Klirens lidokaina kao farmakokinetički parameter metaboličke aktivnosti kod pacijenata sa oštećenjem jetre

  • Marija Jovanović Univerzitet u Beogradu - Farmaceutski fakultet
  • Milena Kovačević Univerzitet u Beogradu - Farmaceutski fakultet
  • Sandra Vezmar Kovačević Univerzitet u Beogradu - Farmaceutski fakultet
  • Ivan Palibrk Univerzitetski klinički centar Srbije, Centar za anesteziologiju i reanimatologiju
  • Jasna Bjelanović Univerzitetski klinički centar Srbije, Centar za medicinsku biohemiju
  • Branislava Miljković
  • Katarina Vučićević
DOI: https://doi.org/10.5937/jomb0-38952
Ključne reči: insuficijencija jetre; lidokain; farmakokinetika;

Sažetak


Uvod Cilj studije bila je procena vrednosti farmakokinetičkih parametara lidokaina (LID) kod pacijenata sa oštećenom funkcijom jetre i procena promene farmakokinetičkih parametara u odnosu na vreme nakon hirurške intervencije.

Metodologija Pacijenti sa oštećenom funkcijom jetre bili su podvrgnuti testu pre, 3. i 7. dana nakon intervencije. LID je primenjen u pojedinačnoj i.v. dozi od 1 mg/kg. Uzorci krvi su sakupljeni 15, 30 i 90 minuta nakon primene leka. Za izračunavanje farmakokinetičkih parametara primenjena je neprostorna analiza.

Reultati Studijom je obuhvaćeno 17 pacijenata sa dijagnozom ciroze i 41 pacijent sa tumorom jetre. Kod obe grupe pacijenata, vrednosti koeficijenata korelacije pokazuju najbolju korelaciju između klirensa (CL) i Child-Pugh skora (-0,693, p<0,005) u odnosu na ostale farmakokinetičke parametre. Rezultati ukazuju na pogoršanje funkcije jetre 3. dana nakon operacije u poređenju sa vrednostima LID CL pre operacije (srednje vrednosti LID CL kod pacijenata Child-Pugh grupe A iznosile su 25,91 L/h, 41,59 L/h, respektivno; dok su kod pacijenata u klasi B iznosile 16,89 L/h, 22,65 L/h, respektivno). Sedmog dana vrednosti LID CL (srednja vrednost u Child-Pugh grupi A i B iznosile su 40,98 L/h i 21,46 L/h, respektivno) bile su veće u odnosu na 3. dan posle hirurške intervencije.

Zaključak Farmakokinetički parametri LID se razlikuju u zavisnosti od težine oštećenja jetre, procenjenih Child-Pugh skorom. Vrednosti farmakokinetičkih parametara LID u kombinaciji sa standardnim biohemijskim parametrima mogu se koristiti za dobijanje kompletnije slike funkcije jetre.

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Objavljeno
2022/12/01
Broj časopisa
Vol. 42 Br. 2 (2023): Journal of Medical Biochemistry
Rubrika
Original paper

Sva prava zadržana (c) 2022 Marija Jovanović, Milena Kovačević, Sandra Vezmar Kovačević, Ivan Palibrk, Jasna Bjelanović, Branislava Miljković, Katarina Vučićević

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