Effects of Plasma Albumin on the Pharmacokinetics of Esomeprazole in ICU Patients

Abstract

Objectives . To evaluate the effects of plasma albumin on pharmacokinetics of esomeprazole in ICU patients. Methods . This study was performed in 32 consecutive intensive care unit (ICU) patients. They were divided into two groups according to the plasma albumin levels. Nineteen patients with low plasma albumin levels (&lt;30 g/L; male/female, 12/7) were assigned to low plasma albumin group (LPAG). Thirteen patients with plasma albumin levels &gt;30 g/L (male/female, 9/4) were assigned to high plasma albumin group (HPAG). All patients were received intravenous (IV) of 40 mg esomeprazole in 5 min. Blood samples were collected via basilic vein at different time points and concentrations of esomeprazole were determined by UPLC-MS/MS. Results . <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant="normal">M</mml:mi><mml:mi mathvariant="normal">R</mml:mi><mml:mi mathvariant="normal">T</mml:mi></mml:mrow><mml:mrow><mml:mo stretchy="false">(</mml:mo><mml:mn mathvariant="normal">0</mml:mn><mml:mtext>-</mml:mtext><mml:mi mathvariant="normal">∞</mml:mi><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msub></mml:mrow></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant="normal">t</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant="normal">1</mml:mn><mml:mo>/</mml:mo><mml:mn mathvariant="normal">2</mml:mn></mml:mrow></mml:msub></mml:mrow></mml:math>, V, CL, and <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant="normal">C</mml:mi></mml:mrow><mml:mrow><mml:mi mathvariant="normal">m</mml:mi><mml:mi mathvariant="normal">a</mml:mi><mml:mi mathvariant="normal">x</mml:mi></mml:mrow></mml:msub></mml:mrow></mml:math> between two groups were significantly difference (P&lt;0.05). Compared with HPAG, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant="normal">M</mml:mi><mml:mi mathvariant="normal">R</mml:mi><mml:mi mathvariant="normal">T</mml:mi></mml:mrow><mml:mrow><mml:mo stretchy="false">(</mml:mo><mml:mn fontstyle="italic">0</mml:mn><mml:mtext>-</mml:mtext><mml:mi mathvariant="normal">∞</mml:mi><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msub></mml:mrow></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant="normal">t</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant="normal">1</mml:mn><mml:mo>/</mml:mo><mml:mn mathvariant="normal">2</mml:mn></mml:mrow></mml:msub></mml:mrow></mml:math>, and V of esomeprazole in LPAG were increased by 1.42-fold, 1.49-fold, and 1.24-fold, respectively; the maximum drug concentration of esomeprazole in LPAG was decreased to 82.5%. <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant="normal">A</mml:mi><mml:mi mathvariant="normal">U</mml:mi><mml:mi mathvariant="normal">C</mml:mi></mml:mrow><mml:mrow><mml:mo stretchy="false">(</mml:mo><mml:mn mathvariant="normal">0</mml:mn><mml:mtext>-</mml:mtext><mml:mi mathvariant="normal">∞</mml:mi><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msub></mml:mrow></mml:math> of LPAG was 1.23 times than that of group B. CL in LPAG was 80% of HPAG. There was no statistical difference between the two groups of <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mrow><mml:msub><mml:mrow><mml:mi mathvariant="normal">A</mml:mi><mml:mi mathvariant="normal">U</mml:mi><mml:mi mathvariant="normal">C</mml:mi></mml:mrow><mml:mrow><mml:mo stretchy="false">(</mml:mo><mml:mn mathvariant="normal">0</mml:mn><mml:mtext>-</mml:mtext><mml:mi mathvariant="normal">∞</mml:mi><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:msub></mml:mrow></mml:math> and CL. Conclusions . Some pharmacokinetic parameters of esomeprazole may be changed in ICU patients with low plasma albumin.