Chest Infections: Infections: Fungal |

Voriconazole Pharmacokinetics and Security in Critically Ill Elderly Patients With Fungal Infection FREE TO VIEW

Huili Zhu, MD; Hui Li, MHSA
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Huadong Hospital Affiliated to Fudan University, Shanghai, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A125. doi:10.1016/j.chest.2016.02.130
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SESSION TITLE: Infections: Fungal

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: The part was to study the pharmacokinetics of voriconazole following a single-administration and the multiple-administration of voticonazole and the correlation between voriconazole plasma concentration and biochemical indicators as well as concurrent drug in elderly patients with fungal infection.

METHODS: There are 10 elderly patients with fungal infection, every patient was given once 300mg voriconazole instilled with 100mLliquid for 1h twice a day, 3-5 ml blood was taken from side antebrachium for every patient at the following time point: before administration 0.5h, and after administration 30 min,1.0 h, 2.0 h, 3.0h, 4.0h, 6h, 8h, 12h, 16h, 18h, 24h, 36h and 48h. All plasma samples was determined by validated HPLC method and the pharmacokinetics parameter was calculated by DAS2.0 soft.

RESULTS: The 10 elderly patients with fungal infection patients had been given single dose injection voriconazole, the pharmacokinetics parameter are:Tmax: 0.90±0.21h, Cmax:3.38±0.68mg/L; t1/2:5.23±0.64h; AUC0-t:23.37±6.41mg g·h·L-1; AUC0-∞: 48.91±26.96 mg·h·L-1. The plasma level of dose voriconazole was significantly associated with weight, age, alanine aminotransferase, direct bilirubin, glucocorticoid and proton pump

CONCLUSIONS: The results showed that pharmacokinetics of voriconazole of elderly patients had coincidence with non-compartment model. These parameter are coincident to the pharmacokinetics parameter reported in the literature. Increasing age and combined with proton pump inhibitor in patients (omeprazole) can significantly improve the voriconazole concentration, while the increasing of body weight of patients and the combined application of Glucocorticoid (methylprednisolone or prednisone / prednisolone, dexamethasone) can reduce the voriconazole drug concentration, the combination of voriconazole glucocorticoid can significantly reduce the concentration of drug.

CLINICAL IMPLICATIONS: Monitoring of blood concentration of voriconazole for patients, not only can guide clinical individualized medication scheme optimization, but also can reduce the incidence of adverse reactions, and improve drug safety and efficacy.

DISCLOSURE: The following authors have nothing to disclose: Huili Zhu, Hui Li

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