The effect of veno-venous ECMO on the pharmacokinetics of Ritonavir, Darunavir, Tenofovir and Lamivudine.
Τίτλος | The effect of veno-venous ECMO on the pharmacokinetics of Ritonavir, Darunavir, Tenofovir and Lamivudine. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Suliman, M. A. Ghazi, Ogungbenro K., Kosmidis C., Ashworth A., Barker J., Szabo-Barnes A., Davies A., Feddy L., Fedor I., Hayes T., Stirling S., & Malagon I. |
Journal | J Crit Care |
Volume | 40 |
Pagination | 113-118 |
Date Published | 2017 08 |
ISSN | 1557-8615 |
Λέξεις κλειδιά | Bayes Theorem, Darunavir, Dose-Response Relationship, Drug, Extracorporeal Membrane Oxygenation, HIV Infections, HIV Protease Inhibitors, Humans, Lamivudine, Male, Middle Aged, Ritonavir, Tenofovir |
Abstract | INTRODUCTION: To our knowledge, there is no published data on the pharmacokinetic (PK) profile of antiretroviral (ART) drugs on patients undergoing extracorporeal membrane oxygenation (ECMO) therapy. We present PK analyses of Ritonavir, Darunavir, Lamivudine and Tenofovir in a patient with HIV who required veno-venous ECMO (VV ECMO).METHODS: Plasma concentrations for Ritonavir, Darunavir, Tenofovir and Lamivudine were obtained while the patient was on ECMO following pre-emptive dose adjustments. Published population PK models were used to simulate plasma concentration profiles for the drugs. The population prediction and the observed plasma concentrations were then overlaid with the expected drug profiles using the individual Bayesian post-hoc parameter estimates.RESULTS: Following dose adjustments, the PK profiles of Ritonavir, Darunavir and Tenofovir fell within the expected range and appeared similar to the population prediction, although slightly different for Ritonavir. The observed data for Lamivudine and its PK profile were completely different from the data available in the literature.CONCLUSIONS: To our knowledge, this is the first study reporting the PK profile of ART drugs during ECMO therapy. Based on our results, dose adjustment of ART drugs while on VV ECMO may be advisable. Further study of the PK profile of Lamivudine is required. |
DOI | 10.1016/j.jcrc.2017.03.010 |
Alternate Journal | J Crit Care |
PubMed ID | 28384599 |