Skip to main content
NCBI home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1994 Jul;38(7):1519–1522. doi: 10.1128/aac.38.7.1519

Pharmacokinetics of ceftriaxone during plasma exchange in polyarteritis nodosa patients.

F Fauvelle 1, O Lortholary 1, M Tod 1, L Guillevin 1, M Louchahi 1, A Léon 1, O Petitjean 1
PMCID: PMC284586  PMID: 7979282

Abstract

Plasma exchange (PE) is currently being used to treat a variety of disorders involving immune complexes, such as polyarteritis nodosa. This procedure removes endogenous toxic components that accumulate in patients with this disease, but it also removes drugs. Plasma-protein binding and the volume of distribution (V) are two kinetic parameters which strongly affect the efficiency of drug removal by PE. Drugs that are highly bound to plasma proteins and have a low V may show a marked decrease in plasma levels as a result of PE. Because ceftriaxone exhibits saturable plasma-protein binding, which influences its pharmacokinetic parameters, particularly its V, we evaluated its removal during PE therapy in this nonrandomized crossover study. Twelve polyarteritis nodosa patients undergoing PE were studied. Each patient was given ceftriaxone intravenously in doses of 1 and 3 g on days 4 and 11, respectively, immediately before (n = six patients; group I) and 6 h before (n = six patients; group II) PE. Plasma was assayed for ceftriaxone by high-pressure liquid chromatography. The mean amounts eliminated +/- standard deviations were 230.8 +/- 38.5 mg (1 g) and 750.0 +/- 168.5 mg (3 g) for group I and 161.0 +/- 66.0 mg (1 g) and 347.0 +/- 121.0 mg (3 g) for group II. The drug fractions eliminated by PE were 23.0% +/- 3.9% (1-g dose) and 24.9% +/- 5.6% (3-g dose) for group I (P > 0.05), and 16.6% +/- 5.9% (1-g dose) and 11.5% +/- 4.0% (3-g dose) for group II (P < 0.05). These results showed that the drug fraction eliminated decreased when V increased only when the distribution phase of ceftriaxone had been completed (group II). These findings suggest that PE may influence ceftriaxone disposition and that it would be better to administer the drug after PE to assure its therapeutic efficacy.

Full text

PDF
1519

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bakken J. S., Cavalieri S. J., Gangeness D., Kubat T., Pollack J. R. Influence of therapeutic plasmapheresis on elimination of ceftiaxone. Antimicrob Agents Chemother. 1993 May;37(5):1171–1173. doi: 10.1128/aac.37.5.1171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bozkurt F., Schollmeyer P., Keller E. Kinetics of ceftazidime during plasmapheresis. Eur J Clin Pharmacol. 1987;33(2):197–201. doi: 10.1007/BF00544567. [DOI] [PubMed] [Google Scholar]
  3. Chavanet P. Y., Bailly F., Mousson C., Waldner-Combernoux A., Lokiec F., Rebibou J. M., Chalopin J. M., Portier H. Acyclovir pharmacokinetics in plasmapheresis. J Clin Apher. 1990;5(2):68–69. [PubMed] [Google Scholar]
  4. Fauvelle F., Nicolas P., Leon A., Tod M., Perret G., Petitjean O., Guillevin L. Diclofenac, paracetamol, and vidarabine removal during plasma exchange in polyarteritis nodosa patients. Biopharm Drug Dispos. 1991 Aug-Sep;12(6):411–424. doi: 10.1002/bdd.2510120603. [DOI] [PubMed] [Google Scholar]
  5. Keller F., Kreutz G., Vöhringer H. F., Offermann G., Distler A. Effect of plasma exchange on the steady-state kinetics of digoxin and digitoxin. Clin Pharmacokinet. 1985 Nov-Dec;10(6):514–523. doi: 10.2165/00003088-198510060-00004. [DOI] [PubMed] [Google Scholar]
  6. Naranjo C. A., Sellers E. M., Khouw V., Alexander P., Fan T., Shaw J. Variability in heparin effect on serum drug binding. Clin Pharmacol Ther. 1980 Oct;28(4):545–550. doi: 10.1038/clpt.1980.201. [DOI] [PubMed] [Google Scholar]
  7. Stoeckel K., McNamara P. J., Brandt R., Plozza-Nottebrock H., Ziegler W. H. Effects of concentration-dependent plasma protein binding on ceftriaxone kinetics. Clin Pharmacol Ther. 1981 May;29(5):650–657. doi: 10.1038/clpt.1981.90. [DOI] [PubMed] [Google Scholar]
  8. Storstein L. Protein binding of cardiac glycosides in disease states. Clin Pharmacokinet. 1977 May-Jun;2(3):220–233. doi: 10.2165/00003088-197702030-00006. [DOI] [PubMed] [Google Scholar]
  9. Wood M., Shand D. G., Wood A. J. Altered drug binding due to the use of indwelling heparinized cannulas (heparin lock) for sampling. Clin Pharmacol Ther. 1979 Jan;25(1):103–107. doi: 10.1002/cpt1979251103. [DOI] [PubMed] [Google Scholar]
  10. Yakatan G. J., Smith R. B., Leff R. D., Kay J. L. Pharmacokinetic considerations in exchange transfusion in neonates. Clin Pharmacol Ther. 1978 Jul;24(1):90–94. doi: 10.1002/cpt197824190. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES