การศึกษาระดับยาซัยโคลสปอรินที่ 2 ชั่วโมงหลังรับประทานยาในผู้ป่วยก่อนการผ่าตัดปลูกถ่ายไต เพื่อใช้คาดคะเนขนาดยาซัยโคลสปอรินที่เหมาะสมหลังการผ่าตัดปลูกถ่ายไต / นรินทร์ สุขะวัชรินทร์ = Study of cyclosporin level at 2 hours after administration in preoperative kidney transplant patients for prediction of postoperative optimal cyclosporin dose / Narin Sukhavasharin
Absorption profiling of cyclosporin is a current concept of drug monitoring. A single blood concentration measurement 2 hours after cyclosporin administration (C2), assumed as a peak level, has been shown to be a good predictor of drug exposure and clinical outcome. The recommendation states that achieving the recommended target level of 1700+-340 ng/ml within 3 -5 days after renal transplantation is associated with lower rate of acute rejection and nephrotoxicity. The highly variation of pharmacokinetic profile and short limited time make it hard to adjust cyclosporin dose that can reach that target level on time. This study was designed to be a method to predict that optimal dose. Patients and method: 11 living-related kidney transplant recipients were recruited to receive cyclosporin and were monitored for C2 level during the 2 weeks before operation by the designed method. The C2 level were used to predict the optimal cyclosporin dose. All patients will receive cyclosporin of this predicted dose within 12-24 hrs before operation until the 3rd day after operation. Result: 1. 9 out of 11 patients (81.81%) can reach the target C2 level on the 3rd day after trasplantation without any serious side effect and complication. The most common side effect, which are found in 81.81% of patients are nausea and flushing sensation that usually abate with later dose especially after transplantion. 2. The predicted optimal dose and C2 level has no correlation with any biological parameters in this study. Conclusion: The early postoperative optimal cylosporin dose can be effectively predicted by preoperative C2 measurement as conducted in this study but cannot be predicted by any biological parameters.
