Abstract
We investigated the pharmacokinetics of Cefoperazone (CPZ) in 10 patients with routine hemodialysis. At the beginning of the hemodialysis, 1g of CPZ was injected intravenously on the dialysis day and, later, on the non-dialysis day at intervals of three dialysises. The patients were hemodialyzed for 5 hours with blood flow rates of 150ml/min and dialysate flow rates of 500ml/min. One patient (case 1) was treated with hemofiltration and one (case 10) had chronic hepatitis. The serum concentration of CPZ was measured by bioassy. The data obtained were analyzed by the two-compartment-theory.
During the dialysis, the serum concentration of CPZ was 122±42μg/ml after 15 minutes, 74.2±31μg/ml after 1 hour, 39.5±12μg/ml after 2 hours, 21.3±8μg/ml after 4 hours, 15.1±6μg/ml after 5 hours, and less than 1.56μg/ml 24 hours later. The difference between the concentrations of CPZ at the inlet and at the outlet of the dialyzer was not statistically significant. On the non-dialysis day, the serum concentration of CPZ was 120±45μg/ml after 15 minutes, 51.2±17μg/ml after 2 hours, 22.5±8μg/ml after 5 hours, and these data were not significantly different from those on the dialysis day. According to the analysis with the two-compartment-theory, Cmax was 171μg/ml, Kel was 0.88hr-1, T1/2 was 2.13 hours. The T1/2 of the patient treated with hemofiltration (case 1) was 2.45 hours. T1/2 more than 4 hours were noticed in one case with liver dysfunction (case 10) and two of nine cases without liver dysfunction (case 5, 7).
In conclusion, CPZ may be administered safely without a change of dose or interval of the drug to most of the patients with normal liver function on routine hemodialysis.
