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신재국,신완균,장인진,신상구,김성민,배현주,최강원,김진규 대한화학요법학회 1990 대한화학요법학회지 Vol.8 No.1
항암화학요법을 받고 있던 중 감염으로 tobramycin을 투여받은 36명의 혈액종양 환자에서 tobramycin의 약동학적 특성을 비종양환자군에서의 population 값과 비교 검토하였다. 이들은 모두 정상 신기능을 가진 16세 이상의 성인남녀(21:15)백혈병 환자들이었다. 36명의 혈액종양 환자에서 산출된 tobramycin의 청소율 및 체내분포용적은 각각 120.3± 27.2ml/lg/hr 및 0.386± 0.11 L/㎏로 population 추정 치보다 유의하게 큰 값을 보였다.(P. <0.05).청소율과 체내분포용적을 해당 population 추정치로 나눈 비율치(ratio)의 평균값은 각각 1.47± 0.34 및 1.20± 0.34였다. 연령, hematocrit치, 혈청albumin치, 발열 및 항암화학요법기간과 tobramycin의 청소율 및 체내분포용적 사이에 유의한 상관관계는 발견할 수 없었다. 본 연구결과 혈액종양 환자에서 tobramycin 투여시는 적정혈장농도를 유지하기 위해 일반 환자군에 비해 용량의 증가 및 투여간격의 조정이 필요하며 지속적인 혈장농도 monitoring을 통하여 용법의 재적정화가 필요할 것으로 사료된다. The pharmacokinetics of tobramycin were evaluated in 36 hematologic malignancy patients undergoing anticancer chemotherapy and compared to the expected values from the population parameters. Total body clearance(mean : 12.3±27.2㎖/㎏/hr) and volume of distribution (mean : 0.386±0.11 L/㎏) in hematologic malignancy patients with normal renal function were significantly greater than those of estimated from population parameter distribution(P<0.05). The ratios of total body clearance and volume of distribution to the population estimates were 1.44±0.37 and 1.20±.034, respectively. No relationships were found between age, hematocrit, serum albumin, fever or duration of anticancer chemotherapy and pharmacokinetic parameters. It is suggested that the increment of tobramycin dose regimen wold be considered in patients with hematologic malignancy, and dose readjustment followed by close monitoring of plasma drug concentration would be required.
신완균,김양수,우준희,최강원 대한화학요법학회 1987 대한화학요법학회지 Vol.5 No.2
Vancomycin in an antibiotics produced by streptemyces orientalis. The emperical formula of vancomycin is C_(66) H_(75) Cl₂N₂O₄and molecular weight is 1,448. It has been in use as an antimicrobial agent for more than 20 years. Nonetheless, understanding of tis pharmacokinatic properties is incomplete. Recent novel clinical applications of vancomycin have stimulated reinvestigations of the pharmacokinetic properties of this drug. After intravenous administration, vancomycin is excreted by kidney, with virtually total recovery in urine. Distribution is consistent with a three compartment open pharmacokinetic toxicity, distribution, metabolism, haemodialysis, peritoneal dialysis and several diseases. The current review of protein binding of vancomycin show variety values as 55%, 53%, 65%, less than 10%. Our study of protein binding of vancomycin was 28.8±3.0% after evaluation of methodology & condition which may affect protein binding in method of equilibrium dialysis. Based on our study of protein binding of vancomycin by equilibrium dialysis, it is required to confirm equilibration depend on memberanes and volume shift.