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Biomedical subjects

Benito García

Publications and source records attributed to Benito García.

5 recordsLinked to original sources
PubMed2006

Population pharmacokinetics of gentamicin in premature newborns.

OBJECTIVES: To determine the pharmacokinetic parameters of gentamicin in a population of 200 premature newborns and to investigate the influence of several clinical and physiopathological covariates on the pharmacokinetics of the drug. To validate the pharmacokinetic analysis performed in another population of 50 premature newborns. METHODS: A total of 200 premature newborns were evaluated at the neonatal intensive care unit of Severo Ochoa Hospital (Madrid, Spain). Four hundred and seventeen serum drug concentrations were included. Mean gestational age (GA) was 32.19+/-2.97 weeks, mean postnatal age (PNA) was 5.49+/-5.41 days and mean body weight (BW) was 1.68+/-0.63 kg. Fifty additional newborns were studied for validation (mean GA 32.62+/-3.07 weeks, mean PNA 5.17+/-3.77 days and mean BW 1.80+/-0.67 kg). Dosing, serum gentamicin concentrations and 15 covariates were collected. Data analysis was performed with NONMEM. One- and two-compartment open models were evaluated. Four parameters were analysed with the two-compartment open model: clearance (CL), central volume (Vc), peripheral volume (Vp) and intercompartmental clearance (Q). RESULTS AND CONCLUSIONS: The two-compartment open model was found to significantly better describe gentamicin pharmacokinetics in the neonate. More than PNA or GA, creatinine clearance (CLCR) plays an important role in the elimination of gentamicin in premature newborns. Creatinine clearance is also related to GA. The appropriate dosing regimens given in accordance with the characteristics of the patients are 5 mg/kg/48 h and 4 mg/kg/24 or 36 h for neonates<32 weeks and >or=32 weeks of GA, respectively.

Age Factors↗
PubMed2005

Cross Hypersensitivity Syndrome between Phenytoin and Carbamazepine.

OBJECTIVE: To evaluate the incidence of cross anticonvulsant hypersensitivity syndrome (AHS) between phenytoin (PHT) and carbamazepine (CBZ) in hospitalized patients. METHOD: Retrospective chart review about the cross AHS was retrieved from pharmacy adverse drug reaction program from 1998 to 2002 in a 450-bed teaching hospital. MAIN OUTCOME MEASURES: AHS was defined as the appearance of at least two symptoms with the first anticonvulsant drug (ACD). Cross AHS was considered if after withdrawal of a first ACD because of hypersensitivity symptoms, a new episode with similar or new symptoms appeared after exposure to a second ACD. The following symptoms were considered- rash, fever, hepatotoxicity, lymphadenopathies or hematological disturbances. RESULTS: Cross AHS between PHT and CBZ was observed in nine cases (45). After the cross-reaction event, four of them were treated with valproic acid, two with vigabatrin, two with phenobarbital and one with no treatment without developing further AHS. CONCLUSIONS: AHS is a severe complication of aromatic ACD that can compromise the future choice of therapy. Because of the high incidence of clinical cross-reaction between these two drugs, non-aromatic ACD alternatives, must be considered.

Adolescent↗
PubMed2005

Nucleoside/nucleotide backbones for the treatment of HIV infection.

Nucleoside/nucleotide analogs (NAs) are essential components of most current antiretroviral regimens. Although many dual NA combinations may be used as backbones, not all display optimal results. For instance, some associations should be avoided due to antagonism (eg, zidovudine plus stavudine), high rates of toxicity (eg, didanosine plus stavudine) and/or increased risk of virological failure (eg, didanosine plus tenofovir). Moreover, the knowledge of plasma and intracellular interactions between different NAs is important for choosing appropriate combinations and optimal doses in order to optimize antiviral efficacy and minimize toxicities.

Animals↗
PubMed2004

Clostridium difficile colitis associated with valaciclovir.

OBJECTIVE: To report a case of Clostridium difficile colitis associated with valaciclovir treatment. CASE SUMMARY: A 73-year-old man with lumbar herpes-zoster started valaciclovir 1 g tid. After three days he began vomiting and developed diarrhea, three to four stools per day. Symptoms worsened over the following days and he was admitted. Valaciclovir was stopped and fluid and electrolyte replacement was started. He continued 6 days later with diarrhea of 7 to 13 stools per day and a stool test for diagnosis of C. difficile infection was performed with a positive result. The patient received oral metronidazole (500 mg/t.i.d. for 10 days) and rapid improvement and eventual resolution of his diarrhea was observed after 3 days of therapy. DISCUSSION: Although no conclusive reports of this reaction exist, we think this is a case of C difficile colitis that appeared three days after valaciclovir was initiated. Colitis improved with metronidazole. Other causes of diarrhea were excluded, such as diabetes mellitus, renal failure, intestinal surgery and intestinal obstruction. Infection was confirmed by a positive test for C. difficile. The application of Naranjo's algorithm asserts the reaction as 'probable'. CONCLUSIONS: Valaciclovir-associated C. difficile colitis, although rare, can have severe consequences for the patient's health. It should be included as a possible adverse effect of valaciclovir treatment by health professionals.

Acyclovir↗