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Flucytosine Pharmacokinetics in a Critically Ill Patient Receiving Continuous Renal Replacement Therapy
Joint Authors
Kunka, Megan E.
Cady, Elizabeth A.
Woo, Heejung C.
Thompson Bastin, Melissa L.
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-07-12
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Purpose.
A case report evaluating flucytosine dosing in a critically ill patient receiving continuous renal replacement therapy.
Summary.
This case report outlines an 81-year-old male who was receiving continuous venovenous hemofiltration (CVVH) for acute renal failure and was being treated with flucytosine for the treatment of disseminated Cryptococcus neoformans infection.
Due to patient specific factors, flucytosine was empirically dose adjusted approximately 50% lower than intermittent hemodialysis (iHD) recommendations and approximately 33% lower than CRRT recommendations.
Peak and trough levels were obtained, which were supratherapeutic, and pharmacokinetic parameters were calculated.
The patient experienced thrombocytopenia, likely due to elevated flucytosine levels, and flucytosine was ultimately discontinued.
Conclusion.
Despite conservative flucytosine dosing for a patient receiving CVVH, peak and trough serum flucytosine levels were supratherapeutic (120 μg/mL at 2 hours and 81 μg/mL at 11.5 hours), which increased drug-related adverse effects.
The results indicate that this conservative dosing regimen utilizing the patient’s actual body weight was too aggressive.
This case report provides insight into flucytosine dosing in CVVH, a topic that has not been investigated previously.
Further pharmacokinetic studies of flucytosine dosing in critically ill patients receiving CVVH are needed in order to optimize pharmacokinetic and pharmacodynamic parameters while avoiding toxic flucytosine exposure.
American Psychological Association (APA)
Kunka, Megan E.& Cady, Elizabeth A.& Woo, Heejung C.& Thompson Bastin, Melissa L.. 2015. Flucytosine Pharmacokinetics in a Critically Ill Patient Receiving Continuous Renal Replacement Therapy. Case Reports in Critical Care،Vol. 2015, no. 2015, pp.1-5.
https://search.emarefa.net/detail/BIM-1058220
Modern Language Association (MLA)
Kunka, Megan E.…[et al.]. Flucytosine Pharmacokinetics in a Critically Ill Patient Receiving Continuous Renal Replacement Therapy. Case Reports in Critical Care No. 2015 (2015), pp.1-5.
https://search.emarefa.net/detail/BIM-1058220
American Medical Association (AMA)
Kunka, Megan E.& Cady, Elizabeth A.& Woo, Heejung C.& Thompson Bastin, Melissa L.. Flucytosine Pharmacokinetics in a Critically Ill Patient Receiving Continuous Renal Replacement Therapy. Case Reports in Critical Care. 2015. Vol. 2015, no. 2015, pp.1-5.
https://search.emarefa.net/detail/BIM-1058220
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1058220