Publications by authors named "A M McKnite"
Background: Milrinone is commonly prescribed to critically ill patients who need extracorporeal life support such as extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Currently, the effect of ECMO and CRRT on the disposition of milrinone is unknown.
Methods: Ex vivo ECMO and CRRT circuits were primed with human blood and then dosed with milrinone to study drug extraction by the circuits.
Background: Azithromycin and methylprednisolone are two medications that are commonly used in patients who require ECMO support. Unfortunately, ECMO support can decrease drug concentrations through adsorption to circuit components. Such interactions have not been well described for either azithromycin or methylprednisolone.
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- * Amiodarone is effective but poses dosing challenges due to its narrow therapeutic window and long half-life, especially in patients undergoing CRRT.
- * An ex vivo study found that CRRT circuits significantly extract amiodarone, with only 23% remaining in plasma after 6 hours, indicating that dosage adjustments may be necessary to maintain effective drug concentrations.
Article Synopsis
- This study focuses on developing a pharmacokinetic model for the drug anakinra in critically ill children undergoing extracorporeal life support (ECLS), which includes continuous renal replacement therapy (CRRT) and ECMO.
- The model was initially created for healthy individuals and then adapted to account for the physiological changes and drug clearance activities related to ECLS in pediatric patients.
- Results indicated that the model accurately predicted anakinra plasma concentrations in adolescents receiving ECLS, suggesting that the dosing recommendations could help improve pharmacotherapy in critically ill children.
Extraction of ketamine and dexmedetomidine by extracorporeal life support circuits★.
J Extra Corpor Technol
September 2024
Background: Patients supported with extracorporeal life support (ECLS) circuits such as ECMO and CRRT often require high doses of sedatives and analgesics, including ketamine and dexmedetomidine. Concentrations of many medications are affected by ECLS circuits through adsorption to the circuit components, dialysis, as well as the large volume of blood used to prime the circuits. However, the impact of ECLS circuits on ketamine and dexmedetomidine pharmacokinetics has not been well described.
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