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Biomedical subjects

A A Firsov

Publications and source records attributed to A A Firsov.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Hypotension caused by intravenous infusion of rifampicin and its relation to the administration schedule].

It was shown in studies on animals that bolus administration of rifampicin induced hypotension whose severity depended on the rate of the antibiotic administration. When the antibiotic was administered in the 5-, 10- or 15-minute regimen in a dose of 10 mg/kg the maximum decrease in blood pressure was 44, 34 or 21% of the initial level and the maximum antibiotic concentration attained in the blood was 34.4, 27.2 or 22.6 micrograms/ml, respectively. With the infusion for 30 minutes, the maximum antibiotic concentration in the blood was 17.6 micrograms/ml and the blood pressure did not undergo any significant changes. When the rate of the antibiotic infusion was high there was pharmacokinetic heterogeneity of the blood serum and biophase which could lead to unpredictable results. After repeated administrations of rifampicin to the same animals pronounced tachyphylaxis to the antibiotic was noted, which manifested itself in decreasing of hypotension, though the serum antibiotic level was 1.5 to 2 times higher that the initial one. It was concluded that administration of rifampicin in the therapeutic dose equal to 10 mg/kg for 30 minutes was the most sparing regimen for the antibiotic bolus intravenous infusion. Gradual increase in the antibiotic dose and administration rate in patients is possible under careful control of blood pressure and pharmacokinetic studies.

Animals↗
PubMed1989

A dynamic model for in-vitro evaluation of antimicrobial action by simulation of the pharmacokinetic profiles of antibiotics.

The general principles of in-vitro simulation of drug pharmacokinetic profiles for linear one-, two- and multi-compartment models are described. An in-vitro dynamic model constructed on the basis of these, incorporating a novel filtration unit to provide efficient filtration of drugs at constant inoculum size, was used to study the antimicrobial action of sisomicin on Escherichia coli A 20363, in conditions simulating the pharmacokinetic profile observed in humans after a single intramuscular dose of 1 mg/kg.

Anti-Bacterial Agents↗
PubMed1989

[Kinetics of the antibacterial effect of ampicillin and sulbactam combinations in dynamic and static conditions].

Kinetics of antimicrobial effect (AME) of ampicillin/sulbactam combinations (ratios of 4:1 to 1:2) on ampicillin resistant bacterial strains producing beta-lactamases of types II, III, IV and V according to Richmond classification was studied with using the computerized system MS-2 (turbidimetric recording) and an in vitro dynamic model (microcalorimetric recording). The concentrations of the drugs in system MS-2 (static conditions) corresponded to the maximum ones observed in serum of humans after bolus intravenous administration of ampicillin in a dose of 0.5 g and sulbactam in doses of 0.125 to 0.5 g. The pharmacokinetic profiles of the drugs observed in the human serum after their oral and intravenous administration and in the tissue-chamber fluid after intravenous administration of ampicillin (0.5 g) and sulbactam (0.125 g) were simulated in the dynamic model. The combination efficacy was estimated with using the parameter of AME duration (TE) reflecting shifts in the curves of the microbial regrowth in the presence of the drugs against the curve of the control growth (in the absence of the drugs) and the parameter of the AME intensity (IE) evaluated by the area between the curves. It was noted that increasing of the ampicillin/sulbactam ratio from 1:4 to 1:1 was accompanied by an increase in the AME. Further increasing of the sulbactam content in the combination did not result in higher AME. For combined ampicillin/sulbactam dosage forms the ratios of 1:1 to 2:1 should be recommended.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1989

[Pharmacokinetic monitoring of antibiotic therapy].

The general strategy in optimization of antibiotic dosage regimens included development of population or common regimens for an "average" patient (the 1st approximation), subpopulation regimens for patients of certain categories on the basis of interactions between the pharmacokinetic parameters and "patient factors" (the 2nd approximation) and individual regimens on the basis of the data of the pharmacokinetic monitoring (the 3rd approximation). Characteristics of every of the approximations in antibiotic therapy of adults and children were analyzed. Out of the peculiarities of the strategy use in pediatrics+ and micropediatrics+ the following should be indicated: (1) pharmacokinetic heterogeneity of the population requiring grouping of the patients and consequently development of subpopulation dosage regimens omitting stage I, (2) possible development of dosage regimens on the basis of the ration between the pharmacokinetic parameters or immediate drug concentration values and the "patient factors" not only in chronic but also in transitory impairment of some functions and (3) the necessity of considering systematic changes in "pharmacokinetic status" of every child during individualization of the dosage regimens by the data of the pharmacokinetic monitoring.

Age Factors↗
PubMed1989

[Pharmacokinetics of azlocillin in critical conditions: an individualized schedule of drug administration in relation to anatomo-physiologic and pathologic factors].

Azlocillin pharmacokinetics was studied after a single intravenous injection of the antibiotic in a dose of 4 g in 20 patients in critical state. To elucidate the causes of significant individual variability of the antibiotic pharmacokinetics observed in the patients, multiple correlation analysis of the main pharmacokinetic parameters i. e. the area under the concentration/time curve, total clearance, steady-state volume of distribution and mean residence time was performed in regard to the "patient factors" such as sex, age, the volumes of transfused liquid, blood, plasma and blood substitutes, hemoglobin levels, erythrocyte count and ESR. Adequate correspondence of the predicted by the "patient factor" values of the areas under the concentration/time curve and the total clearance to the actually determined values was observed. Correspondence of the predicted values to the steady-state volume of distribution and the mean residence time to the actually determined values was satisfactory. A procedure for design of azlocillin individual dosage regimens based on calculating individual clearance by the "patient factors" is described.

Azlocillin↗
PubMed1989

[Individual schedule of administration of aminoglycosides with reference to anatomo-physiological and pathological factors].

Potentiality of designing individual dosage of sisomicin and gentamicin in regard to "patient factors" was estimated. 62 adult patients with various pulmonary diseases at the background of volemic disorders of diverse degrees were treated with the aminoglycosides under monitoring of their blood levels. Concentrations of sisomicin and gentamicin in serum 1, 3 and 6 hours after their single administration in a dose of 1 mg/kg were determined by HELC. The antibiotic pharmacokinetics was characterized by pronounced individual variability. The ratio of the difference between the upper and lower confidence limits to the average values of the steady-state volume of distribution, the total clearance and the mean residence time amounted to 70, 60 and 57 per cent respectively. To elucidate the cause of the variability multiple correlation analysis of the pharmacokinetic parameters by the "patient factors" was performed. The highest coefficient of the multiple correlation (r = 0.690) defined relation between the aminoglycoside concentration 1 hour after the injection and the hematocrit, globular volume and phase of the volemic disorders which was expressed in coded variables. The coefficient of the multiple correlation between the total clearance and the body surface area, concentrations of creatinine and urea in serum, hematocrit, circulating blood volume and the phase of the volemic disorders was equal to 0.439. Therefore, the consideration of the above factors allowed to explain only 20 per cent of the observed individual variability of the pharmacokinetic parameters. In this connection mediated prediction of total clearance and subsequently individual dosage of the aminoglycosides by the "patient factors" was expedient only until the primary data on the pharmacokinetic monitoring were obtained.

Adolescent↗
PubMed1989

[Pharmacokinetic monitoring during aminoglycoside treatment: the optimal method for individualizing the dosage of tobramycin].

The results of tobramycin concentration monitoring in 33 patients with nonspecific pulmonary infections showed a marked individual variability of the antibiotic blood levels and model-independent pharmacokinetic parameters: total clearance, steady-state volume of distribution and mean residence time whose values were distributed log-normally. Adjusting of the tobramycin dosage by the individual values of the clearance (three-point method, by concentrations 1 h (C1), 3 h (C3) and 6 h (C6), after intramuscular single administration of the antibiotic and one-point method, by C3, after repeated administrations of the antibiotic) provided by the end of a 7-day course a 1.7-fold decrease in the individual ranges of the antibiotic concentration as compared to those without the dosage adjusting. Retrospective analysis revealed that reliable individual dosing of tobramycin was provided with the simplest one-point method when the only blood specimen was collected 3 hours after the injection, i.e. the time interval inversed to the elimination rate constant. According to this method individual doses Dind were calculated by the equation Dind = DpopCpop/Cind, where pop was the population value of D and C. The values of Dind estimated in such a way did not practically differ from those estimated with the more complicated two-point (by C1 and C6) and three-point methods. Application of the equation to the tobramycin "maximum" concentration C1 or the "minimum" one (toward the end of the dosing interval, C6) resulted in less accurate and unbiased estimation of Dind.

Adolescent↗
PubMed1989

[Correlation of dose-antimicrobial effect in modeling in vitro pharmacokinetic profiles of normal and impaired elimination of antibiotics].

Relationships between concentration and antimicrobial effect (AME) of sisomicin (SMN) and cefotaxime (CTX) were established by simulating their pharmacokinetic profiles in an in vitro dynamic model. The AME duration (TE, time shift between the curves of bacteria heat output in the presence and absence of the antibiotics) or intensity (IE, area between the above curves) for both the antibiotics depended in the same way on the area under the concentration/time curve (AUC, mimicing of intravenous administration of the antibiotics in various doses). At low and moderate values of the AUC the dependences of IE or TE vs the AUC (the bacteriostatic phase of the AME development) were of the sigmoid shape while at high values of the AUC there was a marked increase in IE or TE (the bactericidal phase). The patterns of the IE or TE vs AUC curves in impaired antibiotic elimination were analogous. At the same time the IE or TE vs AUC curves for both the antibiotics under simulation of normal elimination (T 1/2, SMN-2.1 h, T 1/2, CTX-1.2 h) and impaired one (T 1/2, SMN-8.3 h, T 1/2, CTX-4.6 h) did not match. In the first case the AMESMN was on the whole higher and the AMECTX was lower than in the second case. Therefore, in patients with renal failure the efficient concentration of the aminoglycoside in blood can be higher and that of the cephalosporin on the contrary can be lower than the normal.

Cefotaxime↗
PubMed1989

[Pharmacokinetic validation of the antitumor efficacy of aclarubicin administered by various routes in CBF1 mice with Ca 755 carcinoma].

Aclarubicin was established to be more active against murine mammary gland carcinoma Ca 755 after its intravenous injection as compared to oral administration. Pharmacokinetics of aclarubicin and its biologically active metabolites MA 144 N1, MA 144 T1 and MA 144 M1 was studied by HPLC in the tumour tissues. Not only quantitative but also qualitative differences in the ratios of the unchanged antibiotic and its metabolites in tumour Ca 755 were detected after aclarubicin administration by these methods. Diverse therapeutic activity was shown to be due to these differences.

Aclarubicin↗
PubMed1988

[Pharmacokinetic study of implantable gentamycin preparations. I. Antibiotic pharmacokinetics in the implantation area and an evaluation of the prolonged effect of the preparations].

Gentamicin pharmacokinetics was studied in the zone of subcutaneous implantation to rats of Septopal, a dosage form based on polymethylmethacrylate stable in vivo (4.5 mg of the antibiotic) and of preparations based on biodegradable polymers such as monocarboxycellulose, alginic acid, nonmodified and modified collagens (1 and 5 mg of the antibiotic). A three-phase pattern of gentamicin level changing in the implantation zone was observed: (1) rapid increasing and decreasing of the antibiotic concentration, (2) stabilization of the gentamicin content at a practically constant level and (3) slow lowering of the antibiotic level in the tissue. Comparison of the areas under the concentration/time curves showed that the modified collagen, alginic acid and monocarboxycellulose had the highest prolongation effect among the biodegradable polymers. Their use in the compositions provided during the first hours after the implantation the antibiotic concentrations in the administration site equal to tens micrograms per 1 g of the tissue. After that during 14 days the concentration of gentamicin in the implantation zone maintained at the level higher than its MIC for the main pathogens of wound infections.

Absorption↗
PubMed1988

[Prediction of the pharmacokinetic profiles of doxycycline in humans based on the results of experiments in animals].

Applicability of the "pharmacokinetic time" concept in animal scale-up was evaluated by the findings of the pharmacokinetic study of doxycycline after its bolus intravenous administration to rats in doses of 9 and 18 mg/kg and to cats as 1-hour constant rate infusion in doses of 3.8 and 7.6 mg/kg. Analysis of the pharmacokinetic profiles in the plot of the logarithmic ratio of concentration/dose to "pharmacokinetic time" i. e. time related to body weight raised to the power 0.25 showed that the slopes of the curves for rats, cats and humans (the literature data, intravenous bolus administration in a dose of 2.9 mg/kg) were practically similar. However, no complete coincidence of the curves was observed. When expressed in the "pharmacokinetic time" scale the half lives were equal to 4.6-5.4, 3.5-3.7 and 5.2 h.kg-0.25 respectively. The difference was 1.5-fold while with using the chronological time the difference was about 5-fold (3.1 hours in rats and 15.1 hours in humans). Therefore, with using the "pharmacokinetic time" 10-fold species differences in the total clearance (0.55 and 0.056 l.h-1.kg-1 in rats and humans respectively) transformed into 2-fold differences (0.37 and 0.16 l.h-1.kg-0.75 respectively). Prediction of doxycycline half lives in humans by the experimental findings was successful.

Animals↗
PubMed1987

[Principles for analyzing the kinetic curves of the antimicrobial effect in dynamic systems simulating the pharmacokinetic profiles of antibiotics].

Alternative variants of the available methods for estimating the antimicrobial effect kinetics in the in vitro dynamic systems were analyzed. For defining and analyzing the concentration-effect relations in the in vitro dynamic systems it was recommended that two integral parameters characterizing the antimicrobial effect duration (TE) and intensity (IE) irrespective of the recording means be used. TE is defined by the time from the moment of antibiotic administration into the dynamic system till the moment when the count of the microorganisms reaches again its initial level. IE is defined by the area between the curves of the microbial growth kinetics in the presence and absence of an antibiotic. The possible application of TE and IE is exemplified by relation between the sisomicin antimicrobial effect on P. aeruginosa 58, E. coli 93 and K. pneumoniae 5056 and the antibiotic concentration under conditions of sisomicin pharmacokinetic profiles reproduction after intramuscular administration within the levels of the therapeutic doses with an account of individual variability of the aminoglycoside concentration in the blood of humans.

Anti-Bacterial Agents↗
PubMed1987

[Data averaging in pharmacokinetic analysis: the population pharmacokinetics of cephalothin and cefazolin].

Cephalothin and cefazolin pharmacokinetics was studied in cats after intravenous administration in doses of 20 and 75 mg/kg. The antibiotic serum concentrations were determined microbiologically. It was shown that the antibiotic pharmacokinetics within the above dose ranges was linear. The data on the antibiotic pharmacokinetics were described by bioexponential equations. Various methods for estimating population pharmacokinetic parameters were compared. Two approaches were used in estimating the population parameters: (1) averaging of individual concentrations followed by determining a single set of the parameters (naive pooled data approach) and (2) calculating of the parameters for an individual concentration/time set followed by the parameter averaging (two-stage approach). With the use of every approach the geometric mean of the parameters was calculated along with the arithmetic one. When the two-stage approach was used the population parameters were estimated with two procedures: averaging of the hybrid parameters (macroconstants) and averaging of the microconstants. Estimation of the population parameters as a geometric mean of the individual parameters, proved to be the most preferable approach.

Animals↗