Population Pharmacokinetics of an Indian F(ab')2 Snake Antivenom in Patients with Russell's Viper (Daboia russelii) Bites.
There is limited information on antivenom pharmacokinetics. This study aimed to investigate the pharmacokinetics of an Indian snake antivenom in humans with Russell's viper bites.Patient data and serial blood samples were collected from patients with Russell's viper (Daboia russelii) enven...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2015
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0003873 https://doaj.org/article/136c154cff8f4e9abd5eef85f70f861e |
id |
ftdoajarticles:oai:doaj.org/article:136c154cff8f4e9abd5eef85f70f861e |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:136c154cff8f4e9abd5eef85f70f861e 2023-05-15T15:15:02+02:00 Population Pharmacokinetics of an Indian F(ab')2 Snake Antivenom in Patients with Russell's Viper (Daboia russelii) Bites. Geoffrey K Isbister Kalana Maduwage Ana Saiao Nicholas A Buckley Shaluka F Jayamanne Shahmy Seyed Fahim Mohamed Umesh Chathuranga Alexandre Mendes Chandana Abeysinghe Harindra Karunathilake Indika Gawarammana David G Lalloo H Janaka de Silva 2015-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0003873 https://doaj.org/article/136c154cff8f4e9abd5eef85f70f861e EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4489840?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003873 https://doaj.org/article/136c154cff8f4e9abd5eef85f70f861e PLoS Neglected Tropical Diseases, Vol 9, Iss 7, p e0003873 (2015) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2015 ftdoajarticles https://doi.org/10.1371/journal.pntd.0003873 2023-01-08T01:27:25Z There is limited information on antivenom pharmacokinetics. This study aimed to investigate the pharmacokinetics of an Indian snake antivenom in humans with Russell's viper bites.Patient data and serial blood samples were collected from patients with Russell's viper (Daboia russelii) envenoming in Sri Lanka. All patients received Indian F(ab')2 snake antivenom manufactured by VINS Bioproducts Ltd. Antivenom concentrations were measured with sandwich enzyme immunoassays. Timed antivenom concentrations were analysed using MONOLIXvs4.2. One, two and three compartment models with zero order input and first order elimination kinetics were assessed. Models were parameterized with clearance (CL), intercompartmental clearance (Q), central compartment volume (V) and peripheral compartment volume (VP). Between-subject-variability (BSV) on relative bioavailability (F) was included to account for dose variations. Covariates effects (age, sex, weight, antivenom batch, pre-antivenom concentrations) were explored by visual inspection and in model building. There were 75 patients, median age 57 years (40-70 y) and 64 (85%) were male. 411 antivenom concentration data points were analysed. A two compartment model with zero order input, linear elimination kinetics and a combined error model best described the data. Inclusion of BSV on F and weight as a covariate on V improved the model. Inclusion of pre-antivenom concentrations or different batches on BSV of F did not. Final model parameter estimates were CL,0.078 L h(-1), V,2.2L, Q,0.178 L h(-1) and VP,8.33L. The median half-life of distribution was 4.6 h (10-90%iles:2.6-7.1 h) and half-life of elimination, 140 h (10th-90th percentilesx:95-223h).Indian F(ab')2 snake antivenom displayed biexponential disposition pharmacokinetics, with a rapid distribution half-life and more prolonged elimination half-life. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Indian PLOS Neglected Tropical Diseases 9 7 e0003873 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Geoffrey K Isbister Kalana Maduwage Ana Saiao Nicholas A Buckley Shaluka F Jayamanne Shahmy Seyed Fahim Mohamed Umesh Chathuranga Alexandre Mendes Chandana Abeysinghe Harindra Karunathilake Indika Gawarammana David G Lalloo H Janaka de Silva Population Pharmacokinetics of an Indian F(ab')2 Snake Antivenom in Patients with Russell's Viper (Daboia russelii) Bites. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
There is limited information on antivenom pharmacokinetics. This study aimed to investigate the pharmacokinetics of an Indian snake antivenom in humans with Russell's viper bites.Patient data and serial blood samples were collected from patients with Russell's viper (Daboia russelii) envenoming in Sri Lanka. All patients received Indian F(ab')2 snake antivenom manufactured by VINS Bioproducts Ltd. Antivenom concentrations were measured with sandwich enzyme immunoassays. Timed antivenom concentrations were analysed using MONOLIXvs4.2. One, two and three compartment models with zero order input and first order elimination kinetics were assessed. Models were parameterized with clearance (CL), intercompartmental clearance (Q), central compartment volume (V) and peripheral compartment volume (VP). Between-subject-variability (BSV) on relative bioavailability (F) was included to account for dose variations. Covariates effects (age, sex, weight, antivenom batch, pre-antivenom concentrations) were explored by visual inspection and in model building. There were 75 patients, median age 57 years (40-70 y) and 64 (85%) were male. 411 antivenom concentration data points were analysed. A two compartment model with zero order input, linear elimination kinetics and a combined error model best described the data. Inclusion of BSV on F and weight as a covariate on V improved the model. Inclusion of pre-antivenom concentrations or different batches on BSV of F did not. Final model parameter estimates were CL,0.078 L h(-1), V,2.2L, Q,0.178 L h(-1) and VP,8.33L. The median half-life of distribution was 4.6 h (10-90%iles:2.6-7.1 h) and half-life of elimination, 140 h (10th-90th percentilesx:95-223h).Indian F(ab')2 snake antivenom displayed biexponential disposition pharmacokinetics, with a rapid distribution half-life and more prolonged elimination half-life. |
format |
Article in Journal/Newspaper |
author |
Geoffrey K Isbister Kalana Maduwage Ana Saiao Nicholas A Buckley Shaluka F Jayamanne Shahmy Seyed Fahim Mohamed Umesh Chathuranga Alexandre Mendes Chandana Abeysinghe Harindra Karunathilake Indika Gawarammana David G Lalloo H Janaka de Silva |
author_facet |
Geoffrey K Isbister Kalana Maduwage Ana Saiao Nicholas A Buckley Shaluka F Jayamanne Shahmy Seyed Fahim Mohamed Umesh Chathuranga Alexandre Mendes Chandana Abeysinghe Harindra Karunathilake Indika Gawarammana David G Lalloo H Janaka de Silva |
author_sort |
Geoffrey K Isbister |
title |
Population Pharmacokinetics of an Indian F(ab')2 Snake Antivenom in Patients with Russell's Viper (Daboia russelii) Bites. |
title_short |
Population Pharmacokinetics of an Indian F(ab')2 Snake Antivenom in Patients with Russell's Viper (Daboia russelii) Bites. |
title_full |
Population Pharmacokinetics of an Indian F(ab')2 Snake Antivenom in Patients with Russell's Viper (Daboia russelii) Bites. |
title_fullStr |
Population Pharmacokinetics of an Indian F(ab')2 Snake Antivenom in Patients with Russell's Viper (Daboia russelii) Bites. |
title_full_unstemmed |
Population Pharmacokinetics of an Indian F(ab')2 Snake Antivenom in Patients with Russell's Viper (Daboia russelii) Bites. |
title_sort |
population pharmacokinetics of an indian f(ab')2 snake antivenom in patients with russell's viper (daboia russelii) bites. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2015 |
url |
https://doi.org/10.1371/journal.pntd.0003873 https://doaj.org/article/136c154cff8f4e9abd5eef85f70f861e |
geographic |
Arctic Indian |
geographic_facet |
Arctic Indian |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 9, Iss 7, p e0003873 (2015) |
op_relation |
http://europepmc.org/articles/PMC4489840?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003873 https://doaj.org/article/136c154cff8f4e9abd5eef85f70f861e |
op_doi |
https://doi.org/10.1371/journal.pntd.0003873 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
9 |
container_issue |
7 |
container_start_page |
e0003873 |
_version_ |
1766345426184699904 |