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Dosing Nucleoside Reverse Transcriptase Inhibitors in Adults Receiving Continuous Veno-Venous Hemofiltration

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Abstract

Background and Objective

Characteristics of nucleoside reverse transcriptase inhibitors (NRTIs) make the drug class susceptible to elimination via continuous veno-venous hemofiltration (CVVH), potentially leading to suboptimal drug concentrations if given at the recommended anephric doses during CVVH. The objective of this study was to formulate NRTI dosing recommendations for adults receiving CVVH.

Methods

A mathematical formula that estimates the amount of drug likely to be removed during CVVH at various flow rates was used to calculate the supplemental NRTI dose required during CVVH.

Results

A proposed table of dosing recommendations for NRTIs during CVVH is presented.

Conclusion

Clinicians should utilize these recommendations in the context of each individual patient, taking into consideration patient-specific factors and severity of illness. Future pharmacokinetic research correlating plasma and intracellular concentrations of NRTIs during CVVH is warranted to elucidate appropriate dosing.

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Acknowledgments

Portions of this paper were presented as a poster at the 2012 ASHP Midyear Clinical Meeting, Mandalay Bay Hotel, Las Vegas, NV, USA, 2–6 December 2012.

This article was not supported by any external funding. MMM has served on an advisory board for BioCryst Pharmaceuticals. All other authors have no conflicts of interest that are directly relevant to the content of this article.

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Authors and Affiliations

  1. Department of Pharmacy Practice, Chicago College of Pharmacy, Midwestern University, 555 31st Street, Downers Grove, IL, 60515, USA

    Milena M. McLaughlin & Abeer T. Ammar

  2. Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA

    Milena M. McLaughlin & Lana Gerzenshtein

  3. Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA

    Kimberly K. Scarsi

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  1. Milena M. McLaughlin
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  2. Abeer T. Ammar
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Correspondence to Milena M. McLaughlin.

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McLaughlin, M.M., Ammar, A.T., Gerzenshtein, L. et al. Dosing Nucleoside Reverse Transcriptase Inhibitors in Adults Receiving Continuous Veno-Venous Hemofiltration. Clin Drug Investig 35, 275–280 (2015). https://doi.org/10.1007/s40261-015-0275-9

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