Pharmacokinetics and Saturable Absorption of Gabapentin in Nursing Home Elderly Patients.
Pharmacokinetics and Saturable Absorption of Gabapentin in Nursing Home Elderly Patients.
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DOI：
10.1208/s12248-016-0022-z
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发表时间：
2017-03
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影响因子：
--
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中科院分区：
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加巴喷丁（GBP）在社区老年患者中的药代动力学数据显示，由于肾功能改变，高龄对GBP的药代动力学有显著影响。然而，没有老年养老院（NH）患者的数据来评估加巴喷丁的吸收和消除。我们的目的是表征GBP的药代动力学在老年疗养院患者维持GBP治疗。这是一项前瞻性药代动力学研究，研究对象是来自7家养老院接受GBP治疗慢性疼痛或癫痫的老年养老院患者（≥60岁）。采用非线性混合效应模型估计药代动力学参数。单室模型描述了数据和清除率（CL）与估计的肾小球滤过率（eGFR）相关（p<0.0001）。老年疗养院患者的GBP CL为2.93 L/hr。在调整GFR的影响后，GBP CL不受年龄、性别、体重或合并症评分的影响。未发现体型、年龄和性别对体积分布有显著影响。证明了GBP的剂量依赖性生物利用度，饱和吸收曲线由非线性双曲函数描述。预测校正的视觉预测检查（pc-VPC）表明，足够的固定效应和随机效应模型成功地模拟了加巴喷丁浓度-时间曲线的平均趋势和变异性。在这个分析中，双曲非线性的参数在老年人和年轻人之间似乎是相似的。
Pharmacokinetic data of gabapentin (GBP) in community-dwelling elderly patients show a significant effect of advanced age on GBP pharmacokinetics due to altered renal function. However, there are no data in elderly nursing home (NH) patients to evaluate gabapentin absorption and elimination. Our objective was to characterize the pharmacokinetics of GBP in elderly nursing home patients maintained on GBP therapy. This was a prospective pharmacokinetic study in elderly nursing home patients (≥ 60 years) receiving GBP for the management of chronic pain or epilepsy from seven nursing homes. Pharmacokinetic parameters were estimated by nonlinear mixed effects modeling. A one-compartment model described the data and clearance (CL) was associated with estimated glomerular filtration rate (eGFR) (p<0.0001). The GBP CL in elderly nursing home patients was 2.93 L/hr. After adjusting for the effect of GFR, GBP CL was not affected by age, sex, body weight or comorbidity scores. No significant effects of body size measures, age and sex were detected on volume of distribution. Dose-dependent bioavailability of GBP was demonstrated, and the saturable absorption profile was described by a nonlinear hyperbolic function. Prediction-corrected visual predictive check (pc-VPC) suggests adequate fixed and random effects models that successfully simulated the mean trend and variability in gabapentin concentration-time profiles. In this analysis the parameters of the hyperbolic nonlinearity appear to be similar between elderly and younger adults.
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影响因子：
--
作者：
Du Bois, D;Du Bois, EF
通讯作者：
Du Bois, EF
影响因子：
6.1
作者：
Gill, Jagbir;Malyuk, Rhonda;Levin, Adeera
通讯作者：
Levin, Adeera
影响因子：
2.5
作者：
Carlsson, Kristin C.;van de Schootbrugge, Margunn;Hoem, Nils Ove
通讯作者：
Hoem, Nils Ove
DOI：
10.1093/geronj/31.2.155
发表时间：
1976-01-01
期刊：
JOURNALS OF GERONTOLOGY
影响因子：
--
作者：
ROWE, JW;ANDRES, R;SHOCK, NW
通讯作者：
SHOCK, NW
影响因子：
5.6
作者：
Lackner, TE;Cloyd, JC;Leppik, IE
通讯作者：
Leppik, IE