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Master's Dissertation
DOI
10.11606/D.42.2011.tde-09022012-153405
Document
Author
Full name
Marcus Vinicius de Souza João Luiz
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2011
Supervisor
Committee
Aizenstein, Moacyr Luiz (President)
Martins, Carmen Tzanno Branco
Planeta, Cleopatra da Silva
Title in Portuguese
Vancomicina e insuficiência renal: problemas relacionados ao seu uso em pacientes submetidos à hemodiálise.
Keywords in Portuguese
Farmacologia
Fármacos
Hemodiálise
Terapêutica médica
Uso de medicamentos
Abstract in Portuguese
A vancomicina (VANCO) é a primeira opção terapêutica para o tratamento de infecções por estafilococos meticilina-resistentes. Recomenda-se a manutenção de seus níveis séricos entre 15 e 20 mg/mL para eficácia e segurança dos tratamentos. Foi realizado estudo transversal retrospectivo com 15 pacientes dialítcos em tratamento com doses de 1 g VANCO. As freqüências de administrações de VANCO foram comparadas aos seus níveis séricos. A correlação entre nível sérico com o tempo de tratamento e tempo de omissão de dose foi analisada. Quarenta determinações séricas (43%) se mostravam inferiores a 15 mg/mL enquanto vinte e quatro (25,8%) revelaram níveis superiores a 20mg/mL. Este estudo nos permite sugerir que doses de VANCO utilizadas no tratamento de pacientes dialíticos devem ser calculadas em função de sua massa corpórea real, considerando os resultados dos níveis séricos de amostras colhidas no vale, antes da sessão de diálise. Sugerimos que a vancocinemia seja realizada no vale, a cada 48 horas, em pacientes com clearance de creatinina inferior a 20 mL/min.
Title in English
Vancomycin and renal failure: use-related problems in patients under hemodialysis.
Keywords in English
Drugs
Hemodialysis
Medical therapy
Pharmacology
Use of medicines
Abstract in English
Vancomycin (VANCO) has been considered the first therapeutic option for treatment of MRSA infections. In order to achieve efficacy and safety, it is recommended VANCO therapeutic plasma levels range between 15 and 20 mg/mL. Retrospective cross-sectional study of 15 dialyitc patients who received several doses of 1g of VANCO and the serum levels were analysed. The administration frequencies were compared to VANCO plasma levels. The correlation between VANCO plasma levels and treatment period and missed doses period was got. The most VANCO serum levels were out of the therapeuic range. Forty serum levels (43%) were below 15 mg/mL while twenty four (25.8%) were above 20 mg/mL. This sutdy allows us tosuggest that VANCO doses must be prescribed according to the patient Actual Body Weight (ABW), considering results of trough plasma concentrations obtained before hemodialysis session. Our results suggest that through plasma levels are obtained every 48 hours in patients with creatinine clearance below 20 mL/min.
 
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Publishing Date
2012-03-14
 
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