文章基本信息

标题：A Nomogram for Predicting Optimal Dosage of Cyclosporine in Renal Transplant Patients : Taking Physiological Factors into Consideration for Regimen during Immunosuppressive Therapy
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作者：Nobuhito SHIBATA ; Nobuo HOSHINO ; Tokuzo MINOUCHI 等
期刊名称：Biological and Pharmaceutical Bulletin
印刷版ISSN：0918-6158
电子版ISSN：1347-5215
出版年度：1995
卷号：18
期号：10
页码：1423-1429
DOI：10.1248/bpb.18.1423
出版社：The Pharmaceutical Society of Japan
摘要：We constructed a nomogram for determining the optimal regimen of cyclosporine (CyA), based on physiological changes that occur during immunosuppressive therapy. The nomogram consists of a fixed model and a variable model. In the fixed model, the oral dose of CyA (D, mg/kg) is given by the multiple linear function of logarithmic CyA trough level (TL, ng/ml), the surrogate apparent total body clearance of CyA (CL/f_su, 1/h/kg, being equal to D/TL/12), and the erythrocyte-to-plasma distribution ratio of CyA (CyA-EP), as defined by : D=4.938×log (TL)+1.5037×CL/f_su-0.0326×CyA-EP-10.7156. In the variable model, the CL/f_su is given by the CyA-EP and the patient's intrinsic parameters (P₁, P₂), using a nonlinear equation : CL/f_su=P₁×exp (P₂×CyA-EP)/CyA-EP. An optimal CyA dose to maintain a desired trough level was calculated, and the validity of the nomogram was found satisfactory for clinical use. This offers a very concise and practical method for the therapeutic monitoring of CyA. Because the pharmacokinetics of CyA depends on physiological changes due to several disease states, and because the CyA-EP reflects the pharmacokinetics of CyA and the patient's disease state, the proposed nomogram is believed to provide an optimal dosage adjustment, taking physiological factors into consideration.
关键词：cyclosporine;erythrocyte-to-plasma distribution;renal transplantation;optimal dosage adjustment;nomogram