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Amikacin Pharmacokinetics in Patients with Spinal Cord Injury
Author(s) -
Segal Jack L.,
Brunnemann Sherry R.,
Gordon Stanley K.,
Eltorai Ibrahim M.
Publication year - 1988
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1988.tb03539.x
Subject(s) - medicine , amikacin , pharmacokinetics , volume of distribution , spinal cord injury , anesthesia , fluorescence polarization immunoassay , dosing , spinal cord , antibiotics , psychiatry , microbiology and biotechnology , biology
The influence of chronic (> 1 yr duration) spinal cord injury (SCI) on the disposition of amikacin was studied in seven healthy subjects with SCI (five paraplegic, two tetraplegic) and seven able‐bodied controls (intact neuraxes). The time course of amikacin serum concentration after a 30‐minute infusion (7.5 mg/kg) was followed for up to 8.5 hours using fluorescence polarization immunoassay. Pharmacokinetic values were estimated by a noncompartmental analysis (NC). Amikacin steady‐state volume of distribution (V ss ) was increased to 0.20 ± 0.04 l/kg (mean ± SD) as compared to 0.17 ± 0.02 l/kg in able‐bodied controls (p 0.03), and its mean terminal elimination half‐life in patients with SCI was prolonged by 0.64 hours over the control value of 2.11 ± 0.27 hours (p 0.01). The NC estimated mean residence time (MRT) in patients with SCI (3.65 ± 0.75 hrs) was 0.89 hours longer than that observed in controls (p 0.03). Our data suggest that the V ss , half‐life, and MRT of amikacin are increased in persons with chronic SCI. As a result, amikacin dosing regimens developed in able‐bodied humans may demonstrate diminished efficacy when extrapolated uncritically to these patients.