Biomedical subjects
J W Kern
Publications and source records attributed to J W Kern.
Conjoint marital psychotherapy: an interim measure in the treatment of psychosis.
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The in vivo availability of gentamicin when admixed with total nutrient solutions: a comparative study.
The relative in vivo availability of gentamicin when administered by two different intravenous methods was evaluated in patients treated in a surgical intensive care unit in a randomized, prospective, crossover study. Each patient received gentamicin therapy via intravenous piggyback (IVPB) and in-line burette (ILB) methods. In the IVPB method, the drug was mixed in 5% dextrose in water (D5W) and infused intermittently. In the ILB method, the drug was mixed using the patient's total nutrient admixture (TNA) solution as the diluent in an ILB, which was inserted between the TNA bottle and its administration set and infused intermittently. A serial sampling of four sets of serum concentrations of the gentamicin was obtained. Pharmacokinetic parameters (Kel, Vd, and a maximum serum concentration) were calculated from the four sets of concentrations collected per patient. The IVPB method yielded mean values of Kel, Vd, and C1.5mg/kg of 0.13 hr-1, 0.39 liter/kg, and 5.1 micrograms/ml, respectively. The ILB method yielded mean values of Kel, Vd, and C1.5mg/kg of 0.14 hr-1, 0.34 liter/kg, and 5.6 micrograms/ml, respectively. A t-test for paired samples was applied to these mean values. Significant difference was not found (p greater than 0.05). The intermittent infusion of gentamicin, using TNA as the diluent and an ILB, produced equivalent serum concentrations when compared with D5W as the diluent.
Comparison of serum sampling methods for estimating gentamicin pharmacokinetic variables.
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Piperacillin-tazobactam pharmacokinetics in patients with intraabdominal infections.
STUDY OBJECTIVE: To determine the appropriate compartmental and noncompartmental pharmacokinetic parameters for intravenous piperacillin and tazobactam. DESIGN: Sequential selection of patients entered into a randomized, open-label clinical efficacy trial. SETTING: Los Angeles County-University of Southern California Medical Center. PARTICIPANTS: Sequential sample of 18 patients admitted for intraabdominal infections and consented into a comparative antibiotic trial. INTERVENTIONS: Patients received piperacillin 4 g plus tazobactam 500 mg by intravenous intermittent infusion every 8 hours. MEASUREMENTS AND MAIN RESULTS: The estimated noncompartmental pharmacokinetic parameters (mean +/- SD) for piperacillin and tazobactam, respectively, were as follows: maximum concentration in plasma 218.7 +/- 48.9 micrograms/ml and 27.8 +/- 9.1 micrograms/ml; half-life 1.07 +/- 0.22 hours and 1.00 +/- 0.27 hours; elimination rate constant 0.67 +/- 0.13 hr-1 and 0.73 +/- 0.18 hr-1; area under the concentration-time curve from zero hour to infinity 288.5 +/- 71.25 mg.hr/L and 36.3 +/- 9.55 mg.hr/L; total plasma clearance 14.75 +/- 3.93 L/hour and 14.78 +/- 4.39 L/hour; renal clearance 5.69 +/- 1.94 L/hour and 7.85 +/- 3.37 L/hour; volume of distribution at steady state 21.00 +/- 4.18 L and 22.47 +/- 8.27 L; and mean residence time 1.72 +/- 0.29 hours and 1.79 +/- 0.35 hours. CONCLUSION: Our findings were similar to those in other surgical patient models. The two-compartmental model best described piperacillin and tazobactam disposition in our patients. Bayesian analyses of the two-compartment models of piperacillin and tazobactam were able to predict trough, peak, and 2-hour postadministration levels without bias.