低温治疗对药物的药代动力学和药效学影响的系统性评价

目的 系统评价低温治疗对人体药代动力学和药效学的影响.方法 检索PubMed、EmBase和Cocrane Library从数据库建库至2020-03-17,有关低温治疗对于人体药代动力学及药效学的比较研究,限制语言为英语.将纳入文献中药代动力学及药效学参数用相对差异表示,进行系统性评价.结果 共纳入27项研究.在低温...

Effect of therapeutic hypothermia on pharmacokinetics and pharmacodynamics: A systematic review

Objective To systematically review the effect of hypothermia on pharmacokinetics and pharmacodynamics. Methods A literature search was conducted within the PubMed, EmBase and Cochrane databases from inception to March 17th 2020. Included studies were comparative studies on the effect of therapeutic hypothermia on pharmacokinetics and pharmacodynamics. The searches were limited to English language. The pharmacokinetic and pharmacodynamic parameters of the included studies are expressed as relative differences for systematic evaluation. Results Twenty-seven studies were included. The result of systematic review shows that during therapeutic hypothermia, pharmacokinetics and pharmacodynamics parameters alter. The half-life of the drug was found changed in 50% of the studies, and the clearance of the drug was found decreased in 70.3% of the studies. The increase in drug half-life and the decrease in clearance rate lead to the accumulation of drugs, so the dosage should be reduced. Twenty-three percent of studies show that the volume of distribution of the drug changes. Increased volume of distribution will result in poor efficacy. When the volume of distribution decreases, drugs with a low therapeutic index may produce toxic reactions. Changes in pharmacodynamics parameters are related to drug target location and metabolic pathways.Conclusion Therapeutic drugs should be monitored at the same time to ensure the safety and effectiveness of medication when using drugs with low therapeutic index and narrow therapeutic window during hypothermia treatment.