This work identifies a model for the flow dynamics of retrograde drug infusion, thereby helping to clarify the influence of variables on drug dilution in the apparatus and hence drug infusion rate. The study is a 2(3) factorial design that focuses on the influence of tube diameter (0.065 vs. 0.120 inches) in conjunction with changes in injected drug volume (2.0 vs. 5.0 ml) and iv flow rate (2.0 vs. 10.0 ml h-1). Each of the three variables was shown to exert a statistically significant (p = 0.01) effect on the total volume of fluid necessary to clear a dose from the retrograde apparatus. In all cases studied, smaller diameter tubes, larger injected drug volumes, and slower iv flow rates decreased the total volume fraction (F0.95). Within the confines of the study, practitioners may use an F0.95 value of 1.5 to predict the time at which a patient's retrograde drug infusion is likely to be complete. This, in turn, may be used to facilitate proper timing of blood sampling for therapeutic drug monitoring as well as other pharmacokinetic manipulations.
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http://dx.doi.org/10.1177/106002808602000728 | DOI Listing |
BMC Infect Dis
January 2025
Department of Pharmaceutical Care, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, 73000, Thailand.
Background: The optimal pharmacokinetic and pharmacodynamic (PK/PD) parameters of vancomycin that can improve outcomes in enterococcal infections remain controversial. To clarify the therapeutic target for this antibiotic, this study aimed to determine vancomycin PK/PD parameters associated with efficacy in the early (during 72 h) or later (after 72 h) phase of treatment and nephrotoxicity in enterococcal bloodstream infection patients.
Methods: This multicenter retrospective study reviewed medical records of patients with enterococcal bloodstream infections treated with intravenous vancomycin infusion for at least 72 h between January 2016 and March 2024 at Phramongkutklao Hospital or Nopparatrajathanee Hospital in Bangkok, and Rachaburi Hospital in Rachaburi Province, Thailand.
Neurocrit Care
January 2025
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Oral nimodipine is the only drug approved in North America for patients with aneurysmal subarachnoid hemorrhage (aSAH). However, bioavailability is variable and frequently poor, leading to fluctuations in peak plasma concentrations that cause dose-limiting hypotension. Furthermore, administration is problematic in patients who cannot swallow.
View Article and Find Full Text PDFSci Rep
January 2025
Infectious Diseases Clinic, Azienda Sanitaria Universitaria Friuli Centrale, 33100, Udine, Italy.
Enterococcus faecalis is responsible for numerous serious infections, and treatment options often include ampicillin combined with an aminoglycoside or dual beta-lactam therapy with ampicillin and a third-generation cephalosporin. The mechanism of dual beta-lactam therapy relies on the saturation of penicillin-binding proteins (PBPs). Ceftobiprole exhibits high affinity binding to nearly all E.
View Article and Find Full Text PDFJ Immunother Cancer
January 2025
Rapa Therapeutics, Rockville, Maryland, USA.
Background: Polyclonal autologous T cells that are epigenetically reprogrammed through mTOR inhibition and IFN-α polarization (RAPA-201) represent a novel approach to the adoptive T cell therapy of cancer. Ex vivo inhibition of mTOR results causes a shift towards T central memory (T) whereas ex vivo IFN-α promotes type I cytokines, with each of these functions known to enhance the adoptive T cell therapy of cancer. Rapamycin-resistant T cells polarized for a type II cytokine phenotype were previously evaluated in the allogeneic transplantation context.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Importance: Nelonemdaz selectively antagonizes the 2B subunit of the N-methyl-d-aspartate glutamate receptor and scavenges free radical species.
Objective: To evaluate whether nelonemdaz enhances the clinical outcomes of patients with acute ischemic stroke undergoing emergent reperfusion therapy.
Design, Setting, And Participants: This multicenter double-blind placebo-controlled randomized phase 3 trial (December 25, 2021, to June 30, 2023, in South Korea) recruited patients with acute ischemic stroke who met the following criteria: National Institutes of Health Stroke Scale score greater than or equal to 8, Alberta Stroke Program Early Computed Tomography score greater than or equal to 4, and endovascular thrombectomy within 12 hours after stroke onset.
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