肾病患者连续腹膜透析头孢唑林的药物动力学及给药方案

本文报告5例肾病患者连续腹膜透析应用头孢唑林的药物动力学及给药方案。1g/2L头孢唑林灌入腹腔,留置4h后,流出液内药浓度为187±53μg/ml,吸收量为57±13％;同时测得血清内药峰浓度为76±8μg/ml。停药后20h,用不含头孢唑林的透析液交换3次后,血清内药浓度为50±9μg/ml,经腹膜累积排出率为体内药量的16±3％。建议给药方案为头孢唑林0.5-1.0g/d,分2次分别加于第二、四次交换的透析液中较为合适。

Drug administration schedule of cefazolin regarding to its pharmacokinetics in ambulatory peritoneal dialysis

A design was made to dialyse the peritoneal cavity continuously with 2 L of fluid, retaining there, and then to drain it out at the end of 4 hrs. Each dialysis was considered as a course of treatment. Within 24 hrs 5 to 6 courses should be given. 1 gm of cefazolin dissolved in 2L fluid was given in one course. After that, the drug conicentration in serum was found to be 76+8ug/ml, while the drug concentration in dialysate was 187+53ug/ml. By calculation 57+ 13% of the drug given was retained. In the 2nd,3rd and 4th courses of dialysis no drug was given. Afterwards, the drug concentration in serum was found to be 50+9 /ug/ml, while the drug concentration in dialysate was 12 to 17 ug/ml, therefore even after 20 hrs 16 + 3% of the drug given was excreted.The proper dosage suggested is as follows.The total daily dose is 0.25-0.5 gm,equally divided into 2 portions and given at the 2nd and 4th dialysis every day.