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266 results on '"Colin, Pieter"'

15. Vancomycin Pharmacokinetics Throughout Life: Results from a Pooled Population Analysis and Evaluation of Current Dosing Recommendations

Author

Colin, Pieter J., Allegaert, Karel, Thomson, Alison H., Touw, Daan J., Dolton, Michael, de Hoog, Matthijs, Roberts, Jason A., Adane, Eyob D., Yamamoto, Masato, Santos-Buelga, Dolores, Martín-Suarez, Ana, Simon, Nicolas, Taccone, Fabio S., Lo, Yoke-Lin, Barcia, Emilia, Struys, Michel M. R. F., and Eleveld, Douglas J.

Published
2019
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23. Moving towards a Question‐centric approach for regulatory decision‐making in the context of drug assessment

Author

Musuamba Tshinanu, Flora, primary, Cheung, S.Y. Amy, additional, Colin, Pieter, additional, Davies, Elin H., additional, Barret, Jeffrey S., additional, Pappalardo, Francesco, additional, Chappell, Michael, additional, Dogne, Jean‐Michel, additional, Ceci, Adriana, additional, Della Pasqua, Oscar, additional, and Rusten, Ine S., additional

Published
2023
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24. Development of a pharmacokinetic and pharmacodynamic model for intranasal administration of midazolam in older adults:a single-site two-period crossover study

Author

Barends, Clemens, den Daas, Izaak, Driesens, Mendy, Visser, Anita, Absalom, Anthony, and Colin, Pieter

Abstract

Background: Intranasal midazolam can produce procedural sedation in frail older patients with dementia who are unable to tolerate necessary medical or dental procedures during domiciliary medical care. Little is known about the pharmacokinetics and pharmacodynamics of intranasal midazolam in older (>65 yr old) people. The aim of this study was to understand the pharmacokinetic/pharmacodynamic properties of intranasal midazolam in older people with the primary goal of developing a pharmacokinetic/pharmacodynamic model to facilitate safer domiciliary sedation care. Methods: We recruited 12 volunteers: ASA physical status 1–2, aged 65–80 yr, and received midazolam 5 mg intravenously and 5 mg intranasally on two study days separated by a 6 day washout period. Concentrations of venous midazolam and 1ʹ–OH–midazolam, Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score, bispectral index (BIS), arterial pressure, ECG, and respiratory parameters were measured for 10 h. Results: Time to peak effect of intranasal midazolam for BIS, MAP, and SpO2 were 31.9 (6.2), 41.0 (7.6), and 23.1 (3.0) min, respectively. Intranasal bioavailability was lower compared with intravenous administration (Fabs 95%; 95% confidence interval: 89–100%). A three-compartment model best described midazolam pharmacokinetics following intranasal administration. A separate effect compartment linked to the dose compartment best described an observed time-varying drug-effect difference between intranasal and intravenous midazolam, suggesting direct nose-to-brain transport. Conclusions: Intranasal bioavailability was high and sedation onset was rapid, with maximum sedative effects after 32 min. We developed a pharmacokinetic/pharmacodynamic model for intranasal midazolam for older persons and an online tool to simulate changes in MOAA/S, BIS, MAP, and SpO2 after single and additional intranasal boluses. Clinical trial registration: EudraCT (2019-004806-90).

Published
2023

47. Target-Controlled Infusion of Cefepime in Critically Ill Patients: single center experience

Author

Jonckheere, Stijn, De Neve, Nikolaas, Verbeke, Jan, De Decker, Koen, Brandt, Inger, Boel, An, Van Bocxlaer, Jan, Struys, Michel M. R. F., Colin, Pieter J., and Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)

Subjects
DEFINING ANTIBIOTIC LEVELS, PREDICTIVE PERFORMANCE, PLASMA-CONCENTRATIONS, CLEARANCE, CARE-UNIT PATIENTS, PHARMACODYNAMICS, VANCOMYCIN, intensive care unit, PIPERACILLIN, target-controlled infusion, cefepime, OPTIMIZATION, pharmacokinetics, drug infusion system, RESISTANCE
Abstract

Attainment of appropriate pharmacokinetic-pharmacodynamic (PK-PD) targets for antimicrobial treatment is challenging in critically ill patients, particularly for cefepime, which exhibits a relative narrow therapeutic-toxic window compared to other beta-lactam antibiotics. Target-controlled infusion (TCI) systems, which deliver drugs to achieve specific target drug concentrations, have successfully been implemented for improved dosing of sedatives and analgesics in anesthesia. We conducted a clinical trial in an intensive care unit (ICU) to investigate the performance of TCI for adequate target attainment of cefepime. Twenty-one patients treated with cefepime according to the standard of care were included. Cefepime was administered through continuous infusion using TCI for a median duration of 4.5 days. TCI was based on a previously developed population PK model incorporating the estimated creatinine clearance based on the Cockcroft-Gault formula as the input variable to calculate cefepime clearance. A cefepime blood concentration of 16 mg/liter was targeted. To evaluate the measured versus predicted plasma concentrations, blood samples were taken (median of 10 samples per patient), and total cefepime concentrations were measured using ultraperformance liquid chromatography-tandem mass spectrometry. The performance of the TCI system was evaluated using Varvel criteria. Half (50.3%) of the measured cefepime concentrations were within +/- 30% around the target value of 16 mg liter(-1). The wobble was 11.4%, the median performance error (MdPE) was 21.1%, the median absolute performance error (MdAPE) was 32.0%, and the divergence was -3.72% h(-1). Based on these results, we conclude that TCI is useful for dose optimization of cefepime in ICU patients.

Published
2020

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