5.1217.
Because the physiological changes that occur in patients with acute renal failure could alter the pharmacokinetics of the drugs used to treat the disease, the pharmacokinetics of DA-1131, a new carbapenem antibiotic, were investigated after 1-min intravenous administration of the drug (50 mg/kg of body weight) to control rats and rats with uranyl nitrate-induced acute renal failure (U-ARF rats). The impaired kidney function was observed in U-ARF rats on the basis of physiological parameters observed by microscopy of the kidney and obtained by chemical analysis of the plasma. After a 1-min intravenous infusion of DA-1131, the concentrations in plasma and the total area under the plasma concentration-time curve from time zero to time infinity increased significantly in U-ARF rats compared with those in control rats (13,000 versus 4,400 microg x min/ml). This was due to the significantly slower total body clearance (CL) of DA-1131 (3.84 versus 11.4 ml/min/kg) from U-ARF rats than from control rats. The significantly slower CL of DA-1131 from U-ARF rats was due to both significantly slower renal clearance (0.000635 versus 4.95 ml/min/kg because of a significant decrease in the 8-h urinary excretion of unchanged DA-1131 [1.54 versus 43.8% of the intravenous dose] due to impaired kidney function, as proved by the significant decrease in creatinine clearance [0.0159 versus 4.29 ml/min/kg]) and significantly slower nonrenal clearance (3.80 versus 6.34 ml/min/kg because of a significant decrease in the metabolism of DA-1131 in the kidney) in U-ARF rats. The amounts of DA-1131 recovered from all tissues studied (except the kidneys) were significantly higher for U-ARF rats than for control rats; however, the ratios of the amount in tissue to the concentration in plasma (except those for the kidney, small intestine, and spleen) were not significantly different between the two groups of rats, indicating that the affinity of DA-1131 for rat tissues was not changed considerably in U-ARF rats.
由于急性肾衰竭患者发生的生理变化可能会改变用于治疗该疾病的药物的药代动力学,因此在对对照大鼠和硝酸铀酰诱导的急性肾衰竭大鼠(U-ARF大鼠)静脉注射1分钟该药物(50mg/kg体重)后,研究了新型碳青霉烯抗生素DA-1131的药代动力学。根据通过肾脏显微镜观察和血浆化学分析获得的生理参数,在U-ARF大鼠中观察到肾功能受损。静脉输注DA-1131 1分钟后,与对照大鼠相比,U-ARF大鼠血浆中的浓度以及从时间零到时间无穷大的血浆浓度-时间曲线下的总面积显著增加(13,000对4,400μg·min/ml)。这是由于U-ARF大鼠中DA-1131的总体清除率(CL)比对照大鼠显著减慢(3.84对11.4ml/min/kg)。U-ARF大鼠中DA-1131的CL显著减慢是由于肾清除率显著减慢(0.000635对4.95ml/min/kg,因为由于肾功能受损,未改变的DA-1131的8小时尿排泄量显著减少[静脉注射剂量的1.54%对43.8%],这通过肌酐清除率的显著降低得到证实[0.0159对4.29ml/min/kg])以及U-ARF大鼠中非肾清除率显著减慢(3.80对6.34ml/min/kg,因为肾脏中DA-1131的代谢显著减少)。对于U-ARF大鼠,从所有研究组织(肾脏除外)中回收的DA-1131量显著高于对照大鼠;然而,两组大鼠之间组织中的量与血浆中浓度的比率(肾脏、小肠和脾脏除外)没有显著差异,表明在U-ARF大鼠中DA-1131对大鼠组织的亲和力没有显著改变。