Anesteziyoloji ve reanimasyon yoğun bakım servisinde yatan erişkin hastalarda teikoplaninin çukur düzeyine etki eden faktörlerin terapötik ilaç izlemi ile değerlendirilmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu tez çalışmasında anesteziyoloji ve reanimasyon yoğun bakım servisinde yatan kritik hastalarda hedeflenen teikoplanin çukur düzeyine erişen hastaların oranının ve bu çukur düzeye erişmede etkisi olduğu düşünülen faktörlerin araştırılması amaçlanmıştır. Materyal ve Metot: Bu prospektif tez çalışması 09.05.2022-27.01.2023 tarihleri arasında İnönü Üniversitesi Turgut Özal Tıp Merkezi Reanimasyon YBÜ'de ve 01.05.2023-21.07.2023 tarihleri arasında Erciyes Üniversitesi Tıp Fakültesi Hastaneleri Anestezi YBÜ'de yürütülmüştür. Hastalara ait demografik veriler, laboratuvar verileri, hastaların günlük vital bulguları ile günlük ilaç istemleri ve teikoplanin infüzyonuna ait bilgiler teikoplanin tedavisi boyunca günlük olarak toplanmış ve teikoplanin çukur düzeyi ile aralarındaki ilişki istatistiksel olarak incelenmiştir. Plazma teikoplanin çukur düzeyinin tayini LC/MS-MS ile yapılmıştır ve hedef çukur düzeyi 10 mg/L olarak belirlenmiştir. Sürekli veriler ortanca [ÇAA], kategorik veriler sayı (yüzde) olarak ifade edilmiştir. Bulgular: Çalışmaya yaşı 18'den büyük olan toplamda 20 erişkin hasta dahil edilmiş ve hastaların yaşının ortanca değeri 70 [55.25-73.00] olarak bulunmuştur. Hastalara uygulanan birim teikoplanin dozu ortancası 5.52 [4.51-6.04] mg/kg olarak bulunmuş ve bu dozla hastaların %50'sinin hedef teikoplanin çukur düzeyine eriştiği gösterilmiştir. Teikoplanin tedavi öncesine kıyasla eritrosit, hemoglobin ve hematokrit değerlerinin tedavi sonunda anlamlı şekilde düştüğü görülmüştür (p<0.05). Teikoplanin-indüklü hepatotoksisite, trombositopeni ve serum kreatinin değerinde artış oranları da incelenmiş ancak anlamlı bir değişiklik saptanmamıştır (p>0.05). Sonuç: Bu tez çalışmasıyla teikoplanin yoğun bakım popülasyonunda 6 mg/kg'dan az birim dozlamayla hastaların önemli bir kısmında hedef düzeye erişildiği gösterilmiştir. Bunun nedeninin hastaların böbrek fonksiyonları olduğu düşünülmektedir. Teikoplanin çukur düzeyi üzerinde etkisi olabilecek risk faktörlerinin ve teikoplanin-indüklü advers etkilerin daha net ortaya konabilmesi için klinik eczacıların rol aldığı daha büyük örneklem genişliği olan çalışmalara ihtiyaç duyulmaktadır.
Aim: The purpose of this thesis was to evaluate the proportion of critically ill patients hospitalized in the anesthesiology and reanimation intensive care unit who reached the specified teicoplanin trough level and the factors hypothesized to influence attaining this trough level. Material and Method: This prospective study was conducted between May 9, 2022 and January 27, 2023 at the Inonu University Turgut Ozal Medical Center Reanimation ICU and between May 1, 2023 and July 21, 2023 at the Erciyes University Faculty of Medicine Hospitals Anesthesia ICU. During teicoplanin treatment; daily demographic data, laboratory data, daily vital signs of patients, daily medication order lists, and teicoplanin infusion information were gathered, and the statistical relationship between teicoplanin trough level and these characteristics was studied. The trough level of plasma teicoplanin was determined by LC/MS-MS and the target level was determined to be 10 mg/L. While continuous data are expressed as median [25. percentile – 75th percentile], categorical data are expressed as numbers (percentage). Results: A total of 20 patients over the age of 18 were included in the study, and the median age of the patients was found to be 70 [55.25-73.00]. The median unit dose of teicoplanin administered to the patients was found to be 5.52 [4.51-6.04] mg/kg, and it was shown that 50% of the patients reached the target teicoplanin trough level with this dose. It was observed that the erythrocyte, hemoglobin, and hematocrit values of teicoplanin decreased significantly at the end of the treatment compared to the pre-treatment (p<0.05). Teicoplanin-induced hepatotoxicity, thrombocytopenia, and an increase in serum creatinine values were also examined, but no significant change was found (p>0.05). Conclusion: In this thesis, it has been shown that the target level of teicoplanin is reached in a considerable part of the patients with a unit dosing of less than 6 mg/kg in the intensive care population. The reason for this is thought to be the kidney functions of the patients. More studies with a larger sample size in which clinical pharmacists take a role are needed to more clearly reveal the risk factors that may have an effect on the teicoplanin trough level and teicoplanin-induced adverse effects.
Aim: The purpose of this thesis was to evaluate the proportion of critically ill patients hospitalized in the anesthesiology and reanimation intensive care unit who reached the specified teicoplanin trough level and the factors hypothesized to influence attaining this trough level. Material and Method: This prospective study was conducted between May 9, 2022 and January 27, 2023 at the Inonu University Turgut Ozal Medical Center Reanimation ICU and between May 1, 2023 and July 21, 2023 at the Erciyes University Faculty of Medicine Hospitals Anesthesia ICU. During teicoplanin treatment; daily demographic data, laboratory data, daily vital signs of patients, daily medication order lists, and teicoplanin infusion information were gathered, and the statistical relationship between teicoplanin trough level and these characteristics was studied. The trough level of plasma teicoplanin was determined by LC/MS-MS and the target level was determined to be 10 mg/L. While continuous data are expressed as median [25. percentile – 75th percentile], categorical data are expressed as numbers (percentage). Results: A total of 20 patients over the age of 18 were included in the study, and the median age of the patients was found to be 70 [55.25-73.00]. The median unit dose of teicoplanin administered to the patients was found to be 5.52 [4.51-6.04] mg/kg, and it was shown that 50% of the patients reached the target teicoplanin trough level with this dose. It was observed that the erythrocyte, hemoglobin, and hematocrit values of teicoplanin decreased significantly at the end of the treatment compared to the pre-treatment (p<0.05). Teicoplanin-induced hepatotoxicity, thrombocytopenia, and an increase in serum creatinine values were also examined, but no significant change was found (p>0.05). Conclusion: In this thesis, it has been shown that the target level of teicoplanin is reached in a considerable part of the patients with a unit dosing of less than 6 mg/kg in the intensive care population. The reason for this is thought to be the kidney functions of the patients. More studies with a larger sample size in which clinical pharmacists take a role are needed to more clearly reveal the risk factors that may have an effect on the teicoplanin trough level and teicoplanin-induced adverse effects.
Açıklama
Anahtar Kelimeler
Eczacılık ve Farmakoloji, Pharmacy and Pharmacology
