Biomedical subjects

C A Peloquin

Publications and source records attributed to C A Peloquin.

78 records · Page 5Linked to original sources

PubMedDate not supplied

Variable disposition of ciprofloxacin in critically ill patients undergoing continuous arteriovenous hemodiafiltration.

Continuous arteriovenous hemodiafiltration (CAVHD) is being used increasingly in critically ill patients with acute renal failure (ARF). We prospectively evaluated extracorporeal and total systemic clearances (ClCAVHD and Cls) of ciprofloxacin during CAVHD in four patients with severe ARF to assess the adequacy of drug dosing. Ciprofloxacin serum and ultrafiltrate concentrations were measured by high-performance liquid chromatography. The ClCAVHD accounted for approximately 5.9% (range 2.8-11.6%) of Cls of ciprofloxacin. However, large variability in serum concentrations was observed with the normally recommended dose of 400 mg/day, and doses of up to 800 mg/day were required to maintain concentrations suitable for treatment of serious infections. High daily doses of ciprofloxacin required in these patients are likely related to altered pharmacokinetics in serious illness as well as to the increased extracorporeal clearance during CAVHD. Clinical studies to define appropriate dosing recommendations for ciprofloxacin during CAVHD are necessary to guide clinicians in optimum drug use.

Acute Kidney Injury↗

PubMedDate not supplied

Pharmacokinetic evaluation of aconiazide, a potentially less toxic isoniazid prodrug.

STUDY OBJECTIVE: To determine the bioavailability and renal elimination of isoniazid, acetylisoniazid, monoacetylhydrazine, diacetylhydrazine, aconiazide, and 2-formylphenoxyacetic acid. STUDY DESIGN: Randomized, double-blind, two-period, crossover phase I study. SETTING: Pharmacokinetics unit at a referral hospital that specializes in the treatment of mycobacterial infections. SUBJECTS: Twelve healthy volunteers selected from the hospital staff. INTERVENTIONS: Subjects received aconiazide tablets 650 mg (containing isoniazid 300 mg) and isoniazid tablets 300 mg. Blood and urine samples were collected over 24 hours after the dose. MEASUREMENTS AND MAIN RESULTS: Intact aconiazide and 2-formylphenoxyacetic acid were not detected in the serum. Compared with isoniazid tablets, aconiazide's relative bioavailability (based on the area under the serum concentration-time curve) was 50.7%; its relative maximum serum concentration was 13.4%. CONCLUSIONS: Isoniazid is less bioavailable after aconiazide tablets than after isoniazid tablets. The optimum dose of aconiazide remains to be determined.

Adult↗

PubMedDate not supplied

Mycobacterial infections.

Infection due to Mycobacterium tuberculosis continues to plague humanity. In the United States, conditions have taken a decided turn for the worse, with an increasing frequency of infection and the spread of multiple-drug-resistant strains. A number of strategies are available to improve the management of this epidemic. Mycobacterium avium is now recognized as a significant cause of morbidity and mortality in patients with the acquired immunodeficiency syndrome. Therapy is limited due to relative drug resistance, drug intolerance, and drug malabsorption; however, potentially useful regimens are being developed.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Tuberculosis and multi-drug resistant tuberculosis in children.

Infection and disease caused by Mycobacterium tuberculosis remain a hugh global problem, and are not well controlled in several areas within the United States. Co-infection with the human immunodeficiency virus (HIV) and immigration from areas with high rates of tuberculosis contribute to the problem in the United States. Organisms resistant to the two main drugs, isoniazid and rifampin, known as multidrug-resistant M. tuberculosis or MDR-TB, present serious therapeutic challenges. Strategies for the management of such cases are presented.

Antitubercular Agents↗

PubMedDate not supplied

Pharmacokinetic evaluation of thiacetazone.

STUDY OBJECTIVE: To investigate the steady-state pharmacokinetics of thiacetazone (TB-1), which is active in vitro against Mycobacterium avium complex (MAC). DESIGN: Open-label phase I study. SETTING: Specialized referral hospital. PATIENTS: Twelve healthy men and women. INTERVENTIONS: Oral TB-1 150 mg/day was administered for 7 days, followed by blood and urine collection over 48 hours. MEASUREMENTS AND MAIN RESULTS: The serum concentration versus time curves of TB-1 showed sustained concentrations, with maximum values of 1.59 +/- 0.47 micrograms/ml, time to maximum 3.30 +/- 1.18 hours, and serum half-life of 15-16 hours. Less than 25% of TB-1 was recovered unchanged in the urine over 48 hours. Rashes occurred in two subjects at the end of the 7-day dosing period and resolved without progression or sequelae. CONCLUSIONS: Based on these data, we initiated a phase II study of TB-I in patients with pulmonary MAC infection who do not have the acquired immunodeficiency syndrome.

Adult↗

PubMedDate not supplied

Pharmacokinetics of pyrazinamide under fasting conditions, with food, and with antacids.

STUDY OBJECTIVES: To determine intrasubject and intersubject variability in, and the effects of food and antacids on, the pharmacokinetics of pyrazinamide (PZA). DESIGN: Randomized, four-period, crossover phase I study. SUBJECTS: Fourteen healthy men and women volunteers. INTERVENTIONS: Subjects ingested single doses of PZA 30 mg/kg under fasting conditions twice, without a high-fat meal and with an aluminum-magnesium antacid. They also received standard dosages of isoniazid, rifampin, and ethambutol. MEASUREMENTS AND MAIN RESULTS: Serum was collected for 48 hours and assayed by gas chromatography with mass selective detector. Data were analyzed by noncompartmental methods and a compartmental analysis using nonparametric expectation maximization. Both fasting conditions produced similar results: mean PZA Cmax 53.4+/-10.4 microg/ml, Tmax 1.43+/-1.06 hours, and AUC(0-infinity) 673+/-79.7 microg x hr/ml. Fasting results are similar to those in previous reports. In the presence of antacids, subjects had a mean Cmax of 55.6+/-9.0 microg/ml, Tmax of 1.43+/-1.23 hours, and AUC(0-infinity) of 628+/-88.4 microg x hr/ml. In the presence of the high-fat meal, mean Cmax was 45.6+/-9.44 pg/ml, Tmax 3.09+/-1.74 hours, and AUC(0-infinity) 687+/-116 microg x hr/ml. CONCLUSIONS: These small changes in Cmax, Tmax, and AUC(0-infinity) can be avoided by giving PZA on an empty stomach whenever possible.

Adult↗