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201 results on '"Thomson, Alison H."'

1. Use of Machine Learning for Dosage Individualization of Vancomycin in Neonates

Author

Tang, Bo-Hao, Zhang, Jin-Yuan, Allegaert, Karel, Hao, Guo-Xiang, Yao, Bu-Fan, Leroux, Stephanie, Thomson, Alison H., Yu, Ze, Gao, Fei, Zheng, Yi, Zhou, Yue, Capparelli, Edmund V., Biran, Valerie, Simon, Nicolas, Meibohm, Bernd, Lo, Yoke-Lin, Marques, Remedios, Peris, Jose-Esteban, Lutsar, Irja, Saito, Jumpei, Jacqz-Aigrain, Evelyne, van den Anker, John, Wu, Yue-E., and Zhao, Wei

Published
2023
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2. Drug Clearance in Neonates: A Combination of Population Pharmacokinetic Modelling and Machine Learning Approaches to Improve Individual Prediction

Author

Tang, Bo-Hao, Guan, Zheng, Allegaert, Karel, Wu, Yue-E., Manolis, Efthymios, Leroux, Stephanie, Yao, Bu-Fan, Shi, Hai-Yan, Li, Xiao, Huang, Xin, Wang, Wen-Qi, Shen, A.-Dong, Wang, Xiao-Ling, Wang, Tian-You, Kou, Chen, Xu, Hai-Yan, Zhou, Yue, Zheng, Yi, Hao, Guo-Xiang, Xu, Bao-Ping, Thomson, Alison H., Capparelli, Edmund V., Biran, Valerie, Simon, Nicolas, Meibohm, Bernd, Lo, Yoke-Lin, Marques, Remedios, Peris, Jose-Esteban, Lutsar, Irja, Saito, Jumpei, Burggraaf, Jacobus, Jacqz-Aigrain, Evelyne, van den Anker, John, and Zhao, Wei

Published
2021
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3. A physiological approach to renal clearance:From premature neonates to adults

Author

Holford, Nick, O'Hanlon, Conor J., Allegaert, Karel, Anderson, Brian, Falcao, Amilcar, Simon, Nicolas, Lo, Yoke-Lin, Thomson, Alison H., Sherwin, Catherine M., Jacqz-Aigrain, Evelyne, Llanos-Paez, Carolina, Hennig, Stefanie, Mockus, Linas, Kirkpatrick, Carl, Holford, Nick, O'Hanlon, Conor J., Allegaert, Karel, Anderson, Brian, Falcao, Amilcar, Simon, Nicolas, Lo, Yoke-Lin, Thomson, Alison H., Sherwin, Catherine M., Jacqz-Aigrain, Evelyne, Llanos-Paez, Carolina, Hennig, Stefanie, Mockus, Linas, and Kirkpatrick, Carl

Abstract

Aims: We propose using glomerular filtration rate (GFR) as the physiological basis for distinguishing components of renal clearance. Methods: Gentamicin, amikacin and vancomycin are thought to be predominantly excreted by the kidneys. A mixed-effects joint model of the pharmacokinetics of these drugs was developed, with a wide dispersion of weight, age and serum creatinine. A dataset created from 18 sources resulted in 27,338 drug concentrations from 9,901 patients. Body size and composition, maturation and renal function were used to describe differences in drug clearance and volume of distribution. Results: This study demonstrates that GFR is a predictor of two distinct components of renal elimination clearance: (1) GFR clearance associated with normal GFR and (2) non-GFR clearance not associated with normal GFR. All three drugs had GFR clearance estimated as a drug-specific percentage of normal GFR (gentamicin 39%, amikacin 90% and vancomycin 57%). The total clearance (sum of GFR and non-GFR clearance), standardized to 70 kg total body mass, 176 cm, male, renal function 1, was 5.58 L/h (95% confidence interval [CI] 5.50-5.69) (gentamicin), 7.77 L/h (95% CI 7.26-8.19) (amikacin) and 4.70 L/h (95% CI 4.61-4.80) (vancomycin). Conclusions: GFR provides a physiological basis for renal drug elimination. It has been used to distinguish two elimination components. This physiological approach has been applied to describe clearance and volume of distribution from premature neonates to elderly adults with a wide dispersion of size, body composition and renal function. Dose individualization has been implemented using target concentration intervention.

Published
2024

4. A physiological approach to renal clearance: From premature neonates to adults.

Author

Holford, Nick, O'Hanlon, Conor J., Allegaert, Karel, Anderson, Brian, Falcão, Amilcar, Simon, Nicolas, Lo, Yoke‐Lin, Thomson, Alison H., Sherwin, Catherine M., Jacqz‐Aigrain, Evelyne, Llanos‐Paez, Carolina, Hennig, Stefanie, Mockus, Linas, and Kirkpatrick, Carl

Subjects
PREMATURE infants, NEWBORN infants, ADULTS, KIDNEY physiology, GLOMERULAR filtration rate, BODY composition
Abstract

Aims: We propose using glomerular filtration rate (GFR) as the physiological basis for distinguishing components of renal clearance. Methods: Gentamicin, amikacin and vancomycin are thought to be predominantly excreted by the kidneys. A mixed‐effects joint model of the pharmacokinetics of these drugs was developed, with a wide dispersion of weight, age and serum creatinine. A dataset created from 18 sources resulted in 27,338 drug concentrations from 9,901 patients. Body size and composition, maturation and renal function were used to describe differences in drug clearance and volume of distribution. Results: This study demonstrates that GFR is a predictor of two distinct components of renal elimination clearance: (1) GFR clearance associated with normal GFR and (2) non‐GFR clearance not associated with normal GFR. All three drugs had GFR clearance estimated as a drug‐specific percentage of normal GFR (gentamicin 39%, amikacin 90% and vancomycin 57%). The total clearance (sum of GFR and non‐GFR clearance), standardized to 70 kg total body mass, 176 cm, male, renal function 1, was 5.58 L/h (95% confidence interval [CI] 5.50‐5.69) (gentamicin), 7.77 L/h (95% CI 7.26‐8.19) (amikacin) and 4.70 L/h (95% CI 4.61‐4.80) (vancomycin). Conclusions: GFR provides a physiological basis for renal drug elimination. It has been used to distinguish two elimination components. This physiological approach has been applied to describe clearance and volume of distribution from premature neonates to elderly adults with a wide dispersion of size, body composition and renal function. Dose individualization has been implemented using target concentration intervention. [ABSTRACT FROM AUTHOR]

Published
2024
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6. 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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34. Population pharmacokinetic meta-analysis of individual data to design the first randomized efficacy trial of vancomycin in neonates and young infants

Author

Jacqz-Aigrain, Evelyne, primary, Leroux, Stéphanie, additional, Thomson, Alison H, additional, Allegaert, Karel, additional, Capparelli, Edmund V, additional, Biran, Valérie, additional, Simon, Nicolas, additional, Meibohm, Bernd, additional, Lo, Yoke-Lin, additional, Marques, Remedios, additional, Peris, José-Esteban, additional, Lutsar, Irja, additional, Saito, Jumpei, additional, Nakamura, Hidefumi, additional, van den Anker, Johannes N, additional, Sharland, Mike, additional, and Zhao, Wei, additional

Published
2019
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35. Professional development beyond foundation training: a study of pharmacists working in Scotland.

Author

Rueben, Anna, Forsyth, Paul, and Thomson, Alison H.

Abstract

Objectives: In Scotland, post‐registration hospital pharmacists typically undertake a vocational foundation training programme. Beyond this, there are no mandatory structures for ongoing professional training. To support progression to a more advanced level, competency frameworks are increasingly being used. This study aimed to measure the self‐reported competence of pharmacists against a relevant framework and to determine what support was required to enable further professional development. Methods: An online survey was completed by pharmacists working across six acute hospital sites within NHS Greater Glasgow and Clyde who had completed foundation training between Jan 2013 and Jan 2018. Participants self‐reported competency against the Royal Pharmaceutical Society's Advanced Practice Framework Advanced Stage 1 competencies and gave qualitative feedback through free‐text questions. Key findings: Twenty out of twenty‐eight eligible pharmacists (71.4%) responded to the survey and three core areas requiring further support were identified: leadership, management and research. Participants reported that a strategic plan for professional development, more opportunities and managerial support were needed to help them develop these areas. Mentorship programmes and postgraduate qualifications were suggested as formats to support development. Conclusion: Pharmacists working towards advanced practice reported high levels of competence in expert professional practice, collaborative working relationships and education, training and development. While these results are promising, additional support is likely to be needed to cultivate leadership, management and research skills. Future training strategies need to consider this imbalance if we are to achieve national and international workforce goals for the professional development of pharmacists. [ABSTRACT FROM AUTHOR]

Published
2020
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37. Timing of the first vancomycin maintenance dose in an acute hospital setting - room for improvement?

Author

Carruthers, Andrew, Thomson, Alison H., Semple, Yvonne, and Rodger, Rachael

Subjects
RM
Abstract

Introduction Intravenous vancomycin therapy typically starts with a loading dose followed by a maintenance dose 12 to 24 hours later. In the acute hospital setting, this often results in doses being administered in the middle of the night, which is impractical for both patients and staff. This audit examined current practice and developed new guidelines to support greater flexibility in the timing of the first maintenance dose. Methods Data recording forms used by pharmacists to support the therapeutic drug monitoring of vancomycin were collected from two hospital sites over six weeks. Forms containing at least two vancomycin concentrations were selected and the time of administration of the first maintenance dose was recorded. Individual vancomycin pharmacokinetic parameter estimates were obtained using MAP Bayesian analysis then used to predict vancomycin concentrations 6, 8, 10, 12 and 14 hours after a banded loading dose and 20 mg/kg (capped at 3000 mg). Predicted concentrations were compared with a target range of 10 – 20 mg/L. Results Data were obtained from 49 patients with a mean (SD) age of 63.1 (16.7) years and weight 80.1 (27.6) kg. In all patients, creatinine clearance estimates were >40 mL/min and, according to current practice guidelines, all patients required 12 hourly maintenance dosing. The time recorded for the administration of the first maintenance dose was between 11 pm and 7 am in 30 (61%) of these patients. In 14 patients (29%), the first maintenance dose was administered >12 hours after loading. The target range was achieved with banded doses (20 mg/kg) in 65% (71%) of concentrations at 6 hours, 74% (84%) at 8 hours, 57% (67%) at 10 hours, 53% (55%) at 12 hours and 39% (43%) at 14 hours. Conclusions This audit has shown that current practice results in a high proportion of vancomycin maintenance doses being administered at impractical times. Allowing a more flexible time window of 6-12 hours after the loading dose for administration of the first vancomycin maintenance dose could help to alleviate this problem and reduce the risk of early subtherapeutic vancomycin trough concentrations.

Published
2016

38. Amikacin concentrations and target ranges for mycobacterial infection

Author

Cairney, Tamara M, Bao, Lock, Robb, Fiona, and Thomson, Alison H

Subjects
RS
Abstract

The aim of this research is to determine whether amikacin dosage guidelines for multi - drug resistant mycobacterial infections achieve peaks of 35 - 45 mg/L (OD) or 65 - 80 mg/L (TW) and troughs

Published
2016

43. Hepatocellular damage following therapeutic intravenous iron sucrose infusion in a child

Author

Wood, David M, Thomson, Alison H, Lawes, Matthew, Jones, Alison L, Dargan, Paul I, Wood, David M, Thomson, Alison H, Lawes, Matthew, Jones, Alison L, and Dargan, Paul I

Abstract

The maximum tolerated single dose of intravenous iron infusion and iron pharmacokinetics are not known in children and not clear in adults. The case reported here is of a child given a large dose of intravenous iron sucrose (16 mg/kg) over 3 hours, who subsequently developed features of systemic iron toxicity. A TDM consultant discusses the case in the context of toxicokinetic analysis. Because the maximum tolerated dose and pharmacokinetics of intravenous iron preparations are not known, their use in both adults and children should still be undertaken with caution.

Published
2005

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