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Single‐dose ceftriaxone kinetics in functionally anephric patients
Author(s) -
Stoeckel Klaus,
McNamara Patrick J,
HoppeSeyler Georg,
Blumberg Alfred,
Keller Erich
Publication year - 1983
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1983.86
Subject(s) - ceftriaxone , pharmacokinetics , medicine , regimen , dosing , bolus (digestion) , free fraction , pharmacology , renal function , clinical pharmacology , intravenous bolus , plasma concentration , creatinine , urology , endocrinology , chemistry , antibiotics , biochemistry
The disposition profile of ceftriaxone was studied in 12 functionally anephric patients (creatinine clearance <10 ml/min) who received bolus injections of 150, 500, and 1500 mg IV in a noncrossover fashion. As in healthy subjects, the kinetics in uremic patients were nonlinear for total (bound plus unbound) and linear for free (unbound) drug. The plasma protein binding was reduced due to a decreased association constant, resulting in a doubling of the free fraction in plasma. Ten of 12 patients showed nonrenal clearance values of unbound drug (Cl F NR ) identical to those in healthy adults and only minor increases in their biologic t½ (β) compared to normal (12 and 8 hr). These patients would require no dose adjustments in their dosing regimen. Two of the patients exhibited decreased Cl F NR values and increased t½ (α) of 20 and 34 hr. Anephric patients with impaired nonrenal elimination would require minor dose adjustments. Clinical Pharmacology and Therapeutics (1983) 33, 633–641; doi: 10.1038/clpt.1983.86