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Population pharmacokinetics of vancomycin in adult hospitalized patients

dc.contributor.advisorMilovanović, Jasmina
dc.contributor.otherJanković, Slobodan
dc.contributor.otherĐorđević, Nataša
dc.contributor.otherVeličković Radovanović, Radmila
dc.creatorŽivković Zarić, Radica
dc.date.accessioned2019-05-30T12:15:33Z
dc.date.available2019-05-30T12:15:33Z
dc.date.available2020-07-03T15:16:38Z
dc.date.issued2019-03-07
dc.identifier.urihttp://eteze.kg.ac.rs/application/showtheses?thesesId=6685
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/11138
dc.identifier.urihttps://fedorakg.kg.ac.rs/fedora/get/o:1114/bdef:Content/download
dc.description.abstractVankomicin jeste glikopeptidni antibiotik koji deluje baktericidno na većinu gram pozitivnih bakterija. U praksi se najčešće koristi kod infekcija meticilin rezistentnim stafilokokom, kao i kod infekcija penicilin rezistentnog115 Streptococcus-a pneumonia-e. Ukoliko se primenjuje oralno, ne apsorbuje se iz gastroinestinalnog trakta te se koristi za lečenje pseudomembranoznog kolitisa. Populaciona farmakokinetika vrši procenu i određivanje srednjih vrednosti farmakokinetičkih parametara u određenoj populaciji. Cilj ove doktorske disertacije je da se utvrdi koji faktori utiču na klirens vankomicina kako kod pacijenata sa normalnom bubrežnom funkcijom, tako i kod pacijenata sa blagom do umerenom bubrežnom insuficijencijom. Materijal i metod: Istraživanje je sprovedeno na 156 pacijenata Kliničkog centra Kragujevac. Učestvovalo je 78 pacijenata sa normalnom bubrežnom funkcijom, kao i 78 pacijenata sa bubrežnom insuficijencijom. Uzimana je krv od pacijenata nakon najmanje tri dana terapije vankomicinom i merena je koncentracija leka u Centralnoj laboratoriji. Takođe iz krvi određivani su ostali laboratorijski parametri. Uzimani su demografski podaci od pacijenata kao i podaci o komedikaciji i pratećim bolestima uz pomoć posebno smišljenog upitnika. Svi parametri su na kraju obrađivani u NONMEM-u. Rezultati: Dobili smo da nivo fibrinogena utiče na klirens vankomicina kod pacijenata sa normalnom bubrežnom funkcijom. Takođe, naši rezultati su pokazali da na klirens vankomicina kod pacijenata sa bubrežnom insuficijencijom utiču dnevna doza vankomicina kao i nivo aspartat aminotransferaze. Kreatinin u serumu kao i klirens kreatinina nisu uticali na klirens vankomicina ni kod jedne grupa pacijenta. Zaključak: Kod pacijenata sa normalnom bubrežnom funkcijom nivo fibrinogena utiče na klirens vankomicina, dok kod pacijenata sa bubrežnom insuficijencijom116 uticaj imaju dnevna doza vankomicina i nivo aspartat aminotransferaze. To su rezultati koje kliničari mogu koristiti kod doziranja vankomicina, te stoga izbeći subdozirane kao i predozirane pacijente.sr
dc.description.abstractVancomycin is a glycopeptide antibiotic that acts bactericidally on most gram-positive bacteria. In practice, it is most commonly used in methicillin-resistant staphylococcal infections, as well as in penicillin-resistant Streptococcus pneumoniae. If vancomycin was administered orally, it is not absorbed from the gastrointestinal tract and it is used to treat pseudomembranous colitis. Population pharmacokinetics performs assessment and determination of mean pharmacokinetic parameters in a particular population. The goal of this doctoral dissertation is to determine which factors influence the clearance of vancomycin in patients with normal renal function, as well as in patients with mild to moderate renal insufficiency. Material and methods: The research was conducted on 156 patients of the Clinical Center Kragujevac. In the study participated 78 patients with normal renal function and 78 patients with renal insufficiency. Blood from patients was taken after at least three days of vancomycin therapy and the concentration of the drug was measured in the Central Laboratory. Other laboratory parameters were also determined from the blood. Demographic data from patients, as well as data on comedications and accompanying diseases were taken with the help of a specially designed questionnaire. All parameters were finally processed in NONMEM.120 Results: We have found that the level of fibrinogen affects the clearance of vancomycin in patients with normal renal function. Also, our results have shown that the clearance of vancomycin in patients with renal insufficiency affects the daily dose of vancomycin as well as the level of aspartate aminotransferase. Serum creatinine as well as creatinine clearance did not affect the clearance of vancomycin in any patient group. Conclusion: In patients with normal renal function, fibrinogen levels affect the clearance of vancomycin, while in patients with renal insufficiency, the daily dose of vancomycin and the level of aspartate aminotransferase are affected. These are the results that clinicians can use in dosing vancomycin, and therefore avoid subdosage as well as overdose patients.en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Крагујевцу, Факултет медицинских наукаsr
dc.relationinfo:eu-repo/grantAgreement/MESTD/Basic Research (BR or ON)/175007/RS//
dc.rightsopenAccessen
dc.sourceУниверзитет у Крагујевцуsr
dc.subjectvankomicinsr
dc.subjectvancomycinen
dc.subjectpopulation pharmacokineticsen
dc.subjectrenal insufficiencyen
dc.subjectpopulaciona farmakokinetikasr
dc.subjectbubrežna insuficijencijasr
dc.titlePopulaciona farmakokinetika vankomicina kod odraslih hospitalizovanih pacijenatasr
dc.title.alternativePopulation pharmacokinetics of vancomycin in adult hospitalized patientsen
dc.typedoctoralThesis
dc.rights.licenseBY-NC-ND
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/49008/Disertacija.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/49009/Radica_Zivkovic_Zaric_Medicina.pdf


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