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Search Results: 1 - 10 of 39793 matches for " Silvia Regina Cavani Jorge; "
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Vancomycin pharmacokinetics in preterm infants
Machado, Jose Kleber Kobol;Feferbaum, Rubens;Kobayashi, Celia Etsuco;Sanches, Cristina;Santos, Silvia Regina Cavani Jorge;
Clinics , 2007, DOI: 10.1590/S1807-59322007000400006
Abstract: objetive: the objective of the present study was to evaluate the kinetic disposition of vancomycin in preterm infants with emphasis on the apparent volume of distribution, biological half-life, and total body clearance as well as whether their variations cause significant modification of the trough plasma concentration of the drug, depending on the postconceptional age (pca) and the postnatal age (pna). material and method: twenty-five selected patients were distributed into 2 groups which differed significantly in terms of mean pca (31.2-32.3 weeks in group 1, n = 13; 33.5-34.1 weeks in group 2, n = 12: ci95%, p < .001) and pna (group 1, 12.0-18.5 days; group 2, 18.0-34.0 days, ci95%, p < .05). the parents were informed and signed a written consent for participation of the infants in the protocol that had been previously approved by the ethics committee of the hospital. results: apparent volume of distribution was significantly increased in group 1 compared with patients of group 2 (0.85 vs. 0.56 l/kg, respectively; p = .01,). additionally multiple linear regression revealed a good linear correlation (r = 0.85) of trough plasma concentration of vancomycin with the apparent volume of distribution and also with the biological half-life in patients of group 1, while a good correlation (r = 0.91) was obtained for the trough plasma concentration with total body clearance in infants of group 2. the influence of these kinetic parameters on the trough concentration of vancomycin in preterm infants seems to vary according to pca and pna. conclusion: in conclusion, the trough plasma concentration of vancomycin depends on the pharmacokinetics, and multiple linear correlation indicates that it varies according to the postconceptional and postnatal age of preterm infants.
Intrathecal morphine plus general anesthesia in cardiac surgery: effects on pulmonary function, postoperative analgesia, and plasma morphine concentration
Santos, Luciana Moraes dos;Santos, Ver?nica Cavani Jorge;Santos, Silvia Regina Cavani Jorge;Malbouisson, Luiz Marcelo Sá;Carmona, Maria José Carvalho;
Clinics , 2009, DOI: 10.1590/S1807-59322009000400003
Abstract: objectives: to evaluate the effects of intrathecal morphine on pulmonary function, analgesia, and morphine plasma concentrations after cardiac surgery. introduction: lung dysfunction increases morbidity and mortality after cardiac surgery. regional analgesia may improve pulmonary outcomes by reducing pain, but the occurrence of this benefit remains controversial. methods: forty-two patients were randomized for general anesthesia (control group n=22) or 400 μg of intrathecal morphine followed by general anesthesia (morphine group n=20). postoperative analgesia was accomplished with an intravenous, patient-controlled morphine pump. blood gas measurements, forced vital capacity (fvc), forced expiratory volume (fev), and fvc/fev ratio were obtained preoperatively, as well as on the first and second postoperative days. pain at rest, profound inspiration, amount of coughing, morphine solicitation, consumption, and plasma morphine concentration were evaluated for 36 hours postoperatively. statistical analyses were performed using the repeated measures anova or mann-whiney tests (*p<0.05). results: both groups experienced reduced fvc postoperatively (3.24 l to 1.38 l in control group; 2.72 l to 1.18 l in morphine group), with no significant decreases observed between groups. the two groups also exhibited similar results for fev1 (p=0.085), fev1/fvc (p=0.68) and pao2/fio2 ratio (p=0.08). the morphine group reported less pain intensity (evaluated using a visual numeric scale), especially when coughing (18 hours postoperatively: control group= 4.73 and morphine group= 1.80, p=0.001). cumulative morphine consumption was reduced after 18 hours in the morphine group (control group= 20.14 and morphine group= 14.20 mg, p=0.037). the plasma morphine concentration was also reduced in the morphine group 24 hours after surgery (control group= 15.87 ng.ml-1 and morphine group= 4.08 ng.ml-1, p=0.029). conclusions: intrathecal morphine administration did not significantly alter pulmonary
Micrométodo para quantifica??o de cefuroxima em plasma através da cromatografia líquida de alta eficiência: aplica??o na profilaxia de pacientes submetidos à cirurgia cardíaca
Nascimento, Jorge Willian Leandro;Omosako, Célia Etsuco;Carmona, Maria José;Auler Junior, José Otávio;Santos, Silvia Regina Cavani Jorge;
Revista Brasileira de Ciências Farmacêuticas , 2003, DOI: 10.1590/S1516-93322003000300006
Abstract: an improved, simple, selective and sensitive micromethod based on hplc-uv is described to determine cefuroxime plasma levels, a second generation cephalosporin. once changes on pharmacokinetics of drugs in patients submitted to heart surgery with cardiopulmonary bypass and hypothermia (cpb-h) were reported previously, the objective of the present study was to investigate cefuroxime plasma levels for antimicrobial prophylaxis of infections in those patients after surgery using hplc-uv. only 200 μl of plasma were required, and cefuroxime was determined by a chromatographic method using reversed phase system, after a simple clean up of plasma samples. peaks monitored at 280 nm were eluted isocratically at 12.5 min (cefuroxime) and at 4.0 min (vancomicyn, internal standard,) from a 4 μm, novapak column (150 x 3.9 mm) using a binary mobile phase at flow rate 0.8 ml/min, consisting of 0.375 m acetate buffer, ph 5,0 and acetonitrile, 96:4 (v/v). the method validated with basis of parameters evaluated for the confidence limits of cefuroxime measurements in spiked blank plasma, presents 0.1 μg/ml sensitivity, 0.2 - 200 μg/ml linearity, (r2 0.998), systematic error of 98.2% and 96.9% (intra- and interday accuracy), intra- and interday precision (cv %: 3.2 % and 4.2 %). a good stability and high percentage of recovery (99.2%) were obtained. patients received cefuroxime 6 g i.v. bolus (1,5 g, 4 times in 24 hours), showed in the first postoperative day plasma levels of 108.0 μg/ml (zero), 32.8 μg/ml (3rd h), 9.9 μg/ml (6th h), 3.4 μg/ml (9th h) and 0.8 μg/ml (12th h), after the last dose.
Determining plasma morphine levels using GC-MS after solid phase extraction to monitor drug levels in the postoperative period
Santos, Veronica;López, Karin Jannet Vera;Santos, Luciana Moraes;Yonamine, Mauricio;Carmona, Maria José Carvalho;Santos, Silvia Regina Cavani Jorge;
Clinics , 2008, DOI: 10.1590/S1807-59322008000300004
Abstract: objective: to implement a selective and sensitive analytical method to quantify morphine in small volumes of plasma by gas-liquid chromatography-mass spectrometry (gc-ms), aimed at post-operatively monitoring the drug. method: a gas-liquid chromatographic method with mass detection has been developed to determine morphine concentration in plasma after solid phase extraction. morphine-d3 was used as an internal standard. only 0.5 ml of plasma is required for the drug solid-phase extraction in the bond elut-certify?, followed by the quantification of morphine derivative by gc-ms using a linear temperature program, a capillary fused silica column, and helium as the carrier and make-up gas. the method was applied to determine morphine content in plasma samples of four patients during the postoperative period of cardiac surgery. patient-controlled analgesia with morphine was performed by a venous catheter, and a series of venous blood samples were collected. after the oro-after the orotracheal extubation, morphine plasma levels were monitored for up to 36 hours. results: the run time was 16 minutes because morphine and the internal standard were eluted after 8.8 minutes. the gc-ms method had 0.5 -1000 ng/ml linearity range (r2=0.9995), 0.1 ng/ml limit of detection, intraday and interday precision equivalent to 1.9% and 6.8%, and 0.1% and 0.8% systematic error (intraday and interday, respectively). the analytical method showed optimal absolute (98%) and relative (100.7%) recoveries. morphine dose requirements and plasma levels are discussed. conclusion: the analytical gas-liquid chromatography-mass spectrometry method is selective and adequate for morphine measurements in plasma for applications in clinical studies.
Disposi??o cinética do atenolol em pacientes coronarianos submetidos a revasculariza??o do miocárdio
Leite, Fátima da Silva;Chignalia, Andreia Zago;Carmona, Maria José Carvalho;Auler Junior, José Otávio Costa;Santos, Silvia Regina Cavani Jorge;
Revista Brasileira de Ciências Farmacêuticas , 2006, DOI: 10.1590/S1516-93322006000200006
Abstract: myocardium ischemia is an important factor of risk for mortality and cardiovascular events in the perioperative period of cardiac and non cardiac surgeries. however, the prophylactic administration of b-blocker agents could reduce these risks. physiologic changes, occurred during the coronary artery bypass graft (cabg) surgery with cardiopulmonary bypass (cpb), could alter plasma concentration and pharmacokinetics of many drugs. this study investigated the pharmacokinetics of atenolol in patients with unstable angina and without renal dysfunction, submitted to cabg surgery and treated chronically with atenolol po. for pharmacokinetic analysis, 13 blood samples were collected after doses administrated pre- and post-operatively. compared to the pre-operative period, it was verified a non-significant reduction in the apparent volume of distribution and plasma clearance after the surgery, remaining unchanged the biological half-life, p>0.05 (ns). a negative linear correlation between plasma clearance and elimination half-life was demonstrated in both periods of the study (r: -0.77 p=0.06, pre-surgery and r: -0.89, p=0.06, post-surgery), while a correlation between volume of distribution and biological half-life was established only before revascularization (r: 0,54 p= 0,03 , pre-surgery and r: 0,09, p=0,03, post-surgery). we suggest that the cabg surgery leads to the normalization of the extension of distribution of atenolol.
Obesity influences propranolol pharmacokinetics in patients undergoing coronary artery bypass grafting employing cardiopulmonary bypass
Pereira, Valéria Adriana;Carmona, Maria José Carvalho;Omosako, Célia Etsuco Kobayashi;Auler Júnior, José Otávio Costa;Santos, Silvia Regina Cavani Jorge;
Revista Brasileira de Ciências Farmacêuticas , 2003, DOI: 10.1590/S1516-93322003000400008
Abstract: propranolol plasma levels and kinetic disposition may be altered by hypothermic cardiopulmonary bypass (cpb-h). we investigated the potential influence of obesity on propranolol pharmacokinetics in patients undergoing coronary artery bypass grafting employing cpb-h. fifteen patients, receiving propranolol perorally pre- (10-40 mg, 2-3 times a day) and post-operatively (10 mg, once a day) were distributed in two groups, based on body mass index (bmi), in obese (n = 9, bmi: mean 29.4 kg/m2) and non-obese (n=6, bmi: mean 24.8 kg/m2). a serial of blood samples was collected at the pre- and post-operative periods at time dosing interval (?); propranolol plasma levels were measured one day before and after surgery using a high performance liquid chromatographic procedure described previously. pk solutions software 2.0 was applied to obtain pharmacokinetic parameters. no changes on kinetic parameters as biological half-life (t1/2, p = 0.0625, ns), volume of distribution (vd/f, p=0.8438, ns) and plasma clearance (clt/f, p = 0.1563, ns) were obtained for the non-obese patients, while a prolongation of t1/2 (3.2 to 11.2 h, p< 0.0039), an increase on vd/f (3.0 to 7.7 l/kg, p<0.0039) and reduction on clt/f (11.3 to 9.2 ml/min.kg, p<0.0391) were obtained in the post-operative period for obese patients. pharmacokinetic data could justify propranolol plasma concentrations in obese patients higher than in non-obeses, after surgery.
Monitoring plasma vancomycin concentrations in a burned patient
Daniele Ferreira de Faria Bertoluci,Karín Jannet Vera López,Adriana Macêdo Dell’Aquila,Silvia Regina Cavani Jorge Santos
Einstein (S?o Paulo) , 2008,
Abstract: This paper presents a case report of therapeutic vancomycin monitoring through high performance liquid chromatography (HPLC-UV), as well as pharmacokinetic modelling in extensively burned patients. Data obtained from peak and trough levels indicated that the dosing schedule and type of intravenous infusion should be revised using pharmacokinetics as a powerful monitoring tool.
Influência da circula??o extracorpórea sobre as concentra??es plasmáticas de atenolol
Leite, Fátima da Silva;Santos, Luciana Moraes dos;Bonafé, Wanderley Wesley;Chignalia, Andréia Zago;Carmona, Maria José Carvalho;Suyama, Mariana Junqueira;Malbouisson, Luiz Marcelo Sá;Auler Jr, José Otavio Costa;Santos, Silvia Regina Cavani Jorge;
Arquivos Brasileiros de Cardiologia , 2007, DOI: 10.1590/S0066-782X2007000600003
Abstract: background: betablockers are used in the treatment of angina pectoris and others ischemic coronary diseases, reducing mortality and cardiovascular events. atenolol is a hydrophilic betablocker which is characterized by gastrointestinal absorption, small extent of distribution and renal function-dependent elimination. objective: the study objective was to determine the inter-individual variability of atenolol in coronary patients. methods: plasma atenolol was quantified in six blood samples collected during the preoperative period from seven patients with coronary insufficiency and surgical indication, chronically treated with atenolol po 25 to 100 mg/day. all patients presented a normal or slightly reduced renal function. results: all enrolled patients presented normal or slightly reduced renal function as a result of age and underlying disease. atenolol plasma concentrations showed a monoexponential decline, confirming the first-order pharmacokinetics at the doses employed for the control of coronary insufficiency (mean ± sd): 123 ± 56, 329 ± 96, 288 ± 898, 258 ± 85, 228 ± 79 and 182 ± 73 ng/ml at times zero, 2, 4, 6, 8 and 12h after dose administration. the investigated group showed a small inter-patient variability of atenolol administrated at multiple regimens due to the hydrophilic characteristic of the drug. furthermore, accumulation of atenolol administered chronically was greater in coronary patients, compared to healthy subjects. conclusion: in view of its cardio-selectivity and low-variability, atenolol should be used as the first-choice drug for the treatment of acute coronary syndrome and other cardiovascular diseases.
Propranolol plasma monitoring in children submitted to surgery of tetralogy of Fallot by a micromethod using high performance liquid chromatography
Sanches, Cristina;Galas, Filomena R.B.G.;Silva, Anne G.O. de M.;Carmona, Maria Jose C;Auler Jr., José Otavio;Santos, Silvia Regina Cavani Jorge;
Clinics , 2007, DOI: 10.1590/S1807-59322007000300004
Abstract: objective: to evaluate the analytical micromethod using liquid chromatography for the quantification of propranolol in children submitted to surgery of tetralogy of fallot (tlf). methods: only 0.2 ml of plasma is required for the assay. peaks eluted at 8.4 (propranolol) and 17.5 min (verapamil, internal standard) from a c18 column, with a mobile phase 0.1 m acetate buffer, ph 5.0, and acetonitrile (60:40, v/v) at flow rate 0.7 ml/min, detected at 290 nm (excitation) and 358 nm (emission). surgery was started 776 min of drug administration (8.7mg, mean); seven blood samples were collected from six patients (4m/2f; 2.1yrs;11.5kg; 0.80m; 18.9kg/m2). results: confidence limits of the method showed high selectivity and recovery, sensitivity of 0.02ng/ml, good linearity (0.05-1000ng/ml), precision of 8.6% and accuracy of 3.1%. the mean duration of surgery was 283.2min, with the patients remaining under cardiopulmonary bypass (cpb) for 114min. a declining curve of propranolol plasma concentration was obtained after the last dose in the night that preceded the day of surgery. plasma concentration also was normalized with hematocrit due to the hemodilution caused by the cpb procedure. on the other hand a decrease on drug plasma concentration was obtained between periods, the beginning of surgery to the postoperative day 2 (7.09 ng/ml and 0.05 ng/ml, p<0.05 respectively) and from the end of cpb to the postoperative day 2 (2.79ng/ml e 0.05ng/ml, p<0.05). conclusion: propranolol monitoring of plasma concentrations of children (tlf) normalized after the last preoperative dose revealed a decline from the beginning of surgery to the second postoperative day, suggesting that, once redistribution was restored, propranolol washout was complete.
Sílvia Regina Cavani Jorge Santos
Brazilian Journal of Pharmaceutical Sciences , 2011, DOI: 10.1590/s1984-82502011000100024
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