Farmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapia

ilustraciones, gráficas, tablas

Autores:
Parra González, Daniel Sebastián
Tipo de recurso:
Fecha de publicación:
2021
Institución:
Universidad Nacional de Colombia
Repositorio:
Universidad Nacional de Colombia
Idioma:
spa
OAI Identifier:
oai:repositorio.unal.edu.co:unal/80871
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/80871
https://repositorio.unal.edu.co/
Palabra clave:
610 - Medicina y salud::615 - Farmacología y terapéutica
Febrile Neutropenia
Hematologic Neoplasms
Drug therapy
Neutropenia Febril
Neoplasias Hematológicas
Quimioterapia
Vancomicina
Cefepime
Farmacocinética
Simulación
Dosificación
Área bajo la curva
Neutropenia febril inducida por quimioterapia
Vancomycin
Cefepime
Pharmacokinetics
Simulation
Dosage
Chemotherapy-induced febrile neutropenia
Area under curve
Rights
openAccess
License
Reconocimiento 4.0 Internacional
id UNACIONAL2_25baf7c2c95a5e0afd15d47f70dabe80
oai_identifier_str oai:repositorio.unal.edu.co:unal/80871
network_acronym_str UNACIONAL2
network_name_str Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv Farmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapia
dc.title.translated.eng.fl_str_mv Population pharmacokinetics in the empirical management of infections in patients with hematological malignancies and post-chemotherapy febrile neutropenia
title Farmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapia
spellingShingle Farmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapia
610 - Medicina y salud::615 - Farmacología y terapéutica
Febrile Neutropenia
Hematologic Neoplasms
Drug therapy
Neutropenia Febril
Neoplasias Hematológicas
Quimioterapia
Vancomicina
Cefepime
Farmacocinética
Simulación
Dosificación
Área bajo la curva
Neutropenia febril inducida por quimioterapia
Vancomycin
Cefepime
Pharmacokinetics
Simulation
Dosage
Chemotherapy-induced febrile neutropenia
Area under curve
title_short Farmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapia
title_full Farmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapia
title_fullStr Farmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapia
title_full_unstemmed Farmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapia
title_sort Farmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapia
dc.creator.fl_str_mv Parra González, Daniel Sebastián
dc.contributor.advisor.spa.fl_str_mv Saavedra Trujillo, Carlos Humberto
Díaz Rojas, Jorge Augusto
dc.contributor.author.spa.fl_str_mv Parra González, Daniel Sebastián
dc.contributor.researchgroup.spa.fl_str_mv Grupo de Investigacion en Enfermedades Infecciosas
dc.subject.ddc.spa.fl_str_mv 610 - Medicina y salud::615 - Farmacología y terapéutica
topic 610 - Medicina y salud::615 - Farmacología y terapéutica
Febrile Neutropenia
Hematologic Neoplasms
Drug therapy
Neutropenia Febril
Neoplasias Hematológicas
Quimioterapia
Vancomicina
Cefepime
Farmacocinética
Simulación
Dosificación
Área bajo la curva
Neutropenia febril inducida por quimioterapia
Vancomycin
Cefepime
Pharmacokinetics
Simulation
Dosage
Chemotherapy-induced febrile neutropenia
Area under curve
dc.subject.decs.eng.fl_str_mv Febrile Neutropenia
Hematologic Neoplasms
Drug therapy
dc.subject.decs.spa.fl_str_mv Neutropenia Febril
Neoplasias Hematológicas
Quimioterapia
dc.subject.proposal.spa.fl_str_mv Vancomicina
Cefepime
Farmacocinética
Simulación
Dosificación
Área bajo la curva
Neutropenia febril inducida por quimioterapia
dc.subject.proposal.eng.fl_str_mv Vancomycin
Cefepime
Pharmacokinetics
Simulation
Dosage
Chemotherapy-induced febrile neutropenia
Area under curve
description ilustraciones, gráficas, tablas
publishDate 2021
dc.date.issued.none.fl_str_mv 2021
dc.date.accessioned.none.fl_str_mv 2022-02-03T20:46:25Z
dc.date.available.none.fl_str_mv 2022-02-03T20:46:25Z
dc.type.spa.fl_str_mv Trabajo de grado - Maestría
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.content.spa.fl_str_mv Text
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv https://repositorio.unal.edu.co/handle/unal/80871
dc.identifier.instname.spa.fl_str_mv Universidad Nacional de Colombia
dc.identifier.reponame.spa.fl_str_mv Repositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourl.spa.fl_str_mv https://repositorio.unal.edu.co/
url https://repositorio.unal.edu.co/handle/unal/80871
https://repositorio.unal.edu.co/
identifier_str_mv Universidad Nacional de Colombia
Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.indexed.spa.fl_str_mv Bireme
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spelling Reconocimiento 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Saavedra Trujillo, Carlos Humberto08c609ca0fa0817e557a78e527acaa4fDíaz Rojas, Jorge Augustoec3d060d221609e5088d2b55505c5f5cParra González, Daniel Sebastiána1e7f925c96a57ca3694f138c76532e9600Grupo de Investigacion en Enfermedades Infecciosas2022-02-03T20:46:25Z2022-02-03T20:46:25Z2021https://repositorio.unal.edu.co/handle/unal/80871Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, gráficas, tablasLos pacientes con neoplasias hematológicas y neutropenia febril postquimioterapia podrían presentar alteraciones fisiológicas que lleven a cambios en la farmacocinética (PK) de los fármacos comparado a individuos sin cáncer o neutropenia. Estos cambios, en la PK de antibióticos, podrían resultar en fallos terapéuticos y esto a su vez en hospitalizaciones prolongadas, empeoramiento en la severidad de la infección e inclusive en la muerte. En este estudio, se desarrollaron modelos de PK poblacional para cefepime (FEP) y vancomicina (VAN) en el tratamiento empírico de infecciones en pacientes con neutropenia post-quimioterapia. La farmacocinética de FEP fue descrita por un modelo de dos compartimentos con aclaramiento dependiente del nivel de creatinina sérica (SCR), variabilidad interindividual en todos los parámetros y variabilidad residual con una función aditiva. Por otra parte, la farmacocinética de VAN fue descrita con un modelo de dos compartimentos con aclaramiento dependiente del aclaramiento renal de creatinina (ClCr), variabilidad interindividual en todos los parámetros, correlación entre los parámetros V1 y V2 y una variabilidad residual con funciones aditivas dependientes del método de determinación de VAN. Mediante simulaciones de Monte Carlo se encontró que para FEP, el alcance de los objetivos PK/PD (60%fT>MIC y 100%fT>MIC) es muy dependiente de la duración de infusión, así como del efecto de SCR. Para VAN se encuentra que el alcance del indicador AUC/MIC ≥ 400 se ve afectado por cambios en la dosis diaria total y la prolongación de la duración de infusión no afecta el PTA. Se realizó una comparación entre objetivos dependientes de AUC vs Cmin, y se encuentró que el último no es un predictor adecuado del primero. (Texto tomado de la fuente).Patients with haematological malignancies and post-chemotherapy febrile neutropenia may present with physiological alterations that could lead to changes in the pharmacokinetics (PK) of drugs compared to individuals without cancer or neutropenia. These changes, in the PK of antibiotics, could result in therapeutic failures and this in turn in prolonged hospitalizations, worsening the severity of infection and even death. In this study, population PK models were developed for cefepime (FEP) and vancomycin (VAN) in the empirical treatment of infections in patients with post-chemotherapy neutropenia. FEP pharmacokinetics was described by a two-compartment model with clearance dependent on serum creatinine level (SCR), interindividual variability in all parameters, and residual variability with an additive function. On the other hand, the PK of VAN was described with a two-compartment model with clearance dependent on renal creatinine clearance (CrCl), interindividual variability in all parameters, correlation between parameters V1 and V2, and a residual variability with additive functions dependent on the VAN determination method. Through Monte Carlo simulations, it was found that the achievement of PK/PD objectives (60%fT>MIC and 100%fT>MIC) for FEP is highly dependent on the duration of the infusion, as well as the effect of SCR. It was found that the achievement of the PK/PD objective AUC/MIC ≥ 400 with VAN was affected by changes in the total daily dose and the prolongation of the duration of the infusion does not affect the PTA. A comparison was made between targets relying on AUC or Cmin, and it was found that the latter is not an adequate predictor of the former.Los datos analizados en este proyecto fueron obtenidos con el apoyo del Instituto Nacional de Cancerología con financiamiento para el proyecto, de recursos de Inversión Nación, identificado con el código SAP C41030110-012 y de la Universidad Nacional de Colombia en el marco del convenio interinstitucional entre dos instituciones públicas del estado.Incluye anexosMaestríaMagíster en Ciencias - FarmacologíaModelamiento mediante regresión no lineal de efectos mixtos y simulación mediante métodos de Monte Carlo de datos farmacocinéticos de cefepime y vancomicina en una muestra de pacientes con neutropenia febril post-quimioterapia.Resistencia antimicrobianaxxi, 188 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Ciencias - Maestría en Ciencias - FarmacologíaDepartamento de FarmaciaFacultad de CienciasBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::615 - Farmacología y terapéuticaFebrile NeutropeniaHematologic NeoplasmsDrug therapyNeutropenia FebrilNeoplasias HematológicasQuimioterapiaVancomicinaCefepimeFarmacocinéticaSimulaciónDosificaciónÁrea bajo la curvaNeutropenia febril inducida por quimioterapiaVancomycinCefepimePharmacokineticsSimulationDosageChemotherapy-induced febrile neutropeniaArea under curveFarmacocinética poblacional en el manejo empírico de infecciones en pacientes con neoplasias hematológicas y neutropenia febril pos-quimioterapiaPopulation pharmacokinetics in the empirical management of infections in patients with hematological malignancies and post-chemotherapy febrile neutropeniaTrabajo de grado - Maestríainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMBiremeAarons L. 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Adam: A method for stochastic optimization. 3rd International Conference on Learning Representations, ICLR 2015 - Conference Track Proceedings. 2015:1–15.Instituto Nacional de CancerologíaUniversidad Nacional de ColombiaAdministradoresEstudiantesInvestigadoresMedios de comunicaciónPúblico generalORIGINAL1049629987.2021.pdf1049629987.2021.pdfTesis de Maestría en Ciencias - Farmacologíaapplication/pdf17398780https://repositorio.unal.edu.co/bitstream/unal/80871/5/1049629987.2021.pdfe75ba1004dceae44bb7a7cb80b1b2d5cMD55Anteproyecto de Tesis_190607_03.pdfAnteproyecto de Tesis_190607_03.pdfAnexo 1: Anteproyecto de tesisapplication/pdf1170645https://repositorio.unal.edu.co/bitstream/unal/80871/3/Anteproyecto%20de%20Tesis_190607_03.pdfabfecaeb10cc10eb982dd5e2f8249155MD53SustentacionTesis.zipSustentacionTesis.zipAnexo 2: Sustentación de Tesis de 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