Catching the Culprit: Benzylpenicillin Neurotoxicity Confirmed by Therapeutic Drug Monitoring in a Critically Ill Patient With Continuous Venovenous Hemofiltration.

IF 2.8 4区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Therapeutic Drug Monitoring Pub Date : 2024-08-01 Epub Date: 2024-06-06 DOI:10.1097/FTD.0000000000001215
Thomas G van Gelder, Valentijn A Schweitzer, Esther V Uijtendaal, Maaike A Sikma
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Abstract

Abstract: We present the case of a 65-year-old patient who was treated with high-dose benzylpenicillin for severe invasive pneumococcal pneumonia, complicated by acute renal failure managed with continuous venovenous hemofiltration. After cessation of continuous venovenous hemofiltration, the patient experienced multiple tonic-clonic seizures. Therapeutic drug monitoring revealed high total serum concentrations of benzylpenicillin, identifying it as the likely cause of the neurotoxicity. This case study presents the first documented total serum benzylpenicillin concentration associated with neurotoxicity.

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抓住 "罪魁祸首":通过治疗药物监测确认一名接受连续静脉血液滤过治疗的重症患者的苄青霉素神经毒性。
摘要:我们报告了一例 65 岁患者的病例,该患者因重症侵袭性肺炎球菌肺炎接受大剂量苄青霉素治疗,并发急性肾衰竭,经持续静脉血液滤过治疗。停止持续静脉血液滤过后,患者出现了多次强直阵挛发作。治疗药物监测显示,苄青霉素的血清总浓度很高,这可能是导致神经中毒的原因。本病例研究首次记录了与神经毒性相关的苄青霉素血清总浓度。
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来源期刊
Therapeutic Drug Monitoring
Therapeutic Drug Monitoring 医学-毒理学
CiteScore
5.00
自引率
8.00%
发文量
213
审稿时长
4-8 weeks
期刊介绍: Therapeutic Drug Monitoring is a peer-reviewed, multidisciplinary journal directed to an audience of pharmacologists, clinical chemists, laboratorians, pharmacists, drug researchers and toxicologists. It fosters the exchange of knowledge among the various disciplines–clinical pharmacology, pathology, toxicology, analytical chemistry–that share a common interest in Therapeutic Drug Monitoring. The journal presents studies detailing the various factors that affect the rate and extent drugs are absorbed, metabolized, and excreted. Regular features include review articles on specific classes of drugs, original articles, case reports, technical notes, and continuing education articles.
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