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Population pharmacokinetics and prophylactic anti-emetic efficacy of ramosetron in surgical patients

Authors
 Yong-Hun Lee  ;  Jae-Hyeon Seo  ;  Kyung-Tae Min  ;  Young-Jin Lim  ;  Seong-Wook Jeong  ;  Eun-Kyung Lee  ;  Byung-Moon Choi  ;  Gyu-Jeong Noh 
Citation
 BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Vol.82(3) : 762-772, 2016 
Journal Title
 BRITISH JOURNAL OF CLINICAL PHARMACOLOGY 
ISSN
 0306-5251 
Issue Date
2016
MeSH
Antiemetics/adverse effects ; Antiemetics/blood ; Antiemetics/pharmacokinetics ; Antiemetics/therapeutic use ; Benzimidazoles/adverse effects ; Benzimidazoles/blood ; Benzimidazoles/pharmacokinetics* ; Benzimidazoles/therapeutic use* ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Models, Biological ; Ondansetron/adverse effects ; Ondansetron/blood ; Ondansetron/pharmacokinetics ; Ondansetron/therapeutic use ; Postoperative Nausea and Vomiting/blood ; Postoperative Nausea and Vomiting/prevention & control*
Keywords
anti-emetics ; pharmacokinetics ; post-operative nausea and vomiting ; ramosetron
Abstract
AIMS: This study characterized the pharmacokinetics of ramosetron and compared prophylactic anti-emetic efficacy with that of ondansetron in a large population. METHODS: Fifty-eight patients consented to the pharmacokinetic analysis and were assigned randomly to receive 0.3, 0.45 or 0.6 mg ramosetron after induction of anaesthesia. Blood samples were acquired at preset intervals. Non-compartmental and population pharmacokinetic analyses were performed. In total, 1102 patients consented to the evaluation of prophylactic anti-emetic efficacy and were allocated randomly to receive 0.3 mg ramosetron or 4 mg ondansetron at the end of surgery. An additional 16 mg ondansetron were mixed in the intravenous patient-controlled analgesia pump of the ondansetron group. Post-operative nausea and vomiting (PONV) were evaluated 6, 24 and 48 h post-operatively using the Rhodes index of nausea, vomiting and retching (RINVR). Administration of rescue anti-emetics and adverse events were evaluated. RESULTS: The pharmacokinetic parameter estimates were V1 (l) = 5.12, V2 (l) = 108, CL (l?min(-1) ) = 0.08 + (59?age(-1) ) × 0.09, Q (l?min(-1) ) = 1.42. The incidences of PONV in the ramosetron and ondansetron groups were 77 (13.9%) and 113 (20.6%) and 44 (7.9%) and 66 (12.0%) at 24 and 48 h post-operatively, respectively (P = 0.004, 0.030). RINVR was significantly lower in the ramosetron than the ondansetron group 24 and 48 h post-operatively (P = 0.003, 0.025). Use of rescue anti-emetics and incidence of adverse events were comparable. CONCLUSIONS: A two compartment mammillary model was used to describe ramosetron pharmacokinetics. Prophylactic anti-emetic efficacy of ramosetron was significantly better 24 and 48 h post-operatively than that of ondansetron, particularly when the Apfel score was ≥ 3.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/bcp.13010/abstract
DOI
10.1111/bcp.13010
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Min, Kyeong Tae(민경태) ORCID logo https://orcid.org/0000-0002-3299-4500
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152322
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